Understanding Bursitis

By Dr. John A. Papa, DC, FCCPOR(C)

A bursa is a thin, slippery sac found around a joint that releases lubrication called synovial fluid.  Its primary function is to provide cushioning between bone and surrounding soft tissue, such as skin, muscles, ligaments and tendons.  Under normal circumstances, the bursa provides a smooth surface that allows for minimal friction with movement between these structures.

The term "bursitis" refers to any inflammation or irritation of the bursa.  When this occurs, the bursa loses its gliding capabilities, and becomes thickened and swollen.  As a result, the added size of the swollen bursa causes more friction within an already confined space, and the smooth gliding bursa becomes gritty and rough.

There are approximately 160 bursae in the body.  Fortunately, only a handful of them usually develop bursitis. The most common areas to get bursitis include the shoulder, elbow, hip and knee regions.  Less frequently, bursitis may also occur in the wrist, buttocks, heel and big toe.  Symptoms of bursitis include swelling, pain, and tenderness in the affected region.  This may also be accompanied by reduced range of motion and strength which can lead to a significant decrease in physical functioning.

There are several factors that can contribute to the development of bursitis.  Activities that result in repetitive overuse or prolonged and excessive pressure on a body region are a common culprit.  An example of this would be constant overhead lifting using your shoulders or continuous kneeling on a hard surface with your knees.  A bursa can also become injured as a result of a blunt trauma or fall such as slipping on ice and landing on your hip.  Bursitis is more common in adults, especially in those over 40 years of age.  As soft tissues age they become less elastic and durable making them more susceptible to overuse and traumatic injuries.  Other possible causes and risk factors for developing bursitis which may require additional medical management include infection from an opening on the skin surface, rheumatoid arthritis, gout and diabetes.

Conservative self-care strategies for reducing the pain of bursitis should initially involve relative rest from any painful activities and ice application.  Altering or eliminating the situations that contributed to the bursitis is also important.  This may include activity modification such as using the correct technique, tools, and/or equipment.  In addition, taking breaks to relax overworked muscles and joints, and performing exercises to strengthen the body can also be effective.

Bursitis that does not respond to self-care strategies may require professional treatment.  This can include acupuncture and electrotherapeutic modalities to decrease pain, manual and soft tissue therapy to assist in healing, and specific rehabilitative conditioning training for the affected muscles and joints.

If you are having difficulty with a case of bursitis, a qualified health professional can prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Understanding Golfer's And Tennis Elbow

By Dr. John A. Papa, DC, FCCPOR(C)

The elbow is a complex joint that allows movements of flexion, extension, and rotation.  Most daily activities require a combination of these actions to produce motion in the arm, forearm, wrist, and hand.  Two common elbow injuries include Golfer's Elbow (GE) and Tennis Elbow (TE).  Both of these elbow conditions can cause pain and weakness which results in functional limitations with gripping, pushing, pulling, and lifting activities of the affected arm.

Golfer's Elbow (GE) is medically known as medial epicondylitis and causes the inner part of the elbow to become sore and tender.  This typically affects the muscles and tendons that flex the fingers and wrist, and roll the forearm inwards.

Tennis Elbow (TE) is medically known as lateral epicondylitis and causes the outer part of the elbow to become sore and tender.  This typically affects the muscles and tendons that extend the fingers and wrist, and roll the forearm outwards.

GE and TE can affect anyone involved in activities that require rapid and/or repetitive motion of muscles and joints in the forearm, wrist, and hand.  It is more likely to happen if these movements are combined with awkward posture(s), excessive force, poor technique, and using the wrong equipment or tool.  Occasionally, a direct blow to the elbow may be a causative factor.  Physical deconditioning can also make individuals susceptible to these conditions.

GE and TE can affect a broad variety of people including:  trade workers such as electricians, painters, and carpenters; recreational athletes such as tennis players and golfers; and labourers such as cleaners and assembly line workers.  Computer use, and even hobbies like gardening and knitting can be associated with GE and TE.

