What are Bunions
Bags are small liquid-filled sacs that protect underlying structures from friction and excessive stress. Bursae are usually interposed between two tendons, between a bone and a tendon, or between these and the overlying skin.
When the bags undergo excessive irritation due to mechanical stress such as repeated rubbing and impacts, they can become inflamed, increasing joint friction. These conditions, called bursitis, fall into two large groups: inflammatory bursitis and hemorrhagic bursitis. The first, more frequent, can be of a physical nature (rubbing bursitis), chemical (chemical bursitis), or septic (septic bursitis). The latter, on the other hand, arise as a result of traumatic events such as falls and accidents.
Some inflammatory diseases such as rheumatoid arthritis or chronic such as gout can also cause bursitis.
To know more
Inflammatory bursitis
Rubbing bursitis
Rubbing or functional overload bursitis are common in athletes and in those who carry out work activities characterized by repeated movements. In these cases the bursa on which the tendon rests becomes inflamed due to excessive rubbing and mechanical pressure caused by the movement. For this reason the onset of the disease is generally slow and worsening over time. Rubbing bursitis is mainly localized in the shoulder, elbow (tennis elbow) region of the knee, hip and heel region.
CAUSES
- repeated movements
- shoes that are too tight
- lack of training
DIAGNOSIS
usually the diagnosis of bursitis is made through an objective (or clinical) examination by evaluating the patient's symptoms. Diagnostic investigations such as x-rays and magnetic resonance are not normally necessary but can be done to rule out any complications (bone fractures)
SYMPTOMS
For further information: Bursitis Symptoms
- The inflammation increases the flow of fluid into the bursa which becomes swollen and painful on palpation. If the irritation is particularly intense, the overlying skin appears warm, swollen and red. The characteristic symptoms of the pathology are therefore:
- swelling
- redness
- local temperature increase
- pain on palpation and sometimes on movement
TREATMENT
If it is not treated adequately, bursitis tends to worsen until it evolves into even quite serious infections. For this reason it is good not to underestimate the above symptoms.
Initially, rest is the best weapon, it is therefore advisable to:
- immediately suspend the physical or work activity that generated it.
- avoid overloading the region, relieving the external pressures as much as possible and protecting it from possible trauma
- apply a compression bandage (loosen it if you feel an unpleasant tingling, or if the skin takes on a bluish color)
- cool the area by applying ice to the affected area, this treatment will help reduce swelling and reduce inflammation (4 daily packs of 5-20 minutes for the first 2-3 days)
After three or four days, a hot water bottle can be applied to decrease pain and muscle stiffness (15-20 minutes three to four times a day)
If after a week of rest there is no spontaneous regression of the symptoms, it is advisable to consult a specialist. The doctor can then decide to:
- suck up excess liquid
- apply local infiltrations of corticosteroids
- prescribe anti-inflammatory drugs (to learn more, read: Drugs for the Treatment of Bursitis)
- recommend some physical therapies such as ultrasound, massage and cryotherapy to promote healing
- prescribe antibiotics if the condition worsens (infection and pus formation)
- recommend surgical removal
The pain usually begins to subside after 4-5 days.
The period of competitive stop must be prolonged until the complete disappearance of the pain; however, it is important to perform small movements in the various directions starting from the second week to avoid that prolonged immobility tends to "block" the joint, decreasing its mobility (from avoid if the pain has not subsided)The healing times, except for complications, are usually between 7 and 14 days
PREVENTION
- run on even surfaces
- always perform an adequate warm-up before starting the training session
- alternate gestures and work activities, avoiding repeatedly performing the same movement
- correct any postural defects
- use appropriate footwear
- avoid excessive effort not supported by adequate athletic training
Chemical bursitis
Chemical bursitis are caused by the accumulation of substances deriving from inflammation or tendon degenerative processes. The symptoms of the disease resemble those previously described. Being a particularly disabling pathology, the treatment is entrusted to the doctor who will try to block the inflammation through local infiltrations or possibly by surgically removing the inflamed bursa. If left untreated, chemical bursitis can calcify seriously compromising the functionality of the entire joint.
Septic bursitis
They arise when certain bacteria come into contact with the serous bursa, for example through a skin lesion. If septic bursitis is diagnosed, it is therefore important to combine the above treatments with antibiotic therapy and thorough cleaning of the skin with soap and water.
Hemorrhagic bursitis
The haemorrhagic or traumatic bursitis arises following a violent trauma suffered by the joint. The consequent injury can directly or indirectly affect the bursa causing a spill of blood inside it. The blood in turn causes a local irritation and in the most cases severe coagulates, increasing friction and promoting calcification.
This condition occurs more frequently in contact sports such as rugby, basketball and hockey; even students and employees who keep their elbows resting on their desk for a long time are at risk of developing the disease in the long run (student's elbow)
Symptoms and treatment are similar to other forms of bunions; prevention in the sports and work fields will be aimed above all at protecting the joints by means of padded knee pads, elbow pads and wrist pads.
