By Kurt Ullman, RN
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In most cases, treatment of bursitis is focused on reducing pain and inflammation. When there are no indications of infection or of an underlying rheumatic condition at the root of the bursitis, it is usually treated using a variation of the P-R-I-C-E-M-M method:
Protect. Your doctor may suggest padding over the inflamed bursa. Modifying the way you do certain activities and wearing a brace may also help.
Rest. Rest the affected area and stop doing the activity that may have caused the bursitis.
Ice. Putting something cold on the area can reduce inflammation and pain. You can use an ice pack or a package of frozen vegetables for 20 minutes three or more times a day. Cover the cold pack with a towel so there is no direct contact between the cold pack and your skin.
Compression. An elastic bandage may help with pain and swelling.
Elevation. If you can, try to keep the affected area level with your heart or above it to help limit swelling.
Medication. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (brand name Advil and others), or the analgesic (pain reliever) and antipyretic (fever reducer) acetaminophen (Tylenol and others). He may also administer a corticosteroid.
Modalities. Modality generally refers to a physical form of medical therapy. Modalities that may used to treat bursitis include electrical stimulation and low-energy shock-wave therapy.
If the bursitis does appear linked to a rheumatic condition, steps may be taken to reduce inflammation caused by the condition. Similarly, if your doctor finds uric acid crystals near the inflamed bursa, suggesting that the bursitis was spurred on by gout, treating your gout may be part of your bursitis treatment.
If necessary, your doctor may aspirate the bursa, draining fluid out of it with a syringe. This can decrease the size of the bursa and help to clean it out if it is infected. If your doctor believes that your bursitis is the result of an infection, he will also prescribe antibiotics. It may be necessary to aspirate the bursa every several days until the fluid shows no signs of infection.
Surgical drainage and removal of the bursa may be recommended in some cases, especially if the bursa is infected with particularly dangerous bacteria, such as the bacterium responsible for tuberculosis. However, surgery for bursitis is rare. Most people respond to conservative treatment fairly quickly, often within a few days. Treating bursitis caused by an infection may take longer.
After treatment, try to modify the activity that likely caused the bursitis so that it doesn’t come back. If you have knee bursitis, for example, you could wear kneepads while gardening. Strengthening and flexibility exercises may help a person recover after bursitis and may also help to prevent it from recurring.
Moving forward
Fortunately, bursitis is not forever, even if it comes back. Once your bursitis clears up, there are many things you can do to make developing bursitis again less likely. Depending on the kind of bursitis you had and what caused it, preventive steps might include keeping the muscles near the affected bursa strong, stretching before exercise, cross-training rather than engaging in just one sport or physical activity, wearing appropriate knee or elbow pads when doing activities that put pressure on those joints, and using adaptive equipment that protects your joints when performing repetitive tasks. It also doesn’t hurt to ask your doctor or physical therapist for individualized advice on what you can do to keep future bursitis at bay.
Last Reviewed 12/31/15
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