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BURSITIS

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Bursitis has some funny nicknames. Its called Housemaids Knee, Clergymans Knee, and Bakers Cyst, among others. But anyone whos experienced the pain of bursitis knows that its no laughing matter.
The bursa is a fluid-filled sac that helps protect muscle, ligaments, tendons, or skin that rubs across bone. There are bursae throughout our bodies, but the ones where inflammation most commonly occurs are at the shoulder, elbow, knee, and heel.
The painful inflammation of a bursa is called bursitis. Its caused by bumping or bruising, repeated pressure, or overuse. It can develop after an activity you re not used to doing or after increasing a familiar activity. If you havent been in the garden, and you start hoeing several rows. That one exposure may give you acute bursitis," says Jack Harvey. M.D., chief of sports medicine at the Orthopaedic Center of the Rockies in Fort Collins, Colorado. "Conversely. swimmers who swim 5.000 yards a day may do fine until they up their workout to 7,500 yards a day."
Sometimes, bursitis can flare up without a clue as to its cause. All you know is, it hurts. "It can occur spontaneously with no real clear precipitating event, or doing an activity that youve done a million times," says Joseph P. lannotti, M.D., Ph.D., assistant professor of orthopedic surgery and chief of Shoulder Service at the University of Pennsylvania in Philadelphia.
The good news is, once you tone down your activity, the symptoms begin to disappear. Heres how to speed your recovery along:


Dont Shrug Off Shoulder Pain
Dont be too quick to label your shoulder pain as bursitis, especially if your condition doesnt improve after a few days of rest. There are many conditions for which shoulder pain is a symptom, but absolutely none for which pain and swelling should be ignored.
Orthopedic surgeons who specialize in shoulder problems say that treatment shouldnt be left to the patient or even to nonspecialist doctors. A physical examination by an expert, usually followed by X rays, is the first step in proper treatment of the condition.
I think if a person has significant shoulder pain, if its interfering with their activities or their sleep, then in my view its best to be examined early by a physician, says Lanny L. Johnson, M.D.

Give it a rest.
The pain of bursitis may disappear completely after a few days of resting the joint. This doesnt mean ceasing all movement, warns Harvey. Particularly in a shoulder, immobilization could "freeze" the joint with fibrous tissue and scar tissue. Just take it easy and try to avoid the activity that brought on the pain.

Get new shoes.
If you have bursitis on your heel, you probably got it because of improperly fitting shoes. The solution is simple: Toss the shoes and put on a better-fitting pair.

Make a change.
If you have bursitis on your elbow or your knee, change the activity that caused it or wear protection. "Change the shoe, wear knee elbow or crawl on your knees," advises Lanny L. Johnson. M.D., orthopedic surgeon and clinical professor of surgery at Michigan State University in East Lansing.

Deflate the inflammation.
Take two five-grain aspirin four times a day to reduce the swelling of the bursa. Ibuprofen is another option. But avoid these if youre taking blood pressure medicine or you have kidney problems, says lannotti.

Skip the acetaminophen.
Unlike aspirin and ibuprofen, this over-the-counter pain reliever isnt an anti-inflammatory, so it doesnt do as much for bursitis. "Many people, in their mind, translate aspirin to Tylenol," says Harvey. "So I tell them plain aspirin, just to avoid confusion."

Put it on ice.
Ice brings down swelling by slowing down the blood flow into the area. Leave an ice pack wrapped in a thin towel on the joint for about 20 minutes twice as long if your bursitis is deep in your shoulder, says Harvey.

Warm it up.
After the initial swelling has been brought down, heat from a heating pad or heat pack wills not only feel good but will get rid of excess fluid by increasing circulation. "The heat increases the blood flow, picks up the excess fluid, and carries it away, says Charles A. Rockwood, Jr., M.D., professor of orthopedics at the University of Texas Medical School in San Antonio.

Get in the swing of things.
Retaining range of motion in the joint is important, so certain exercises are a necessary part of treatment. "Theyre to maintain motion in the least strenuous way," says lannotti. While most of these exercises should be prescribed by a doctor, there are a couple that you can do on your own, says lannotti. One effective exercise for bursitis in the shoulder is the pendulum swing. To do this exercise, bend at the waist, and support your weight by leaning your good arm against a desk or chair back. Swing your sore arm back and forth and then in clockwise and counterclockwise circles.

Play "itsy bitsy spider."
Another exercise you can do to restore your shoulders range of motion is to have your hand crawl up the wall, like a spider. Make it a laid-back spider, however. Anything other than slow, gradual movement may do more harm than good.

Use a stepladder.
Overhead reaching or pushing and pulling at or above shoulder level may worsen shoulder pain, says lannotti. His advice: Use a stepladder, or better yet, have someone else reach that top shelf for you.