Bursitis is inflammation of the bursa, a sac-like membrane pouch that lubricates joints. There are 150 different bursae sacs throughout the body. Bursitis is caused by strenuous activity, heavy lifting, repetitive motion, or extended working in unusual positions. The most common joints affected are the shoulder, elbows, hips, and knees. Most bursitis will improve and go away on its own (although it may last several months), but chronic bursitis can lead to the formation of calcium deposits, which can cause stiffness and decreased motion of the joint.

Common Symptoms

• Pain in the joint
• Occasional swelling
• Decreased range of motion

Your Home Healing Action Plan for Bursitis

• If you have bursitis for more than one month, or it is chronic, go directly to step 4.

Step 1: Use the RICE Method

If you have recent onset or mild bursitis, use the RICE approach:

• Rest the joint: Avoid using it, especially for strenuous activities such as lifting (shoulder) or walking/climbing (knee, hip).
• Apply ice to the affected area: You can use commercial ice packs sold in drug stores or wrap a towel around some ice. Do not apply it for more than 20 minutes per hour.
• Compress the joint: Wrap the joint with an elastic bandage such as an ACE wrap, but don’t tighten it so much that you cut off blood circulation.
• Elevate the affected limb. Keep the joint elevated; for example, put your knee on some pillows.

Step 2: Take Bromelain, Curcumin, and Citrus Flavonoids to Promote Healing

In addition to step 1, start taking supplements of bromelain (250mg-750mg three times per day between meals) and curcumin (200mg to 400mg three times per day between meals), which can decrease inflammation and bruising. To cut healing time by half, add citrus flavonoids (5,600mg to 1,000mg three times daily) to these two supplements. You should feel better within one to three weeks.

Step 3: Take an NSAID If Pain and Swelling Continue

While the above measures are healing your bursitis, you may continue having pain aro swelling. If so, take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIOs), such as ibuprofen or naproxen (Aleve), which give you short-term pain relief and red inflammation while your tissues heal naturally. You should get some relief within a few days. If these are not effective, prescription NSAIDs (such as Naprosyn, Feldene, Daypro, Orudis, Mobic, Cataflam, Relafen, Arthrotec, and many more) may work. However, these drugs can cause stomach irritation and bleeding. If this occurs, try Cox-2 inhibitors, which have less risk of these side effects.

NOTE: Recent studies show an increased risk of heart attack in patients who use high-dose Cox-2 inhibitors along with naproxen (Aleve), so caution is advised. Also, if you have taken an NSAID (including ibuprofen) for a long time, it may precipitate a heart attack if you stop taking it suddenly. Obtain guidance from your doctor, especially if you have heart disease. All these drugs should be used short term to relieve pain and swelling while the following steps have time to work.

Step 4: Undergo Physical Therapy

If your symptoms have not responded to the first three steps within a few weeks, add physical therapy treatments. These include electrical stimulation (passing direct or alternating low-voltage current through the painful joint), ultrasound (high-frequency sound that provides heat to the deep tissues), and iontophoresis (application of a topical steroid solution through the skin into the affected joint). I also highly recommend infrasound, or low-frequency sound. Infrasound works by increasing the local circulation of blood and lymph, thereby accelerating the healing process. It not only can reduce pain, it can also decrease swelling. Infrasound is used by numerous chiropractors, naturopaths, acupunc­turists, and a few doctors.

Wait until any inflammation subsides before performing exercises. If your symptoms improve, you can then discontinue or reduce the drugs from step 3. You should start feeling better within one to two weeks.

Step 5: Undergo Acupuncture

If your bursitis persists after three to four weeks of physical therapy, I recommend acupuncture. Principal points depend on the particular joint involved. The Liver-Gall Bladder channels are important to treat because they control the tendons and sinews of the body. You should always seek evaluation and treatment from a practitioner certified in acupuncture.You should feel better within six acupuncture treatments, but you might need additional sessions to get maximum benefits.

Step 6: Undergo Low-Level Energy Laser Therapy

If acupuncture is not effective or only partially effective, I recommend low-level energy laser therapy, which appears to help heal the tissue, reduce the inflammatory response, and give long-lasting relief. These lasers are called “cold” lasers because they do not produce heat like the hot lasers used in surgical procedures do. Their primary side effect (in about 25 percent of patients) is that they cause a temporary increase in soreness, which may last one to three days. You should feel better within six to nine treatments. I often use this laser in conjunction with acupuncture for better and faster results. Because the low-level laser is currently a research device, it is unavailable to most doctors.

Step 7: Undergo Corticosteroid Injections

If your bursitis is still giving you problems, your doctor can give you a local injection of corticosteroids. Sometimes these injections will resolve your symptoms, but often they will give only temporary relief (a few days or weeks). If they work, they can be repeated if the pain recurs, but you should not have more than three to four per year because the steroids can soften the bone and damage the joint. If one injection is not helpful, further injections won’t work either, so discontinue the treatment.

Step 8: Surgery

Surgery to remove the offending bursa sac is a treatment of last resort. I have found surgery to help only a small percentage of people. It can cause permanent problems, such as decreased strength and range of motion.

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