Bursitis Cause

Bursitis Caused By Repetitive Strain

Repetitive strain injuries (RSIs) stem from frequent stress on the body’s soft tissues, such as muscles, tendons, and nerves. A recent study found adults aged 18 and over in the United States, 9.0% had repetitive strain injuries in the past three months. These injuries typically affect individuals who engage in repetitive movements, whether at work or during recreational activities. Examples of RSIs include tendon-related issues like rotator cuff tendinopathy, peripheral nerve entrapment disorders such as carpal tunnel syndrome, and bursitis. The primary culprits behind bursitis are repetitive movements or prolonged positions that exert pressure on the bursae surrounding a joint, making the tiny fluid-filled sacs inflamed. Examples include:

• Repeatedly throwing a baseball or lifting objects overhead.
• Prolonged leaning on elbows.
• Extensive kneeling during activities like carpet laying or floor scrubbing. 

Bursitis Caused By Physical Trauma or Injury

Physical trauma is defined as ‘A tissue injury that occurs more or less suddenly due to violence or accident’. While there are various mechanisms of injury, trauma can generally be classified into three main groups: penetrating (an object penetrates the skin or body, causing open wounds), blunt (an object or force impacts the body, leading to injuries such as concussions, deep cuts, or fractures), and deceleration trauma (a person in motion suddenly stops, the brain, which still has forward momentum, impacts the inner surface of the skull). Injuries such as falling or impacting the shoulder against a hard surface can lead to the bursa filling with blood and inflammation of its lining. Even after the body reabsorbs the blood, the inflammation of the bursar’s lining may persist, resulting in bursitis symptoms. This condition is referred to as traumatic bursitis.

Bursitis Caused By Infection

Bursitis caused by infection occurs when an infection infiltrates either the superficial bursae directly or spreads from other sites, involving deeper bursae, leading to septic bursitis. This condition can manifest as acute, subacute, or recurrent/chronic. Septic bursitis tends to occur more frequently in males, with the average age of onset around 50 years. While some studies indicate a correlation between the incidence of septic bursitis and individuals with underlying medical conditions such as diabetes mellitus, most cases stem from repetitive trauma associated with occupational activities. Professions such as plumbing, carpentry, roofing, clergy, and athletics are commonly affected. Interestingly, septic bursitis can result from joint steroid injections intended to alleviate symptoms of non-infectious bursitis.

Bursitis Caused By Arthritis 

Arthritis can exacerbate bursitis due to the inflammatory nature of these conditions. In osteoarthritis, the breakdown of joint cartilage can lead to abnormal bone growth, elevating the risk of bursitis. Conversely, rheumatoid arthritis is an autoimmune disorder provoking inflammation across the body, affecting the bursae. The persistent inflammation associated with both arthritis types can inflame the bursae, indirectly resulting in bursitis. Furthermore, arthritis-induced joint deformities and restricted movement can exacerbate bursitis symptoms, making it a prevalent complication among those with arthritis. Bursitis itself doesn’t trigger arthritis, nor does arthritis directly cause bursitis. However, the presence of arthritis does increase the likelihood of developing bursitis. It’s common to find them coexisting. For example, when someone develops arthritis in their shoulder, it may alter their shoulder usage, potentially leading to bursitis. Similarly, arthritis in the knee or hip can alter one’s gait, resulting in irritation of the bursa in those regions.

Bursitis Caused By Calcium Deposits

Calcific bursitis occurs when calcium deposits accumulate in the soft tissues surrounding the bursa, resulting in discomfort and reduced mobility in the affected joints. The bursa is a cushion, facilitating smooth movement by minimising tissue friction. However, chronic inflammation of the bursa can lead to the formation of calcium deposits over time. These deposits may persist even after the inflammation diminishes, causing ongoing pain and stiffness. This condition often affects joints like the shoulder and hip, which are prone to repetitive strain or injury. While the exact cause of calcific bursitis remains unclear in many cases, certain factors, such as joint injuries and underlying conditions like ankylosing spondylitis and pseudogout, can elevate the risk of developing the condition.

Bursitis Caused By Poor Gait and Footwear 

Bursitis, particularly in the foot, can manifest in various ways. It may result from direct trauma to the foot, such as falls, slips, auto accidents, or impacts during sports activities. However, bursitis in the forefoot often stems from irritation due to repetitive use and overuse, such as prolonged standing or running. Wearing tight boots that apply direct pressure to a bursa can contribute to its development. Specific foot abnormalities like abnormal toe joints, overpronation, flat feet, bunions, or hammer toes can exacerbate bursitis by placing extra stress on the bursa. Pronation of the foot can lead to the pinching of tissues between the metatarsal heads, prompting the formation of a protective bursa. While this initially may not cause issues, continued friction can lead to bursa enlargement, swelling, and pain. The type of footwear worn during high-impact activities like running, walking, and jumping also influences foot bursitis, as improper shoes can increase the shock absorbed by the bursa.

Bursitis Caused By Obesity

Obesity exacerbates bursitis primarily by placing excessive mechanical stress on weight-bearing joints, including the knees, hips, and ankles. A heavier body weight increases the load on these joints during activities like walking, running, and standing. This heightened pressure can irritate the bursae, leading to inflammation and subsequent bursitis. Furthermore, obesity is often associated with poor posture and altered gait mechanics, which can further exacerbate joint stress and bursa irritation. Metabolic disorders commonly linked to obesity, such as diabetes and hyperlipidemia, may contribute to systemic inflammation, potentially exacerbating bursitis symptoms. Lastly, having more adipose tissue produces pro-inflammatory cytokines, exacerbating local inflammation within the bursae.