Bursitis

Inflammation of the bursa is known as bursitis. A bursa is a small sac containing fluid that lies between bones and other body parts such as tendons and muscles. A bursa allows a tendon to move smoothly over a bone by acting as an anti-friction device and shielding tendons and muscles from rubbing against bones. Bursae are found in the foot, knee, hip, elbow, shoulder, buttock, and wrist.

The main symptoms of bursitis are pain and swelling in or around the joint. In some cases, people may experience a limited range of movement and stiffness.

The diagnosis of bursitis is made by physical examination. To confirm the diagnosis, medical tests such as magnetic resonance imaging (MRI), ultrasound, or x-rays may be necessary.

Common causes of bursitis are repetitive motions, overuse, injury, or infection.  Bursitis is also associated with medical conditions such as arthritis, gout, tendonitis, diabetes, and thyroid disease.

Treatment depends on the cause, but rest is typically a treatment option. It is important to avoid or reduce any work activities suspected of causing bursitis. The treatment of bursitis includes anti-inflammatory and pain medication, and corticosteroid injections.  Medications may be prescribed if the bursa is infected. Most patients respond to treatment, and they usually go back to work without any restrictions.

Any occupation that requires repetitive motion or poor posture (prolonged pressure on a bursa) can put workers at risk. Some examples of types of bursitis and occupations at risk include:

• Elbow (Olecranon) bursitis: occupations that require leaning on or movement of the elbows (e.g., plumbers, heating, ventilation and air conditioning (HVAC) technicians, athletes, musicians)
• Hip bursitis: occupations that require overuse (bending, heavy lifting) of the lower extremities (e.g., warehouse labourers, cyclists)
• Knee bursitis: occupations that require kneeling, jumping, or squatting (e.g., carpet and floor layers, gardeners, carpenters, plumbers, wrestlers, runners)

The prevention of bursitis should focus on the avoidance or reduction of activities that can lead to inflammation of the bursa (i.e., repetitive motions and poor posture). The type of tasks involved in a job determine the most effective controls. For example, if kneeling is necessary, regular breaks which disrupt the prolonged pressure are recommended, supplemented by knee padding. If possible, avoid the need to kneel altogether by providing seating, or by lifting the working surface.

General prevention steps include:

• Take breaks from repetitive tasks
• Practise good posture (e.g., avoid kneeling or bending for prolonged periods)
• Warm up before physically strenuous work
• Use padding as necessary (e.g., when tasks require kneeling or elbow support)
• Maintain a healthy weight which can reduce pressure on joints