Bursitis

Soft Tissue Injuries. Some of the more common soft tissue injuries are sprains, strains, contusions, tendonitis, bursitis, and stress injuries, caused by damaged tendons, muscles, and ligaments. A sprain is a soft tissue injury to the ligaments. Certain sprains are often associated with small fractures. This type of injury is normally associated with a localized trauma event. The severity of the sprain depends on how much of the ligament is torn and to what extent the ligament is detached from the bone. The areas of the human body that are most vulnerable to sprains are ankles, knees, and wrists. 

A bursa, a sac filled with fluid located around a principal joint, is lined with a synovial membrane and contains synovial fluid. This fluid minimizes friction between the tendon and the bone, or between tendon and ligament. Repeated small stresses and ovemse can cause the bursa in the shoulder, hip, knee, or ankle to swell. This swelling and irritation is referred to as bursitis. Some patients experience bursitis in association with tendonitis. Bursitis can usually be reheved by rest and in some cases by using antiinflammatory medications. Some orthopedic surgeons also inject the bursa with additional medication to reduce the inflammation. 

Commercially available electrotransport systems are bulky and limited to acute appHcations (96). One example, the Drionic system used for the treatment of hyperhidrosis (excessive perspiration), is presoaked in water for 30 min before each 20- to 30-min treatment. Another system, the Phoresor, approved for the deHvery of Hdocaine [137-58-6] for local anesthesia, and of dexamethasone [50-02-2] for treatment of local inflammation such as bursitis or tendinitis, is powered by a 9 V replaceable battery and features a disposable, fiHable dmg electrode. 

The corticosteroids may be used to treat rheumatic disorders such as ankylosing spondylitis, rheumatoid arthritis, gout, bursitis (inflammation of the bursa, usually the bursa of the shoulder), and osteoarthritis. 

Short-term management of acute ankylosing spondylitis, acute and subacute bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, psoriatic arthritis, rheumatoid arthritis, post-traumatic osteoarthritis, synovitis of osteoarthritis, epicondylitis... 

Naproxen is used to relieve fever, pain, and symptoms of arthritis, gout, bursitis, and menstrual cramping. 

The musculoskeletal system consists of the muscles, bones, joints, tendons, and ligaments. Disorders related to the musculoskeletal system often are classified by etiology. Acute soft-tissue injuries include strains and sprains of muscles and ligaments. Repeated movements in sports, exercise, work, or activities of daily living may lead to repetitive strain injury, where cumulative damage occurs to the muscles, ligaments, or tendons.1-3 While tendonitis and bursitis can arise from acute injury, more commonly these conditions occur as a result of chronic stress.3,4 Other forms of chronic musculoskeletal pain, such as pain from rheumatoid arthritis (see Chap. 54) or osteoarthritis (see Chap. 55), are discussed elsewhere in this text. 

Bursitis is an inflammation of the bursa, the fluid-filled sac near the joint where the tendons and muscles pass over the bone. The bursa assists with movement by reducing friction between joints. Tendonitis (also known as tendinitis) is an inflammation of the tendon or, more specifically, the fibrous sheath that attaches muscle to bone.3 Tenosynovitis is an inflammation of the tendon sheath. 

Repeated use also may cause degradation of collagen.17 In fact, many patients diagnosed with chronic tendonitis may not have inflammation but instead have tendinosis, a condition marked by these collagen changes. Overuse of a joint also can result in an inflamed bursa. Since the bursa serves to reduce friction within the joint space, bursitis causes stiffness and pain. 

In some cases, muscle pain, edemas in extremities, bursitis in the area of large joints are observed. Severe cases of acute poisoning may lead to anemia, leukopenia and even pancytopenia. 

Burserelin, registered for use in aquaculture in Europe, 3 220t Bursitis, 3 724, 725... 

Rheumatic disorders Adjunctive therapy for short-term use (acute episode or exacerbation) in psoriatic arthritis rheumatoid arthritis (RA), including juvenile RA ankylosing spondylitis acute and subacute bursitis acute, nonspecific tenosynovitis acute gouty arthritis posttraumatic osteoarthritis synovitis of osteoarthritis epicondylitis. 

Acute painful shoulder (bursitis or tendinitis) - 75 to 150 mg/day in 3 or 4 divided doses. Discontinue the drug after inflammation has been controlled for several days. Usual course of therapy is 7 to 14 days. 

Rheumatoid arthritis, osteoarthritis, ankyiosing spondyiitis, pain, dysmenorrhea, acute tendinitis, and bursitis ... 

