Bursitis and Tenosynovitis: Prevention and Treatment of Joint Inflammation
Bursitis and tenosynovitis
Maintain joint flexibility
Perhaps on that first crisp autumn Sunday, you arrived at the field with the same light steps as football star John Alway, ready for a thrilling game. You made a beautiful tackle like John, only to fall hard yourself, and then you were tripped over by someone else, but you didn't dwell on these minor incidents. However, when you woke up the next morning, you were like the Denver Broncos quarterback in the 1988 season-you couldn't even lift your arm after the game.
Or perhaps it's on a bright, sunny spring weekend that you suddenly feel like showing off your skills on the weightlifting track. But after a day of training, the excruciating pain in your shoulders makes you vow never to lift weights again in your next life.
The simplest explanation for the aforementioned common situations is that the joints of the human body are like the hubs of a machine; they will eventually malfunction due to constant wear and tear. This usually happens after the human body has been operating for nearly 40 years, and the cause of the malfunction is often one of the two common joint diseases: bursitis and tenosynovitis.
Dr. James Richard, an orthopedic surgeon and MD at Matthews Orthopedic Clinic in Florida, often speaks of bursitis and tenosynovitis with a touch of humor: "Patients have no choice but to endure premature aging. If you're destined for a long life, these two conditions are almost inevitable. Perhaps that's one of the prices of longevity."
How to eliminate inflammation in the joints
Tenosynovitis most commonly occurs in the shoulder, wrist, elbow, knee, and ankle; bursitis most commonly occurs in the shoulder, elbow, knee, and heel. Both diseases are caused by inflammation of the joints where muscles and tendons connect to bones.
"In most cases, these two joint conditions are very similar, making it difficult to distinguish between them," said Kent Pomore, MD, a physical therapist in Goddard, Arizona, and former president of the American Academy of Orthopaedics.
Bursae are tiny, thin-walled pouches that help relieve friction in joints. There are more than 150 bursae throughout the joints of the human body. "When a bursa in a joint becomes inflamed," explains Steven Haberst, a private osteopath in Toledo, Ohio. "its normally paper-thin outer wall thickens, and the bursa fills with fluid, causing redness, swelling, and pain in the joint."
Similarly, tenosynovitis-which is more common than bursitis-refers to injury at the point where the tendon connects to the bone.
By your 30s, these tiny bursae and tendon sheaths in your body have already worn down considerably. So, an overexertion weekend is enough to make you feel like you want to saw off a painful joint. For most people, this is simply the result of decades of normal wear and tear. Dr. Richard says, "Most of the patients I treat have no history of this; they all develop these two joint conditions very suddenly."
Comparatively, men aged 35 and 50 are most susceptible to conditions related to bursitis and tenosynovitis. Dr. Ben Kimble, director of the Sports Medicine Center at Lexington Clinic in Kentucky, believes that most conditions commonly diagnosed as tenosynovitis are "actually less a result of inflammation and more a consequence of organ aging."
Latest Information
• Commonality: Approximately one-quarter of active men suffer from bursitis and tenosynovitis. Men aged 35 to 50 account for two-thirds of all joint patients with bursitis and tenosynovitis.
• Risk factors: Overexertion and excessive physical activity can both lead to these two types of joint diseases. Repetitive movements or physiological factors such as leg length discrepancies are also contributing factors.
• Affected age groups: The chances of developing bursitis and tenosynovitis increase with age. Men aged 30 to 50 are particularly susceptible to these two conditions because they bear a heavier physical burden than women and men of other ages, and tend to overuse their joints.
• Gender differences: Women are equally likely to develop bursitis and tenosynovitis as men. Because these conditions are overuse injuries, men are slightly more likely to develop them due to their greater physical exertion and wider range of activities.
• Target patients: family doctors, joint specialists, or physical therapists who specialize in treating injuries using physical therapies such as light, heat, cold, and exercise.
Moderate exercise, effective protection, and proper prevention
The causes of bursitis and tenosynovitis are not immediately obvious, but in most cases they are due to overexertion. Don't assume that only sports enthusiasts who suddenly decide to exercise on weekends are most susceptible to injury; office workers who keep their arms propped up on their desks for long periods while continuously processing documents can also develop bursitis, and those who work in front of computers or typewriters all day are more prone to wrist tenosynovitis.
