Q: I am 67 and was diagnosed approximately two months ago with bursitis. I have some good days and some bad ones. Are there any other treatments available besides injections?
A: Bursitis commonly occurs in the shoulder, elbow and hip areas of the body; however, it can also be present in the knee, heel and base of the great toe. The condition may be the result of excessive pressure, trauma, overuse and repetitive movement. Other possible causes may include having rheumatoid arthritis, scleroderma, gout, systemic lupus erythematosis, and more. The purpose of the small fluid-filled sacs (bursae) at joint areas is to cushion bones, tendons and muscles; the condition known as bursitis is the result of inflammation of those mall fluid-filled sacs.
Bursae are lined with a synovial membrane that secrete lubricating synovial fluid and allow healthy bursae to create a smooth gliding surface when an individual moves the affected joint. In the instance of bursitis, however, the inflammation present prohibits easy, pain free movement and instead causes pain and stiffness.
Symptoms of bursitis may include the joint pain and inflammation mentioned, as well as restricted range of motion, stiffness and a feeling of warmth when movement is attempted. The pain experienced increases in intensity with movement, exercise and activity of the affected joint.
Treatment is often in the form of rest, ice, elevation, anti-inflammatories and pain medication. Should the bursae be infected, antibiotics may be ordered. As you apparently have discovered, injected corticosteroids are often prescribed in an effort to reduce the pain and inflammation present. While repeat injections may be allowed on a very restricted basis, they are not endorsed for chronic use because of the potential side effects, yet it is generally felt that low, intermittent doses pose little risk of significant side effects.
You don’t mention where the bursitis is. Nonetheless, options to injections might include physical therapy at your local hospital or clinic and range of motion exercises. It goes without saying that resting the affected joint as much as possible to allow it to heal on its own, using over-the-counter anti-inflammatory drugs, and applying cold compresses are all essential since lastly and when all else fails, surgery may follow.
Speak with your primary care physician to get an idea of what might be the best option(s) for you based on your physical condition and other possible health issues. He or she may also have other options for your consideration such as acupuncture. If you are dissatisfied with the options presented, request a referral to an orthopedic specialist who just might have a trick or two up his or her sleeve that will get you on the road to recovery.
