Bursitis is a rheumatic condition that occurs when a bursa becomes inflamed and painful. The bursae are small sacs or pouches at the ends of bones that act as cushions between the bones and muscles, tendons, or skin. They contain a lubricating fluid to eliminate joint friction and maintain smooth movement of muscles over the bones. Inflamed bursae produce tenderness and swelling near the affected joint. This ranges from minor discomfort to severe and virtually disabling pain that makes it almost impossible to move the joint. The condition can result from a sudden and extreme traumatic pressure or, more often, from continuous strain. Some occupations and sports that require constant, repetitious motion can lead to either acute or chronic bursitis, so called housemaid’s knee, which is caused by frequent kneeling, is one of the most familiar examples. The joints most commonly affected are the shoulders, knees, elbows, and hips.
Diagnostic Studies And Procedures
Bursitis is easily diagnosed on the basis of symptoms and a physical examination. Your account of recent activities helps a doctor determine the cause of the flare up and also provides clues to whether or not the problem might be a sign of a more general condition. During the physical examination, a doctor manipulates the joint to identify the most painful area and to determine the degree of joint mobility. An X-ray, blood studies, and other tests may be ordered to rule out conditions that cause similar symptoms.
Aspirin, ibuprofen, and stronger nonsteroidal anti inflammatory drugs are the mainstays to relieve both pain and inflammation of bursitis. In acute cases, a corticosteroid such as cortisone, a powerful anti inflammatory drug, may be injected into the inflamed area. When given by this type of injection, steroids are less likely to produce serious side effects than when taken orally. Excess fluid in the bursa may be drawn off with a hollow needle and syringe to reduce swelling, then the joint wrapped with an elastic bandage. If a shoulder or elbow is involved, the doctor may recommend an arm sling to rest and protect the joint.
Manipulation may ease pain caused by bursitis, particularly if misalignment is involved. A patient who has any form of arthritis should bring this to the chiropractor’s attention before beginning treatment, however, because manipulation can be harmful in certain cases.
Some herbal remedies may ease the swelling and pain of bursitis, although none are a substitute for medical treatment. Many herbalists recommend rubbing fresh garlic on the painful area, as well as taking garlic pills twice a day. A poultice made with 3 tablespoons of horseradish stirred into ½ of boiled milk is also said to alleviate pain. It should be applied hot, using a piece of cheesecloth or a gauze pad, and removed when it has cooled. A note of caution: Both garlic and horseradish may irritate mucous membranes and skin. Test the substance first on a small area of skin, and avoid using it if it produces blistering, reddening, or a rash.
Ice is used first in an acute attack of bursitis to alleviate pain and reduce swelling. After the first two days, switch to heat treatment. You can apply heat with hot packs, a heating pad, an infrared lamp, or by taking hot showers or baths.
Most cases of bursitis will clear up within a week or two with attentive self care. Rest the affected area as much as possible and wrap it firmly, but not too tightly, in an elastic bandage. ‘lake aspirin or ibuprofen to alleviate the pain and inflammation, ingesting them with milk or food to prevent stomach irritation. Use heat or cold treatments for additional pain relief. As the bursitis disappears, you can begin gentle and gradual exercising to gain muscle strength. A physical therapist at a sports medicine center or an athletic trainer can provide guidance as to which exercises are beneficial and which ones should be avoided. The most important aspect of self treatment is determining what activity triggered the bursitis. Once you know what it is, you can avoid overdoing it or learn better techniques for performing that particular motion.
Other Causes of Bursitis Symptoms
Some forms of arthritis, including gout, can cause inflammation of the bursae. Tendinitis, an inflammation of the thick tissue that connects muscles and bones, may also mimic bursitis.