Bursitis Pain and Treatment

Bursitis is a condition that can affect many areas of the body due to the presence of bursae near most joint structures. Hip and shoulder bursitis are two common forms seen in an an MSK Therapy Clinic setting. Bursae are small, slippery, fluid-filled pads that sit between soft tissues and bone and occur in high friction areas. The bursae act a bit like a cushion or damper and differ in size and shape. Bursitis is simply the inflammation of a bursa, which may occur for many reasons. An inflamed bursa is likely to restrict mobility and result in myofascial pain, and if incorrectly managed, symptoms can quickly worsen. Once a bursa is inflamed, it is easy to create further irritation, immobility and pain. Not only are hips and shoulders more susceptible to bursitis, and for a variety of reasons, it is more common to see chronic cases in an MSK Clinic setting. Most daily activities rely heavily upon shoulder and hip joint structures for movement, making it relatively easy to irritate tissues further. Chronic or Persistent Pain can add a variety of complexities to treatment outcomes. Many types of sports and activities involve repetitive motions, which can easily highlight existing or unresolved issues. There are many seemingly unrelated Sports Injuries which can result in Bursitis symptoms.

Another cause of bursitis is often more subtle and due to changes in biomechanics. If everything is moving normally, load transfer occurs without irritation to underlying tissues or structures. If the transfer of loads changes from normal, this can lead to increased loads on some areas, creating irritation and injury. The body's response is inflammation, which can lead to a cycle until the person notices a problem. The human body is very good at adapting (see the related article on tissue adaptation), and things become "normal" to us very quickly. Hence, most people do not notice the body's subtle changes to adapt to minor issues until a noticeable injury occurs. Runner's may experience Trochanteric Bursitis due to iliotibial band syndrome issues, caused by something else, a symptom of a symptom. Typically, changes in biomechanics occur due to either unresolved injuries or habitual behaviours. Far too often, people do not seek treatment for injuries or finish a treatment plan early. Just being out of pain does not mean that one has recovered from an injury. Equally, that does not mean that one needs constant treatment either, as the goal is self-management.

Although the body adapts to injuries, it also adapts to what we do with it, good or bad. How we move becomes learnt and second nature. If one were doing a repetitive activity and moving incorrectly, this is likely to irritate tissues and structures near the joints involved. Shoulders are quite susceptible to such injuries. One might see similarities with a sedentary lifestyle and prolonged sitting, quickly affecting the shoulders or hips. The tissues will adapt to how we use them and then adapt again when we start using them differently. Hence, in the case of some long-term issues, successful treatment may highlight some other unknown problems that still need resolving.