Urolithiasis or bursitis – What is it?
Sickle cell disease is the term used to describe the painful condition that occurs when the joint’s serous bursa is swollen or irritated.
When we talk about a serous pocket, we mean the small sac between the bone and the tendon or cartilage that containssynovial fluid.
The serous pocket essentially protects the tissues from friction and compression during movement, essentially acting as a protective ‘cushion’.
Due to the nature of its construction, the serous bursa has both anti-vibration properties in intense or abrupt joint movements, but it is also relatively prone to injury and inflammation, causing bursitis or seronolactitis.
Our body has over 150 of these ‘protection bags’.
Serovaginitis occurs when for any reason the synovial fluid within the bursa increases causing the bursa to dilate. So any movement now causes increased pressure within the bursa with consequent painful symptoms in the person’s joint movements.
Of course such a condition can occur in any joint structure that contains a serous follicle, but it is most commonly found in the shoulder, elbow, hip, knee and ankle joints.
What causes serogonothylakitis?
1) Prolonged pressure on the bursa from a hard anatomical structure (e.g. tendon or bone) or an external hard surface. A typical example is knee bursitis in people who have to work with knee flexion for long hours or who rest on their knees without the protection of a soft material.
2) Repetitive movement: some people are more likely to develop bursitis because of some repetitive movement involved in their daily activities, work or sport. For example, javelin throwers who repeat the throwing motion in training sessions very often develop shoulder bursitis.
3)A joint injury after e.g. a sudden movement can include a bursa injury.
4) Infection: in more rare cases we may have a microbe infection in the synovial fluid. In this case we have septic bursitis
5) Of course, seronothyrolakitis can be a concomitant secondary symptom in a number of known articular pathologies such as rheumatoid arthritis or gout.
6) Finally, let’s not forget the obvious. Like all anatomical structures, the serous follicle wears out and degenerates with age. Also the fluid within the follicle decreases over time. Therefore the painful symptoms that one may experience in old age can often be described as ‘normal’.
How is the diagnosis of serogonothylakitis made?
The trained and qualified health care professional can make the diagnosis with relative ease through detailed history taking, clinical picture and physical examination. Sensitivity to palpation of the bursal capsule, swelling and associated pain on movement and rest will provide the diagnosis.
However, it is important to differentiate serogonothylakitis from other conditions with common symptoms and imaging tests such as MRI will help you do this. Also a simple X-ray will rule out bone damage in the area such as a stress fracture.
What can physiotherapy do?
- Can train patients to conservatively treat the serogonothylakitis with the classical methods of rest, correct joint positioning, ice placement, etc.
- Your therapist should show you which movements to avoid and what ergonomics you can use to replace these movements in your daily routine. For example, if the bursitis is caused by repetitive movement at work, the therapist should find alternatives so that you can escape the problem and still be able to work at the same time.
- Therapeutic massage – targeted massage of the appropriate tissues will remove muscle tension peripheral to the problem area, giving the joint structures room to heal without being further irritated by tensile muscle forces.
- Kinematic taping – Kinematic taping is a modern way of bandaging that offers both the necessary joint stabilization and a series of other actions that aim to remove swelling and desensitize the area from painful symptoms.
- manual therapy – The ”heavy artillery” of modern physiotherapy is an essential tool for both diagnosis and treatment plan. Specific manipulations and targeted joint mobilization will put all joint elements including the serous bursa into proper and harmonious function.
- Targeted and specific exercise is also an important component of rehabilitation. The physiotherapist, in collaboration with a trainer experienced in clinical pathologies, should strengthen the appropriate muscle groups and restore normal movement with rules of “everyday life”. In this way the joint and the bursa will be ready for the stresses of daily activities without the fear of re-injury.
- Of course, if the situation requires it, the physiotherapist must refer the patient to a qualified physician for further investigation.
Morochliadis Stefanos
Physiotherapist PT,MT,RFL, Formthotics specialist