The following remedies can help prevent these two diseases.
Covering key areas of the bursa of Fabricius is crucial, as the knees and elbows are closest to the skin surface, making them two of the most vulnerable areas for injury. Dr. Haberst says, "Before engaging in an activity that involves repetitive strain on the elbows and knees, it's best to wrap these areas beforehand." For example, roofers and floor installers should regularly wear knee braces to wrap their knees.
Before engaging in any strenuous sport-whether it's a friendly ball game or a weightlifting workout-it's essential to spend time warming up.
Dr. Pomore says, "Men tend to go all out in any sport, which is most likely to aggravate damage to the bursa of Fabricius, not to mention the damage to muscles and tendons. The purpose of warming up before high-intensity exercise is to soften muscle tissue, increase its flexibility, and improve blood flow to tissue cells. In short, it's about minimizing the risk of injury." Dr. Pomore believes that five minutes of jogging in place, or a few aerobics and joint stretching exercises are sufficient for a warm-up. It's also important to allow the body to cool down for a few minutes after warming up to promote relaxation.
Benefit from the rules of baseball: If your job requires you to repeat a certain movement-whether it's typing or lifting weights-make sure to take a break every hour to move around. Dr. Pomore says, "In baseball, there's always a timeout in the seventh inning. This allows the players to rest and recover, and it also gives spectators who have been watching the game all day, whose bodies are stiff and sore, a chance to get up and stretch. This is very beneficial for your health."
Maintaining a cheerful and optimistic mood is crucial, as the body is significantly more susceptible to injury under high stress. Dr. Richard explains, "For example, the psychological stress of someone who is constantly moving and living a nomadic life is immense. This sense of instability is one of the most troubling things in the world, and the body is more vulnerable to injury under such immense pressure." Therefore, Dr. Richard suggests taking deep breaths and relaxing before moving or cleaning to ease tension.
To maintain proper office posture, if your work requires frequent computer use, ensure your elbows and wrists are level with the keyboard. This will prevent excessive pressure on your wrists, which can lead to tenosynovitis. Dr. Richard says, "If you can position the keyboard on your thigh instead of on your desk, you can avoid both of these problems."
Once you get these two types of joint diseases
The typical symptoms of bursitis and tenosynovitis include pain, redness, swelling, and increased temperature around the inflamed area-these are usually quite obvious, so treating the symptoms is not difficult.
Dr. Haberst says, "Feeling pain is a very natural physiological response; your body is telling you not to overuse a certain organ, and men's biggest problem is that they always want to push themselves. If your body is telling you to stop using a certain organ, then you shouldn't force yourself to use it."
So how much rest should you take? Dr. Haberst suggests that if the pain persists while you are resting, you need to rest completely and absolutely stop using the painful area. Only when the pain completely disappears or becomes very mild while resting can you gradually-note, it must be gradual-reinstate exercising the painful area. There are exceptions, of course. If the pain is in the shoulder, you must persist in exercising to maintain its flexibility, even if it causes significant pain. Dr. Pomore says, "If you stop exercising immediately after experiencing shoulder pain, that area will become very stiff within three days, so consistent shoulder exercise is crucial, even more so than treating bursitis or tenosynovitis."
Besides rest, the following methods are effective in eliminating symptoms.
Taking anti-inflammatory drugs such as aspirin can quickly reduce swelling and pain. However, Dr. Kimble cautions that relieving pain does not equate to eradicating the cause of the disease.
Applying cold compresses to the affected area can also reduce swelling and pain, especially when inflammation is severe. If the pain is very intense, Dr. Haberst recommends applying cold compresses to the affected area three times a day for 20 minutes each time. When applying a cold compress, be sure to place a thin towel between the ice and the heated skin to avoid irritating the skin.
Dr. Pomore says that once the redness and swelling subside, applying heat helps the affected area recover more quickly. Applying steam or massaging the affected area with a hot towel are both very effective.
While severe bursitis and tenosynovitis can often heal within a few days, if the inflammation persists for two weeks, you must seek professional medical help. Dr. Haberst says, "If symptoms such as pain and swelling don't subside, you need to see a doctor. Don't think it's nothing serious."
It's important to reiterate that if the pain is in your shoulder, you shouldn't wait two weeks to see a doctor. Dr. Pomore says that if the shoulder pain is unusually severe, you should see a doctor within 72 hours.