Bursas are fluid-filled sacks that surround joints. They are filled and surrounded by synovial fluid and help to decrease friction between tissues during movement. Often they are found between ligaments and tendons, but they are all around the joint. The hip joint, for example, has 18 different bursas that surround it. When the bursas become irritated through injury or repetitive motion, they will swell and cause pain.
Rest
The Mayo clinic recommends rest for bursitis as it is often caused by injury or overuse. Still try to move in pain-free ranges of motion, but the muscles and joint near the inflamed bursa should be used less until the area has healed and is no longer causing pain.
Decreased Inflammation
Inflammation is best decreased with ice over the area of pain. Ice should be used over the area until the skin is numb, or about 10 minutes. Icing before and after activity, if rest is not an option, keeps inflammation down locally. Additionally using a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen or a supplement called bromelain will help reduce inflammation globally. Bromelain is a natural anti-inflammatory that is made from pineapple and can be found in a natural food or supplement store.
The "Journal of Clinical Immunology" published a research article in July 2008 that looked at the effects of bromelain and injury. It was found that not only did bromelain help reduce specific inflammatory agents to the site of injury but also helped improve removal of other specific inflammatory makers.
Stretching
When the muscles become tight, or hypertonic, they will pull on the tendons which may put more pressure on a specific bursa. By stretching and relaxing these muscles, it will help relieve tension on the bursa. Stretching the muscles surrounding the bursa is the most helpful. A health professional can teach what specific muscles around the area need to be stretched, and can also do assisted stretches in the office. Some massage therapists also specialize in myofascial release, stretching and deep tissue massage to help relax the muscles.
Adjustments
The pain of bursitis can lead to altered movement of the muscles and joints nearby or even further away as a compensating mechanism. This can lead to uneven wear across the joints and cause muscles to become even tighter. Seeing a chiropractor or osteopath to receive adjustments to the joints will help the joint function properly as well as help the muscles move correctly around the joint. Extremities like knees, hips and shoulders can be adjusted just like the spine can. Make an appointment with a doctor who has had extra training with extremities or sports medicine to get the best adjustment possible.
Corticosteroids
When conservative options do not work, the Mayo Clinic recommends talking to a doctor about receiving a corticosteroid injection directly into the bursa. Corticosteroids are powerful anti-inflammatory drugs, and just like all drugs there are some side effects. The bursitis pain should calm down with in a few days of the shot. Do not resume activity immediately after an injection, for the feeling and sensation in the area are altered due to the injection.
References
- Mayo Clinic: Bursitis
- "Journal of Clinical Immunology;" Bromelain treatment decreases nutrophil migration to sites of inflammation; Fitzhugh, DJ, et. al.; July 2008.
- Mayo Clinic: Cortisone Shots
