Dr. M.J. Bazos, MD
Patient
Handout
BURSITIS
About Your
DiagnosisBursitis is inflammation
of a closed sac of fluid known as a bursa. Bursae are located in many areas of
the body, usually where tendons and muscles move directly over bony prominences.
The bursa helps this motion by providing a gliding surface between the two
structures. Several bursae are found in and around the shoulder, elbow, hip,
knee, and foot. Overuse injuries and chronic irritation are the usual causes of
bursitis; however, direct trauma, systemic disorders such as rheumatoid
arthritis and gout, and puncture wounds with subsequent infection may lead to
this painful condition. Localized pain combined with swelling, redness, and
tenderness are the usual presenting signs and symptoms. Pain usually worsens
when resistance is placed against the muscle that is affected. Radiographs
(x-rays) may show calcium deposits in the region around the bursa, but this
finding should rarely affect the treatment. Radiographs are helpful for
eliminating other possible causes of pain in the area, such as a stress
fracture.Living With Your
DiagnosisBursitis can become a
frustrating diagnosis. It tends to return, even after successful treatment,
unless the offending activity is eliminated or altered. A physical therapist,
occupational therapist, or athletic trainer may be able to provide retraining
for certain activities to minimize the bursitis. Substituting other forms of
exercise for those that are producing the symptoms is an important first
step.TreatmentThe
area is rested by means of discontinuation of the offending activities for at
least 2 weeks. Immobilizing the extremity with a splint or cast for 7 to 10 days
sometimes is effective. Ice is placed on the acutely inflamed area to reduce
swelling and provide pain relief. Anti-inflammatory medications such as aspirin,
ibuprofen, or naproxen are available without a prescription and are used to
manage mild to moderate cases of bursitis. Prescription strength
anti-inflammatory drugs are used to manage severe bursitis that has not
responded to initial treatment and to manage extreme pain. Aspiration, or
removal of fluid from the bursa, can provide temporary relief and gives the
physician the opportunity to evaluate the fluid for signs of infection or gout.
The fluid may quickly return, however, which may lead to repeated aspiration and
possible infection. An injection of steroid medication sometimes can be given to
provide temporary relief, but this therapy is used sparingly. If infection of
the bursa is confirmed by means ofculture
of the fluid, an operation may be required to remove the infected tissue.
Intravenous antibiotics may be necessary to cure the
infection.The
Dos• Take as directed
over-the-counter anti-inflammatory medications such as aspirin, ibuprofen, or
naproxen if the bursitis is mild to moderate. You may need prescription
anti-inflammatory drugs to relieve severe
symptoms.• Eliminate the offending
activity and allow the affected area to rest for at least 2 weeks. Immobilizing
the area may speed recovery.•
Substitute the offending activity with those that do not cause
symptoms.• Return to activity
gradually, as long as you are entirely free of
pain.The
DON’Ts• Do not return
to activity too soon or too suddenly. Six weeks is the usual time needed for
inflammation to subside. Symptoms, not your level of frustration, dictate
whether you are ready to resume
activity.When To Call Your
Doctor• If the usual treatments
have failed. Your bursitis symptoms may be due to something else, and your
doctor should be consulted to rule out other, more dangerous
conditions.For More
Informationhttp://www.merk.com/!!RHnW3FDmtRHuM37hm/pubs/mmanual/html/hhilihej.htmhttp://www.mayo.ivi.com/mayo/9506/htm/bursitis.htm