Effectiveness of physical medicine and kinesitherapy treatment in patients with bursitis

Bursae: bursae are flattened sac-like structures filled with a small amount of fluid called synovial fluid (almost the same as that found in joints). Bursae are located in many places in the human body (mostly around joints) where movement occurs between two planes and separate part of the surface of the bones and the muscles or tendons that lie on them (deep bursae) or the skin and the tendons that move underneath it (superficial bursae). Bursae are lined on the inside by a thin membrane called synovial membrane, which produces a small amount of fluid. Some bursae have direct contact with the joints they are located next to. There are about 160 bursae in the human body. Deep bursae are present at birth, while superficial bursae develop months to years after birth, at sites where friction exists. Bursae reduce friction and cushion movement between bones, tendons, and other tissues. The largest bursae are located under the tendons around large joints such as the shoulder, elbow, hip, and knee. Bursitis is an inflammation of the bursae in the human body. Inflammation of the bursae causes irritation of the tissue lining their walls, causing them to become rough and produce more fluid than normal. Normally, the synovial fluid in a non-inflamed bursa has a very small volume and the walls of this "squeezed" sac slide smoothly against each other, facilitating the movement of the structures between which the bursa is located. In an inflamed bursa, the increased pressure in it (increased amount of fluid in a limited volume) and the thickened walls impair function and cause pain during movement. If the inflammatory process continues for a long time, it can lead to the deposition of calcium crystals in the bursa (this is most commonly seen in the bursa of the shoulder). Some more important bursaries are as follows: • Shoulder bursa, • Elbow bursa, • Hip bursa, Bursa of the buttock, • Heel bursa, • Bursae of the knee, •"Pes anserinus" (goose foot) bursa, • Infrapatellar bursa, • Iliopsoas bursa. Research Methods: The research was conducted at the PHI "Clinical Hospital - Shtip, in the departments of Physical Medicine and Kinesitherapy. The research included 17 patients with diagnosed Bursitis, (9 men and 8 women) of which, 6 patients had shoulder bursitis, (4 men and 2 women), 4 had hip bursitis, (3 women and 1 man), 2 had elbow bursitis (2 men) 2 had iliopsoas bursitis (2 women) and 2 had heel bursitis (men), (1 had bursitis of the buttock (1 woman). Bursitis Treatment: The treatment of bursitis largely depends on establishing an accurate diagnosis and determining the exact cause of bursitis. It is of paramount importance to assess whether bursitis is infectious, i.e. whether the penetration of a pathogenic microbe into the bursa is the cause of its inflammation. Physical therapy plays a key role in the treatment of bursitis, including cryotherapy, thermotherapy, ultrasound, and iontophoresis. Kinesiotherapy is also a very important segment of the comprehensive treatment to establish a balance between limiting movement in the affected area and performing exercises that aim to restore range of motion and muscle strength. Complete immobilization is avoided as it can lead to the formation of adhesions around the joints and tendons, and stiffness of the joint. Results: In most cases of bursitis, with accurate diagnosis, discovery of the cause in the specific case, and proper treatment, the complaints subside completely within a few days to a week. The results show a significant reduction in symptoms in patients affected by Bursitis. Discussion: Kinesitherapy is a very important segment of comprehensive treatment for establishing a balance between restricting movement in the affected area and performing exercises aimed at restoring range of motion and muscle strength. Conclusion: Physical therapy plays a key role in the treatment of bursitis. Treatment with ultrasound, thermotherapy, cryotherapy, and iontophoresis of medications reduces pain and increases range of motion of joints affected by bursitis.
Keywords: Bursitis, symptoms, pain, diagnosis, treatment, prognosis;
Field: Medical Sciences