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Bursitis

Bursitis involves inflammation and pain from one of the small lubricating sacs in the body which are known as bursae, with one being a bursa. A bursa is lined with synovial membrane which secretes the lubricating fluid and there are at least 160 in the human body. A bursa's function is to sit between a muscle and bone or between a tendon and bone and provide a gliding surface which allows painless, low friction movement to occur.

When bursitis occurs, inflammation of the sac causes pain on movement of the nearby structures and limits the ability to use the affected area, with continued use of the part causing further aggravation. Overuse of a part by excessive repetition of a particular movement is the typical main cause of bursitis, with knees and elbows typically affected as they move a lot with repeated activities.

Local pain and stiffness are the usual symptoms of bursitis but it can spread to the surrounding area and be of a burning quality. As it is an overuse condition it is worse during and after performance of an activity, with increased stiffness once it is left to rest for a while.

Types of bursitis vary with the anatomical location and include housemaid's knee (technically called prepatellar bursitis), clergyman's knee (infrapatellar bursitis), olecranon bursitis of the elbow and subacromial bursitis of the shoulder. Occupations which involve a lot of kneeling such as gardening and carpet laying carry an increase risk of knee bursitis.

Lateral hip pain can be caused by hip bursitis which is often termed trochanteric bursitis although research work has shown that inflammation rarely occurs in this case and the pain may connected with the degree of degenerative changes in the hip muscle tendons. Hip pain running is a common complaint of distance runners and may be bursitis, iliotibial band syndrome or degenerative changes in the hip tendons.

Most bursitis settles very quickly over a few days and most people do not seek medical attention for this kind of thigh pain unless the symptoms are severe or they last for some time and interfere with job or day to day life.

Physiotherapy management of bursitis can give good hip pain relief and includes ice, deep friction massage, ultrasound and alteration in typical activities to give the area time to settle down. Once the condition is settling the area should be mobilised with deep massage to prevent scarring of adjacent structures. The local area and the structures above and below the affected area will be stretched out so that the biomechanical function of the area improves and the reasons for the bursitis lessens. Early treatment is important to prevent it from developing into chronic bursitis.

A physiotherapist may examine the person's lumbar spine as low back pain problems are known to refer pain round to the lateral hip area and need to be checked as a source of hip pain. If significant arthritic change is found on examination then a hip replacement may be considered. In some cases this kind of pain may be related to a lower back pain syndrome which your physio will be able to help you with

Further information about this condition can be found in the Wikipedia page about bursitis and MedicineNet's page on bursitis.


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