Bursitis is an inflammation of the bursa, (fluid filled sacs around the joints) a thing walled sac lined with synovial tissue.

The function of the bursa is to facilitate the movement of tendons and muscles over bony prominences.

Excessive frictional forces, trauma, systemic diseases (e.g. rheumatoid arthritis, gout), or infection may cause bursitis. The affected part is commonly the shoulder.

Causes and symptoms

The bursa may be inflamed due to injury, inflammation and due to an underlying rheumatic condition.

Bursitis also results from trauma or overuse but can also be seen in patients with rheumatoid arthritis.

The commonly seen symptoms are pain, tenderness over the area and limited movements.

It may further aggravate due to excessive strain of the affected part or excessive exercise.

Types of bursitis

The type indicates the location involved in the inflammation of the bursa.

Subacromial bursitis is the most common form of bursitis. Another is trochanteric bursitis, which involves the bursa around the insertion of the gluteus medius to the greater trochanter of the femur. Patients experience pain over the lateral aspect of the hip and upper thigh and are tender over the posterior aspect of the greater trochanter. External rotation and resisted abduction of the hip elicit pain.

Oleacranon bursitis occurs over the posterior elbow, and when the area is acutely inflamed, infection should be excluded by aspirating and culturing fluid from the bursa.

Achilles bursitis involves the bursa located above the insertion of the tendon to the calcaneus and results from overuse and wearing tight shoes.

Retrocalcaneal bursitis involves the bursa which is located between the calcaneus and posterior surface of the Achilles tendon. The pain is experienced at the back of the heel, and swelling appears on the medial and/or lateral side of the tendon. It occurs in association with rheumatoid arthritis, gout and trauma.

Ischial bursitis affects the bursa separating the gluteus medius from the ischial tuberosity and develops from prolonged sitting on hard surfaces.

Illiopsoas bursitis affects the bursa that lies between the illiopsoas muscle and hip joint and lateral to the femoral vessels. Pain is experienced over this area and is worsened by flexion and hip extension. Bursitis results from trauma or overuse but can also be seen in patients with rheumatoid arthritis.

Anserine bursitis is an inflammation of the sartorius bursa located over the medial side of the tibia just below the knee and is manifested by pain on climbing stairs. Tenderness is present over the insertion of the conjoint tendon of the sartorial, gracilis, and semitendinosus.

Prepatellar bursitis (housemaid’s knee) occurs in the bursa situated between the patella and overlying skin and is caused by kneeling over hard surfaces.

Conventional treatment

The aim of treatment is to reduce the inflammation and cause of pain and treating infection, if any. If infection is not present, the patient can be advised rest and administration of anti-inflammatory and pain medicines. Sometimes, the Doctor treats with Cortisone injection to reduce the swelling. In severe cases, sometimes it involves aspiration of the bursa fluid. This method involves removal of fluid under sterile conditions.

Treatment of bursitis consists of prevention of the aggravating condition, rest of the involved part, a non-steroidal anti-inflammatory drug and local steroid injection.

Herbal medicines useful in bursitis

Medicines like Triphala guggulu, Yogaraja guggulu and Maha yogaraja guggulu are useful in treating the disease.

Application of Mahanarayana oil is also useful in reducing the inflammation and pain.

Herbs like turmeric, cayenne, cyperus etc. are also useful in treating inflammation. These relieve pain and also promote flexibility.

Herbal pack for bursitis

• Kaishore guggulu – 2 tablets before food with plain water twice a day

• Joint aid plus – 2 capsules twice daily with plain water