Bursitis and Tendinitis

Bursitis and Tendinitis

A few years back, the New York Times published a story about my lifelong love affair with medicinal plants. Some time after it ran, I got a call from a Times employee who said that something like 20 percent of the newspaper's employees who banged away daily on computer keyboards were experiencing problems with inflamed joints, including tendinitis in their wrists or shoulders or bursitis of the shoulder.

He said that he was looking into alternative medical treatments, came across my name in the Times archives and called me. I sent him what I had, and my sympathy as well. I've had bursitis myself and can vouch for the pain and disability it causes. Like the man at the Times, I, too, spend hours on end working at a computer. I also enjoy playing the guitar and bass fiddle and do a fair amount of driving and lawn mowing, all of which can aggravate bursitis and tendinitis.

These two disorders are often lumped together, but they're actually two distinct conditions. Bursitis is an inflammation of the bursae, the fluid-filled sacs that help lubricate the joints in places where muscles and tendons meet bone. Tendinitis is an inflammation of the tendons, the tough, elastic, fibrous tissues that connect muscles to bones.

The two terms are often used interchangeably because the bursae are located near tendon-bone connections, and both conditions cause pain in and around the joints. Bursitis and tendinitis also have the same cause--overuse of a particular joint. These kinds of problems show up as a result of sports, as in tennis elbow, and in jobs that require repetitive movement, such as carpentry and butchering. Whatever you call them, though, bursitis and tendinitis really hurt. And interestingly enough, they both respond to the same kinds
of treatments.

Physicians generally treat bursitis, tendinitis and related problems with rest and medications that relieve pain and reduce inflammation--aspirin and other nonsteroidal anti-inflammatory drugs and corticosteroids.

Green Pharmacy for Bursitis and Tendinitis

I think resting a joint that has been affected by tendinitis or bursitis is a great idea. Ice packs might also help control the pain and inflammation. But don't count on an ice pack to provide complete relief. And while taking aspirin and related drugs is fine, you should be aware that there are also a number of natural alternatives.

Willow (Salix, various species) and other natural pain relievers. Willow bark is herbal aspirin. So are meadowsweet and wintergreen. They all contain salicylates, natural precursors of aspirin. To make a tea, I suggest using one to two teaspoons of dried herb per cup of water and boiling it for about 20 minutes. Have a cup two or three times a day. Or try a teaspoon of tincture of any of these herbs three times a day. Remember, though, that if you're allergic to aspirin, you probably shouldn't take aspirin-like herbs, either.

Ginger (Zingiber officinale). Ginger has a long folk history in Asia as a bursitis treatment. Since I like ginger, I suggest trying it in combination with pineapple and a little licorice (both discussed below) for recurring bursitis.

Echinacea (Echinacea, various species). This herb, also called coneflower, is good for connective tissue injuries such as tennis elbow, skier's knee and jogger's ankle, according to Michael Moore, author of Medicinal Plants of the Desert and Canyon West and one of the nation's leading herbalists. All of these injuries are, in fact, types of tendinitis. He recommends taking up to a half-ounce of echinacea tincture daily until the swelling and pain are reduced. That's a lot of tincture, but echinacea is not hazardous (although it may cause your tongue to tingle or become numb), so it's probably worth a try.

Horsetail (Equisetum arvense). This herb is one of Nature's richest sources of the element silicon, and some say that it is in a form that is especially easy for your body to use. A number of studies show that silicon plays an important role in the health and resilience of both cartilage and connective tissues such as tendons. (Cartilage forms a significant portion of joints.)

I can't say that I'm entirely sold on high-silicon herbs and foods for treating bursitis and tendinitis, but two scientists I respect, herbal pharmacologist Daniel Mowrey, Ph.D., author of The Scientific Validation of Herbal Medicine and Herbal Tonic Therapies, and Forrest Nielsen, M.D., director of the Grand Forks USDA Human Nutrition Research Center in North Dakota, tout silicon. So I think it's worth trying, although you should not use this herb without the guidance of a holistic practitioner.

If you're advised to take this herb, you can make a tea by putting five teaspoons of dried horsetail, one teaspoon of sugar and one quart of water in a pot. (The sugar will pull more silicon out of the plant.) Bring it to a boil, then reduce the heat and let it simmer for about three hours. Strain the tea and let it cool before drinking it.

Other plants high in silicon include barley, chickweed, cucumbers, parsley, stinging nettle, walnuts, Brazil nuts, cashews, pistachios, string beans and turnips.

Licorice (Glycyrrhiza glabra). Licorice can be every bit as effective a treatment for bursitis and tendinitis as the commonly prescribed drug hydrocortisone, according to Dr. Mowrey. Plus, the herb has none of the usual side
effects, such as weight gain, indigestion, insomnia and lowered resistance to infection, that are associated with cortisone and hydrocortisone. From what I know of licorice's anti-inflammatory effects, I believe this herb is worth trying. (While licorice and its extracts are safe for normal use in moderate amounts--up to about three cups of tea a day--long-term use or ingestion of larger amounts can produce headache, lethargy, sodium and water retention, excessive loss of potassium and high blood pressure.)

Pineapple (Ananas comosus). This tasty fruit contains enzymes that break down protein. One of these enzymes, bromelain, is particularly important because it has anti-inflammatory properties. Pineapple reduces swelling, bruising and pain and speeds the healing of joint and tendon injuries.

Many athletes believe that pineapple helps heal sprains and tendinitis. Some eat lots of pineapple before and after strenuous workouts to help protect their tendons, as tendinitis is a major problem for them. Does it work? I don't have a definite answer for that, but my colleague James Gordon, M.D., president and director of the Center for Mind-Body Medicine in Washington, D.C., told me that he was amazed at how pineapple alleviated his chronic back condition that involved pain and inflammation.

The bromelain content of pineapple is not all that high, but if I had bursitis or tendinitis, I'd try this approach. It probably can't hurt to add fresh pineapple and pineapple juice to your menu while you're getting over an episode of tendinitis or bursitis. Papaya contains enzymes similar to those in pineapple, so you might want to add some of this fresh fruit to your menu as well.

Purslane (Portulaca oleracea) and other foods containing magnesium. Magnesium is an important mineral for muscles, bones and connective tissues. And since leafy green vegetables are a good source of magnesium, I've created a Magnesium Medley Salad. To make it, include any of the following ingredients to which you have access, in whatever amounts are pleasing to you: fresh purslane, green beans, spinach and lettuce. And throw some poppy seeds into the dressing; they also contain magnesium.

stinging nettle (Urtica dioica). This silicon-rich herb has strong folkloric support as a treatment for gout and rheumatism, which means it's long been used to treat inflammatory conditions that affect the joints. So it seems promising as a treatment for bursitis and tendinitis as well.

Turmeric (Curcuma longa). Joseph Pizzorno, N.D., president of Bastyr University in Seattle, and naturopath Michael Murray, N.D., co-authors of A Textbook of Natural Medicine, are just two of the herbal scholars who note that curcumin, a compound abundant in turmeric, has proved as effective as
cortisone in the treatment of some kinds of inflammation. They suggest taking both 250 to 500 milligrams of curcumin and 250 milligrams of bromelain three times a day, between meals.

You can purchase these isolated compounds in natural food stores, but I have a suggestion that you might enjoy more. Try preparing ripe pineapple, for bromelain, with turmeric, for a generous amount of curcumin. Come to think of it, a fruit cocktail made of pineapple and papaya spiced with ginger and turmeric would taste pretty darn good.

I always take a whole-foods approach whenever possible. I think that
generally, whole foods have more healing power going for them than any
individual ingredients that have been isolated from them.