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Health Topics     April 25, 2013
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Bursitis



Bursitis is an inflammation of the bursa (a small fluid-filled sac located between movable parts of a joint and sometimes between tendons and muscles). These little membranous bags are positioned around the shoulders, elbows, knees, and between large muscle groups in the arms, legs, and feet. These sacs provide cushioning between joints allowing movable parts to slip more easily against one another.

The shoulder joint is most commonly affected by bursitis. The shoulder bursa, located between the cup-like socket and the ball-shaped end of the arm bone, cushions this socket and absorbs shock to prevent bruises. The bursa and its adjacent tendons can become inflamed. As a result, it is difficult to raise the arm straight out along the side of the body.

Heavy lifters and sedentary workers are more prone to develop bursitis than active individuals who keep the muscles firm and tendons healthy.


Prevention:

Avoid excessive fatigue, such as from carrying heavy handbags, buckets of paint or suitcases over long periods. Any repetitive motion such as painting, wallpapering, window washing or other long-continued unaccustomed activity may induce bursitis.


Treatment:

Injections and painkillers should not be used for bursitis. Chronic pain can be managed in other ways that do not endanger the health of the person, such as with hot and cold applications, manipulation or exercise, massage, counter-irritation, and various plaster and poultices.

1. Apply an ice pack to the shoulder for six to ten minutes. This will provide sufficient relief enabling the arm to move more freely. The ice pack is the first line of treatment used during the first week of pain and discomfort.

After the first week, apply hot packs followed briefly with cold packs. Follow this regimen everyday until the pain subsides.

2. Hot packs also help relieve pain. Use thick steam packs made from wool, if available, or large Turkish towels, dipped in hot water and wrung dry. Apply continuously for 45 to 60 minutes changing the pack as it cools. Afterward, rub the treated area with an ice cube for 50 seconds. This treatment should be effective unless the person has hardened calcium deposits.

Hot packs must be applied daily, and the heat must be intense. The maximum or tolerable heat is necessary to sufficiently warm the bursa for healing. After one hour of hot pack application and the ice-rub, a brief cool shower should be taken to close off the pores and reduce sweating.

3. Exercise for bursitis is extremely important to prevent "frozen shoulder." During the early phases, cold application will enable the person to experience pain relief to engage in exercises. With the heat treatments, the inflammation should reduce sufficiently to allow exercising the extremities.

Lean forward to one side with the affected arm hanging down. Hold onto a table or desk with the opposite arm. This pulls the head of the arm bone away from the bursa. With a body movement, swing the hand in a small circle. Gradually increase the size of the circle as far as it can be done without pain. Day-by-day make the circle wider as the pain recedes and the joint becomes more flexible. Two minutes at a time is usually sufficient. This exercise can be repeated several times a day. This exercise should prevent frozen shoulder from developing.

4. Avoid chilling the extremities. Take care to cover the shoulders during the night, as the shoulders can become uncovered in bed and chilled. Be careful of air conditioning. Wear warm sleepwear.

5. Do not begin heavy work until you have warmed-up by doing some light work.

6. Do not use deep massage for bursitis as it can increase inflammation.

7. Do not prolong inactivity as a stiff joint may result. Two or three days of wearing a sling may decrease the inflammation.

8. The following exercises may be done comfortably after any hot or cold treatment.

  • The Wall Walker: Stand at arm's length from a wall. Lean your hands into the wall starting slightly above waist level. With a walking movement, hand-overhand, walk your hands as high as you can reach without pain. Try to increase the highest position of the hands on the wall each day. Repeat the exercise four times a day.
  • The Butterfly: Slowly extend the arms backwards and up, then extend them forward and up, then outward and up. Repeat this exercise for five minutes once or twice a day.
  • The Pully Pull: Rig an overhead pulley with a five pound weight, preferably out-of-doors. Pull down on the rope as far as it will go. Start out with five pulls, three times a day. Gradually work up to 50 pulls three times a day.



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