Bursitis medical therapy: Difference between revisions
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==Overview== | |||
Medical therapy for traumatic bursitis includes the RICE regimen (rest, ice, compression, elevation), [[anti-inflammatory]] agents such as [[Aspirin]], [[Naproxen]], or [[Ibuprofen]], [[ultrasound]] therapy, and/or [[corticosteroid]] injections. Restriction of activity is encouraged to prevent further injury and promote healing. Antimicrobial therapy is administered for infectious bursitis. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Treatment focuses on healing the injured [[bursa]]. The first step is to reduce pain and inflammation with rest, compression, elevation, and [[anti-inflammatory]] medicines such as [[ | Treatment focuses on healing the injured [[bursa]]. The first step is to reduce pain and inflammation with rest, compression, elevation, and [[anti-inflammatory]] medicines such as [[Aspirin]], [[Naproxen]], or [[Ibuprofen]]. Ice may also be used in acute injuries, but many cases of bursitis are considered [[chronic]], and ice is not helpful. When ice is needed, an ice pack can be applied to the affected area for 15–20 minutes every 4–6 hours for 3–5 days. Longer use of ice and a stretching program may be recommended by a [[health care provider]]. | ||
Activity involving the affected [[joint]] is also restricted to encourage healing and prevent further [[injury]]. | Activity involving the affected [[joint]] is also restricted to encourage healing and prevent further [[injury]]. | ||
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[[Category:Inflammations]] | [[Category:Inflammations]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
[[Category:Primary care]] | [[Category:Primary care]] | ||
Revision as of 19:10, 21 August 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical therapy for traumatic bursitis includes the RICE regimen (rest, ice, compression, elevation), anti-inflammatory agents such as Aspirin, Naproxen, or Ibuprofen, ultrasound therapy, and/or corticosteroid injections. Restriction of activity is encouraged to prevent further injury and promote healing. Antimicrobial therapy is administered for infectious bursitis.
Medical Therapy
Treatment focuses on healing the injured bursa. The first step is to reduce pain and inflammation with rest, compression, elevation, and anti-inflammatory medicines such as Aspirin, Naproxen, or Ibuprofen. Ice may also be used in acute injuries, but many cases of bursitis are considered chronic, and ice is not helpful. When ice is needed, an ice pack can be applied to the affected area for 15–20 minutes every 4–6 hours for 3–5 days. Longer use of ice and a stretching program may be recommended by a health care provider.
Activity involving the affected joint is also restricted to encourage healing and prevent further injury.
The doctor or physical therapist may use ultrasound (gentle sound-wave vibrations) to warm deep tissues and improve blood flow. Iontophoresis may also be used. This involves using an electrical current to push a corticosteroid medication through the skin directly over the inflamed bursa. Gentle stretching and strengthening exercises are added gradually. Massage of the soft tissue may be helpful. These may be preceded or followed by use of an ice pack. The type of exercises recommended may vary depending on the location of the affected bursa.
If there is no improvement, the doctor may inject a corticosteroid medicine into the area surrounding the inflamed bursa. While corticosteroid injections are a common treatment, they must be used with caution because they may lead to weakening or rupture of the tendon (especially weight-bearing tendons such as the Achilles [ankle], posterior tibial [arch of the foot], and patellar [knee] tendons). If there is still no improvement after 6-12 months, the doctor may perform either arthroscopic or open surgery to relieve pressure on the bursae, although this is rare.
If the bursitis is caused by an infection, the doctor will prescribe antibiotics.
Antimicrobial Regimen
- Olecranon bursitis or prepatellar bursitis [1]
- 1. Staphylococcus aureus, methicillin-susceptible (MSSA)
- Preferred regimen (1): Nafcillin 2 g IV q4h
- Preferred regimen (2): Oxacillin 2 g IV q4h
- Preferred regimen (3): Dicloxacillin 500 mg PO qid
- 2. Staphylococcus aureus, methicillin-resistant (MRSA)
- Preferred regimen (1): Vancomycin 1 g IV q12h
- Preferred regimen (2): Linezolid 600 mg PO qd
References
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.