Bursitis: An overview of clinical manifestations, diagnosis, and management
Evaluation of elbow pain in adults
Approach to the adult with unspecified knee pain
Evaluation of the adult with hip pain
Evaluation of the patient with shoulder complaints
Overview of running injuries of the lower extremity
Overview of soft tissue rheumatic disorders
Greater trochanteric pain syndrome (formerly trochanteric bursitis)
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Applying ice is often recommended for bursitis. Icing constricts local blood vessels and temporarily decreases the blood flow, thus can be useful for controlling acute local inflammation. We also use a traditional heat therapy called moxibustion . In many cases, muscles around the inflamed hip joint and tendons are actually in an ischemic state (poor flow of blood and oxygen). Application of localized heat on specific acupuncture points is used to enhance blood flow and reduce the muscle tension. Therefore, with careful selection of acupuncture points, moxibustion heat therapy can be effectively used for bursitis during both acute and chronic stages.
The treatment of any bursitis depends on whether or not it involves infection. Noninfectious or aseptic hip bursitis can be treated with ice compresses, rest, and anti-inflammatory and pain medications. Occasionally, it requires aspiration of the bursa fluid. This procedure involves removal of the fluid with a needle and syringe under sterile conditions. It can be performed in the doctor’s office. Sometimes the fluid is sent to the laboratory for further analysis. Frequently, there is inadequate fluid accumulation for aspiration. Noninfectious hip bursitis can be treated with an injection of cortisone medication, often with an anesthetic, into the swollen bursa. This is sometimes done at the same time as the aspiration procedure.