Acute painful shoulder (acute subacromial bursitis/supraspinatus tendinitis) and acute gouty arthritis - 200 mg twice/day. After satisfactory response, reduce dosage accordingly. 

The sahcylates are useful in the treatment of minor musculoskeletal disorders such as bursitis, synovitis, tendinitis, myositis, and myalgia. They may also be used to relieve fever and headache. They can be used in the treatment of inflammatory disease, such as acute rheumatic fever, rheumatoid arthritis, osteoarthritis, and certain rheumatoid variants, such as ankylosing spondylitis, Reiter s syndrome, and psoriatic arthritis. However, other NS AIDS are usually favored for the treatment of these chronic conditions because of their lower incidence of GI side effects. Aspirin is used in the treatment and prophylaxis of myocardial infarction and ischemic stroke. 

The prototypes of this large class of NSAIDs are in-domethacin and ibuprofen. These drugs are indicated for the relief of acute and chronic rheumatoid arthritis and osteoarthritis. In addition, a number of drugs of this class are also useful in ankylosing spondylitis, acute gouty arthritis, bursitis, and tendinitis. 

Mild to moderate pain, Bursitis, tendinitis PO Initially, 500 mg naproxen (550 mg naproxen sodium), then 250 mg naproxen (275 mg naproxen sodium) q6-8h as needed. Maximum 1.25 g/day naproxen (1.375 g/day naproxen sodium). Naprelan 1,000 mg once a day. 

Acute shoulder pain, gouty arthritis, bursitis, tendinitis PO 200 mg twice a day... 

It is indicated in osteoarthritis, rheumatoid arthritis, musculoskeletal disorders, primary dysmenorrhoea, acute gout, pelvic inflammation, ankylosing spondylitis, tooth extraction, tendinitis, bursitis and juvenile arthritis. 

It is indicated in the treatment of a variety of painful inflammatory conditions, including osteoarthritis, oncology, postopera-tively, trauma, sports injuries, ear, nose and throat disorders, dental surgery, bursitis/ tendinitis, thrombophlebitis, upper airways inflammation and gynaecological disorders. Nimesulide has shown to be well tolerated even by aspirin sensitive asthmatic patients. 

Scapulohumeral periarthritis, periarthritis of hip, bursitis, tendinitis, synovitis, tenosynovitis, tarsalgia, metatarsalgia, epicondylitis, Du-puytren s contracture, Peyronie s disease, cystic tumors of aponeurosis or tendon (ganglia). 

Inflammatory conditions of bones and joints Arthritis, bursitis, tenosynovitis... 

Physical therapists may encounter the use of local anesthetics in several patient situations because of their various clinical applications. For example, therapists may be directly involved in the topical or transdermal administration of local anesthetics. As discussed earlier, repeated topical application of local anesthetics may help produce long-term improvements in motor function in patients with skeletal muscle hypertonicity, so therapists may want to consider incorporating topical anesthetics into the treatment of certain patients with CNS dysfunction. Therapists may also administer local anesthetics transdermally, using the techniques of iontophoresis and phonophoresis. Agents such as lido-caine can be administered through this method for the treatment of acute inflammation in bursitis, tendinitis, and so on. 

Problem/lnfluence of Medication. During the initial physical therapy evaluation, the therapist asked if the patient was taking any medication for the bursitis. The patient responded that he had been advised by the physician to take aspirin as needed to help relieve the pain. When asked if he had done this, the patient said that he had taken some... 

Lidocaine Soft-tissue pain and inflammation (e.g., bursitis, tenosynovitis] Local anesthetic effects (see Chapter 12] 4°/o-5°/o solution or ointment from positive pole 5°/o ointment... 

There are many types of steroid hormones in the body, such as the sex/gonadal hormones testosterone and estrogen, thyroid hormones, growth hormones, and stress hormones, which serve various normal functions. One type of steroid— corticosteroids or glucocorticoids—is secreted by the adrenal glands (located just above the kidneys). These steroids, particularly synthetic versions of them, have powerful antiinflammatory actions that help to relieve pain. They are often given as an epidural injection to relieve neck or back pain that results from a compressed or pinched nerve. They can also be injected directly into a joint to relieve pain caused by inflammation in conditions such as tendonitis (inflammation of the tendons), carpal tunnel syndrome, tennis elbow, bursitis (inflammation of sac-like cavities in tendons or muscles that allow them to slide easily over bone), or other joint pain. Professional athletes, who routinely experience one or more of these conditions, are often given local steroid injections. Frequently, the steroid is combined with a local anesthetic such as lidocaine. 

Dexamethasone 392 Cation Tendonitis, bursitis, arthritis, tenosynovitis 24... 

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