From the Guidelines
Bursitis should be treated with rest, ice, and over-the-counter pain relievers like ibuprofen (400-800mg three times daily) or naproxen (220-500mg twice daily) for 1-2 weeks, as this approach has been shown to be effective in managing symptoms and improving quality of life 1.
Diagnosis and Treatment
Bursitis is inflammation of a bursa, a fluid-filled sac that cushions joints, muscles, and tendons. The diagnosis of bursitis typically involves a physical examination and medical history, and in some cases, imaging tests such as MRI or ultrasound may be used to confirm the diagnosis 1.
Treatment Options
Treatment for bursitis usually involves a combination of non-pharmacological and pharmacological approaches. Non-pharmacological approaches include:
- Rest and ice to reduce inflammation and pain
- Physical therapy exercises to strengthen surrounding muscles and prevent recurrence
- Avoiding activities that worsen pain and using padding or supports for affected areas Pharmacological approaches include:
- Over-the-counter pain relievers like ibuprofen or naproxen
- Corticosteroid injections directly into the bursa for persistent pain
Prevention Strategies
Prevention strategies for bursitis include:
- Proper warm-up before exercise
- Using appropriate equipment
- Maintaining good posture
- Taking regular breaks during repetitive activities It is essential to seek medical attention if symptoms persist or worsen over time, or if there are signs of infection, such as severe pain, redness, warmth, or fever 1.
From the FDA Drug Label
Naproxen tablets are also indicated: For relief of the signs and symptoms of tendonitis For relief of the signs and symptoms of bursitis The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. The initial total daily dose should not exceed 1250 mg of naproxen. Thereafter, the total daily dose should not exceed 1000 mg of naproxen. The diagnosis of bursitis is not explicitly stated in the provided drug labels. The treatment for bursitis (inflammation of the bursae) is naproxen, with a recommended starting dose of 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required, not to exceed 1000 mg per day 2.
From the Research
Diagnosis of Bursitis
- The diagnosis of bursitis is usually based on clinical presentation, with a particular focus on signs of septic bursitis 3
- Ultrasonography can help distinguish bursitis from cellulitis 3
- Blood testing (white blood cell count, inflammatory markers) and magnetic resonance imaging can help distinguish infectious from noninfectious causes 3
- If infection is suspected, bursal aspiration should be performed and fluid examined using Gram stain, crystal analysis, glucose measurement, blood cell count, and culture 3
Treatment of Bursitis
- Conservative measures, such as rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and stretching exercises, are often effective in treating bursitis 4, 5, 6
- Corticosteroid injections may be used to treat bursitis, especially in cases of trochanteric bursitis 4 and chronic inflammatory bursitis 3, 7
- Antibiotics are used to treat septic bursitis, with surgery reserved for cases that do not respond to antibiotics or are recurrent 3, 7
- Surgical intervention may be required for recalcitrant bursitis, such as refractory trochanteric bursitis 6
- Treatment of bursitis depends on the type of bursitis, with acute traumatic/hemorrhagic bursitis treated conservatively, and chronic microtraumatic bursitis treated by addressing the underlying cause 3