Bursitis

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Bursitis

It's one of those -itis problems with the power to make you cringe and reach for the aspirin. A common condition, bursitis rarely causes serious damage if it is recognized early and treated properly.

Bursitis occurs when the bursae--small sliding pouches that allow parts of the body to move smoothly--become inflamed. It can happen for a number of reasons. You may simply have bumped your elbow or spent too many hours on your knees in the garden. Or the problem may be caused by infection or gout.

The first signs of bursitis are usually pain and swelling. "For example, with bursitis over the elbow, there is often obvious swelling, the flesh is soft, and it feels like there's fluid inside," says Morris B. Mellion, M.D., who is clinical associate professor at the University of Nebraska Medical Center and medical director of the Sports Medicine Center, both in Omaha.

But that joint pain might also be a symptom of arthritis, which is a condition that demands long-term treatment. So the first thing you should do is visit a doctor to find out which -itis is causing you problems.

If it's bursitis, here are some ways to give your doctor's advice a healing boost.

Rest is best. Some people might use a splint or a sling to immobilize the area, says Steven F. Habusta, D.O., of Parkwood Orthopedics in Toledo. But for the most part, the affected area just needs time to rest. When the pain is gone and the bursae are no longer inflamed, then slowly resume your regular activities.

Find relief with nonprescription medications. "There are things you can buy without a prescription to relieve bursitis," says James Richards, M.D., an orthopedic surgeon with Matthews Orthopedic Clinic in Orlando, Florida. "Aspirin, or anything with ibuprofen in it (such as Advil), will decrease the swelling and hopefully the pain."

However, says Dr. Habusta, painkillers aren't always painless. He has three cautions. First, don't use aspirin and ibuprofen together; they don't work well in combination. Second, some adults are allergic to aspirin. Third, children should avoid aspirin, which in those under age 12 can cause Reye's syndrome, a potential killer.

When to See the Doctor Though painful, bursitis may subside after you give your body some tender loving care. But if the bursitis is due to infection or gout, you have a problem that requires a doctor's care. "Septic bursitis, due to infection, can spread or become severe," says Morris B. Mellion, M.D., who is clinical associate professor at the University of Nebraska Medical Center and medical director of the Sports Medicine Center, both in Omaha. "If it does, surgical drainage may be needed. But in its early stages, septic bursitis should respond well to antibiotics." If bursitis is caused by gouty arthritis, it can also be treated with medication. How can you tell if your bursitis is due to infection or gout? "The bursa is tender, warm and red," says Dr. Mellion. "But sometimes those signs won't be present, even though you have an infection there." So rather than trying to diagnose it yourself, you should get a doctor's advice when you have a flare-up of bursitis.

Try ice. "Ice reduces inflammation and pain by decreasing swelling," says Dr. Habusta. "You can use ice on a regular basis-there is no such thing as too much!

"But if the skin gets too cold, it could 'burn' and blister. To avoid that, place a terry cloth towel between the ice pack and the treatment site."

Warm up the compresses. Warm compresses might make bursitis feel better, says Dr. Richards. Place a damp, hot (but not too hot to handle--you don't want to burn the skin) towel on the area and leave it on as long as it feels comfortable.

Go for a cold/warm combo. The other option is to alternate ice and heat applications. Dr. Richards recommends cooling the area with ice for 15 minutes, then applying a warm compress for 15 minutes.

Wrap it Up. "An elastic bandage around a knee or another affected area might not make bursitis go away, but it may make it feel better," adds Dr. Richards.

Eliminate the cause. "You might have to cut out the activity that is causing the bursitis for a while," says Dr. Richards. "If you've been bowling, or painting, or doing anything else that uses the same joints over and over and you have pain in those areas, it's best to stop the activity until you're feeling better."

Limber up. "A great number of Americans think that building muscles is the best way to protect against problems such as bursitis," says Dr. Richards. "But that is not necessarily true. Staying limber through stretching is a better way to help you stay comfortable through your entire life."

Relax in a spa. "Anything that reduces the inflammation of the bursae will help bursitis," says Dr. Richards. "Soaking in a Jacuzzi or whirlpool will do this." So if you have access to either of these, give it a try.