Bursitis
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Diagnosing bursitis typically involves a combination of clinical assessment, medical history review, physical examination, and occasionally, diagnostic tests to confirm the diagnosis and rule out other conditions. Here’s an overview of the diagnostic process for bursitis:
1. Medical History: The doctor will begin by discussing the patient’s symptoms, including the location, duration, and severity of pain or discomfort. They may inquire about any recent activities or injuries that could have triggered the symptoms.
2. Physical Examination: A thorough physical examination follows, focusing on the affected joint. The doctor will assess for signs of inflammation, such as swelling, tenderness, warmth, and changes in range of motion. They may also palpate the area to identify specific points of tenderness.
3. Diagnostic Tests: While most cases of bursitis can be diagnosed based on medical history and physical exam findings, additional tests may be ordered to confirm the diagnosis or rule out other conditions:
- Imaging Studies: X-rays can help detect calcium deposits or assess joint alignment, while ultrasound or MRI scans may provide detailed images of soft tissues and fluid-filled bursae.
- Aspiration: In cases where infection or a more complex condition is suspected, the doctor may perform a bursa fluid aspiration (joint fluid aspiration). This involves using a needle to withdraw fluid from the bursa for analysis, checking for signs of infection or inflammatory markers.
4. Laboratory Tests: Blood tests are generally not needed for routine bursitis diagnosis, but they may be performed if there is suspicion of infection (septic bursitis) or an underlying inflammatory condition.
Once diagnosed, treatment for bursitis focuses on relieving symptoms, reducing inflammation, and addressing any underlying causes or contributing factors.
Treatment
Treating bursitis aims to alleviate symptoms, reduce inflammation, and prevent recurrence, tailored to the severity of symptoms and underlying causes. Here are the primary approaches medical professionals use in managing bursitis:
1. Rest and Activity Modification: Initially, reducing or avoiding activities that exacerbate symptoms can help alleviate pain and allow the inflamed bursa to heal. Resting the affected joint and modifying activities to minimise repetitive movements or pressure can be crucial.
2. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are commonly prescribed to reduce pain and inflammation associated with bursitis. In some cases, corticosteroid injections directly into the affected bursa may be recommended to provide more targeted and immediate relief.
3. Physical Therapy: Physical therapists design specific exercises to improve flexibility, strength, and range of motion around the affected joint. They may also use modalities like ultrasound or ice therapy to reduce inflammation and promote healing.
4. Supportive Measures: Using supportive devices like splints or braces can help protect the affected joint and reduce strain on the bursa during activities. Assistive devices may also be recommended to modify daily tasks and minimise discomfort.
5. Aspiration and Drainage: If bursitis is accompanied by significant fluid accumulation (effusion), the doctor may perform aspiration—using a needle to drain excess fluid from the bursa. This can relieve pressure and pain, especially in cases of acute or septic bursitis.
6. Surgical Intervention: In rare cases where conservative treatments fail or if there is chronic bursitis causing persistent symptoms and joint damage, surgical removal of the affected bursa (bursectomy) may be considered. This procedure aims to alleviate symptoms and prevent recurrence.
7. Lifestyle Modifications: Educating patients about proper body mechanics and ergonomic practices can help prevent bursitis from recurring. Maintaining a healthy weight and incorporating joint-friendly exercises can also support long-term joint health and reduce the risk of future flare-ups.