It is important to establish an accurate diagnosis of GE and TE.  This can be accomplished by performing a proper medical history, along with a physical examination.  Other causes of elbow pain may include: fractures, bursitis, arthritis, sprains, nerve irritation, or referred pain from the neck and/or shoulder region.  Any elbow injury with obvious evidence or suspicion of fracture or joint dislocation necessitates the need for emergency medical care.

Chiropractors are healthcare professionals skilled in diagnosing and treating muscle and joint conditions such as GE and TE.  Initially, relative rest and altering or eliminating the conditions that contributed to the injury is important.  This may include making changes to a work station, using the correct tools/equipment, and taking breaks to relax overworked muscles and joints.  Treatment options include electrotherapy, acupuncture, ultrasound, taping, bracing, specialized soft tissue therapy, and manual joint mobilization.  In addition, a comprehensive rehabilitation program should also include stretching and strengthening exercises that target the muscles of the forearm, upper arm, shoulder and upper back.

If elbow pain is keeping you away from your favourite activities, consider chiropractic care.  A chiropractor will assess your symptoms, diagnose your condition, and recommend a treatment plan to put you on the road to recovery.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Understanding Golfer's And Tennis Elbow

By Dr. John A. Papa, DC, FCCPOR(C)

The elbow is a complex joint that allows movements of flexion, extension, and rotation.  Most daily activities require a combination of these actions to produce motion in the arm, forearm, wrist, and hand.  Two common elbow injuries include Golfer's Elbow (GE) and Tennis Elbow (TE).  Both of these elbow conditions can cause pain and weakness which results in functional limitations with gripping, pushing, pulling, and lifting activities of the affected arm.

Golfer's Elbow (GE) is medically known as medial epicondylitis and causes the inner part of the elbow to become sore and tender.  This typically affects the muscles and tendons that flex the fingers and wrist, and roll the forearm inwards.

Tennis Elbow (TE) is medically known as lateral epicondylitis and causes the outer part of the elbow to become sore and tender.  This typically affects the muscles and tendons that extend the fingers and wrist, and roll the forearm outwards.

GE and TE can affect anyone involved in activities that require rapid and/or repetitive motion of muscles and joints in the forearm, wrist, and hand.  It is more likely to happen if these movements are combined with awkward posture(s), excessive force, poor technique, and using the wrong equipment or tool.  Occasionally, a direct blow to the elbow may be a causative factor.  Physical deconditioning can also make individuals susceptible to these conditions.

GE and TE can affect a broad variety of people including:  trade workers such as electricians, painters, and carpenters; recreational athletes such as tennis players and golfers; and labourers such as cleaners and assembly line workers.  Computer use, and even hobbies like gardening and knitting can be associated with GE and TE.

It is important to establish an accurate diagnosis of GE and TE.  This can be accomplished by performing a proper medical history, along with a physical examination.  Other causes of elbow pain may include: fractures, bursitis, arthritis, sprains, nerve irritation, or referred pain from the neck and/or shoulder region.  Any elbow injury with obvious evidence or suspicion of fracture or joint dislocation necessitates the need for emergency medical care.

Chiropractors are healthcare professionals skilled in diagnosing and treating muscle and joint conditions such as GE and TE.  Initially, relative rest and altering or eliminating the conditions that contributed to the injury is important.  This may include making changes to a work station, using the correct tools/equipment, and taking breaks to relax overworked muscles and joints.  Treatment options include electrotherapy, acupuncture, ultrasound, taping, bracing, specialized soft tissue therapy, and manual joint mobilization.  In addition, a comprehensive rehabilitation program should also include stretching and strengthening exercises that target the muscles of the forearm, upper arm, shoulder and upper back.

If elbow pain is keeping you away from your favourite activities, consider chiropractic care.  A chiropractor will assess your symptoms, diagnose your condition, and recommend a treatment plan to put you on the road to recovery.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.