Bursitis is an inflammation of a bursa, a small structure inside every joint
that helps to lubricate and cushion it. Usually bursitis occurs in the larger
joints, such as the shoulder, hip, knee, or elbow. It can happen once or can
recur over time. Without seeing your health care provider, you usually can't
easily tell the difference between bursitis and pain caused by a strain or
Signs and Symptoms
Pain in the joint that gets worse when you move the joint (the pain
may come all at once or develop gradually over time)
Fever and warm joint area (if an infection is
What Causes It?
Typically the bursa becomes irritated or injured when the area is overused
with repetitive motion or strenuous activity. It may also be caused by a
bacterial infection. Certain other medical conditions, such as gout or
rheumatoid arthritis, can also cause bursitis.
What to Expect at Your Provider's Office
Your health care provider will ask you to identify exactly where the joint
hurts and feel the joint for swelling or particular areas of tenderness. Your
health care provider may remove some fluid from the bursa with a small needle to
check for signs of infection. You may also be given a blood test to check for
other medical conditions.
Sometimes simply resting and elevating the joint can help the area heal. A
splint, sling, or other device can support the joint and keep it from moving.
Applications of heat or cold may help relieve pain and swelling.
Corticosteroids—injections into the bursa or
taken orally help to reduce inflammation; side effects include blurred vision,
frequent urination, and increased thirst; may be given with a local anesthetic
to reduce pain
Antibiotics—for bursitis that is
Acetaminophen, aspirin, and ibuprofen—to
Surgical and Other Procedures
In rare instances, the bursa is surgically removed.
Complementary and Alternative Therapies
Alternative therapies may be useful in reducing the pain and inflammation of
bursitis while supporting healthy connective tissue.
Include in your diet anti-inflammatory oils such as those found in cold-water
fish, nuts, and seeds. The following supplements may help.
Glucosamine sulfate (500 mg two or three times a day), for connective
Omega-3 oils (1,000 mg two or three times a day), such as flaxseed
oil, as an anti-inflammatory agent
Vitamin C with flavonoids (250 to 500 mg two times a day), for
connective tissue repair
Proteolytic enzymes such as bromelain (250 mg twice a day), to reduce
Flavonoids and oral digestive enzymes for
Herbs are generally a safe way to strengthen and tone the body's systems. As
with any therapy, it is important to work with your provider on getting your
problem diagnosed before you start any treatment. Herbs may be used as dried
extracts (capsules, powders, teas), glycerites (glycerine extracts), or
tinctures (alcohol extracts). Unless otherwise indicated, teas should be made
with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or
flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures
may be used alone or in combination as noted.
Herbs that reduce swelling include meadowsweet (Filipendula
ulmaria), white willow (Salix alba), Jamaica dogwood (Piscidia
piscipula), and turmeric (Curcuma longa). A tincture of one, or a
combination of these, may be taken at 15 drops every 15 minutes up to four doses
for acute pain relief, or 30 drops four times per day for general pain relief.
Turmeric increases the effects of bromelain.
For bursitis with muscle spasm, add valerian (Valeriana
For chronic bursitis, add hawthorn (Crataegus
Some of the most common remedies are listed below. Usually, the dose is 3 to
5 pellets of a 12X to 30C remedy every one to four hours.
Arnica gel applied topically (to the skin) as directed gives
excellent short-term pain relief.
Arnica for bursitis occuring after an injury to the
Ruta graveolons for rheumatic pains in the joint
Bellis perennis for injury with a great deal of
Rhus toxicodendron for pain that gets better with
"Traumeel" injections as an alternative to
Acupuncture can be helpful in reducing swelling and inflammation, and
especially in relieving pain.
Although no well-designed trials have evaluated the effectiveness of
chiropractic treatment for bursitis, chiropractors commonly treat people with
this condition and report that some experience improvements in symptoms,
including reduced pain and increased range of motion. Chiropractors are also
likely to use other treatments in addition to spine and joint manipulation (such
as ice massage and ultrasound therapy) for the treatment of
You should not use massage if your bursitis is caused by an infection.
Otherwise, massage (especially myofascial release therapy) can be used for
general relaxation and to reduce discomfort from inflammation and from
compensating for a sore joint.
Tell your health care provider if your symptoms are not relieved by your
treatment. Be sure to follow your provider's instructions for resting the joint
to allow the swelling to subside before returning to your usual routines. You
can help prevent bursitis from recurring by avoiding repetitive motions, resting
between periods of intense activity, and doing stretching exercises before
starting an activity.
Do not take aspirin, acetaminophen, or ibuprofen for more than a few days
unless so directed by your provider. Be sure to tell your health care provider
if you are pregnant.
Reviewed By: Participants in the review process include: Gary Guebert, DC, DACBR,
(Chiropractic section October 2001) Login Chiropractic College, Maryland
Heights, MO; Richard A. Lippin, MD, President, The Lippin Group, Southampton,
PA; Joseph Trainor, DC, (Chiropractic section October 2001) Integrative
Therapeutics, Inc., Natick, MA; Leonard Wisneski, MD, FACP, George Washington
University, Rockville, MD.
The publisher does not accept any responsibility for the accuracy of
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of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed