Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

Bursitis is an inflammation of a small, flat sac that contains a minute quantity of fluid to cushion or lubricate the muscles and tendons, promoting smooth functioning of these structures. After middle age, the tendons are prone to degenerative changes. These sacs, located around the shoulders, knees, elbows, and other joints, begin to get calcium deposited in the area of the degenerating tendons and cause inflammation. Women get bursitis more than men because their shoulders slope more sharply. The sloping causing increased pressure. Heavy lifters and sedentary workers are most prone to bursitis.

‍Try the following instructions:

• Avoid injury to the joints that are especially vulnerable to bursitis. A strain, a direct blow, the stress of overweight, unusual shoulder or knee motions such as from painting, swimming, lifting heavy objects at arm's length, etc., may precipitate bursitis.
• Allergies and infections in the body elsewhere may precipitate bursitis. Live at a high level of health to avoid bursitis.
• Do not allow excessive fatigue to develop while doing an unusual motion to which you are unaccustomed. When heavy objects must be taken in the hand for some distance, the best position is in front of one, using both hands, holding the object somewhat like a tray.
• Do not allow chilling of the extremities, particularly the shoulders, which are especially vulnerable at night. Be careful to wear warm sleepwear.
• Never begin heavy work until you have "warmed up'' by doing some light work.

Use these treatments for bursitis:

• Ice compresses to the affected area, especially in the acute phase. Keep the ice on for about 5-7 minutes. Remove for 1 minute, and repeat 3 times.
• Hot and cold compresses are sometimes helpful in relieving the inflammation. Three minutes of hot compresses as hot as can be tolerated, should be followed immediately by a 20-second ice water compress. Repeat 4 times. Give the treatment 3-4 times daily.
• Do not use deep massage as it may increase inflammation.
• A short period of complete rest for the part may decrease the inflammation. Do not prolong a period of inactivity, as a stiff joint may result.
• Exercises: Do these after any hot or cold treatments:
• Wall-walking exercise: Face the wall at arm's length and lean into your hands placed against the wall. Starting slightly above the level of the water, walk hand over hand as high as you can reach without pain. As you make progress, reach higher each time before pain or tightness stops you. Repeat the exercise four times daily.
• Stooping arm swing: Bend forward at the waist until the chest is parallel to the floor. Let your affected arm and hand relax and swing from the shoulder. Using your shoulder as a pivot, make a motion with your trunk that causes your arm and hand to swing in a circle. The more you improve, the larger the circle you can make without discomfort.
• Standing arm swing: Slowly extend the affected arm back and up. Raise it outward and up. Repeat this exercise for 10 minutes using the opposite hand and arm as a symmetrical balance.
• Rig up an overhead pulley with a 5-pound weight on a rope. Pull down on the rope and then allow it to pull the arm up as far as it will go. Start out with 5 pulls 3 times a day, and gradually work up to 50, 3 times daily.
• Continue the usual, accustomed activities as permitted by the pain or stiffness.