About a year ago, Lisa Marinelli says she got off a stationary bike and experienced a pain that she’d never felt before, radiating from her left hip, which progressively — and very quickly — got worse. She thought at first that maybe she’d pulled a muscle and hoped her discomfort would subside.
Instead, the active 51-year-old from Scarsdale, New York, found herself physically lifting her leg to get in and out of her car, and waking up to severe pain. “I got out of bed and it was excruciating. It took like a half-hour of icing and heating before I could start my day,” Marinelli says. The pain began keeping her up at night, too.
On a recommendation from an orthopedic surgeon friend, Marinelli saw Dr. Dennis Cardone, a sports medicine specialist and chief of primary care sports medicine at NYU Langone Medical Center in New York City. He diagnosed her with bursitis.
Like arthritis and tendinitis, this common source of discomfort, which affects millions in the U.S. annually — particularly older individuals, including those seeking to stay active — traces back to irritation or inflammation in the joints. However, unlike arthritis and tendinitis, which involves the irritation or inflammation of a tendon, onset occurs swiftly, whether in the shoulder, elbow or hip — three joints bursitis commonly affects, or another joint. “It was a pain all over that I couldn’t believe,” Marinelli says. “It came out of nowhere. It didn’t even build up. It just happened.”
Bursitis owes its name to tiny fluid-filled sacs called bursa, located in joints large and small throughout the body. These bursa help make movement smoother, by providing cushion to reduce friction in joints, where bone, muscles and tendons converge. “So, it really provides for gliding of muscle and tendon over a bony prominence,” explains Cardone, who is also an associate professor in the department of orthopedic surgery at NYU Langone.
For many, bursitis just causes some joint tenderness, which subsides on its own over time, he says. Experts say often giving the joint a break, such as not kneeling on an affected knee or leaning on an elbow with bursitis, along with modifying or limiting other activities that involve repetitive use of the joint, can help. Couple that with over-the-counter pain medicine, as needed, and that’s typically sufficient to address the issue. In some cases, Cardone says, bursitis proves asymptomatic — and it’s only discovered accidentally, such as during an MRI, if it’s detected at all.
But frequently, as in Marinelli’s case, the pain can prove more substantial. As a result, bursitis can stand in the way of everything from gardening and running to physical work, such as painting that requires reaching overhead, says Dr. Brandee Waite, a rehabilitation specialist, and an associate professor of physical medicine and rehabilitation at UC Davis School of Medicine in Sacramento, California.
Often other issues, such as tendinitis may occur in the same joint, Waite says. That can compound problems.
In addition to rest and over-the-counter acetaminophen like Tylenol to address the discomfort and quell inflammation in the bursa, doctors may recommend an anti-inflammatory medicine, such as ibuprofen or naproxen. Experts say it’s important to see a doctor if problems don’t resolve with such interventions for a proper diagnosis — bursitis and tendinitis can be confused — and to discuss further treatment.
“You could try modifying activity, a short course of an inflammatory medicine, a stretching and strengthening program, or a physical therapy program, and in some cases, that might be enough,” Cardone says. “Typically, if that doesn’t do it, then you can move on to a cortisone injection.” An injection goes directly into the affected bursa. “In most cases, it can be a long-term fix,” he says. That differs from treatment for some other common conditions affecting joints, like arthritis, which routinely involve ongoing therapies.
In the most severe, persistent cases, surgery may be recommended to remove the affected bursa. “But it’s not typical,” Cardone says.
Marinelli says undergoing physical therapy, doing stretches and modifying her daily activity — including reducing how often she rides the stationary bike — along with receiving two cortisone injections from Cardone since he diagnosed her with bursitis last fall has worked well to treat her bursitis. That’s allowed her to get back to her active lifestyle without significant pain. Though she still experiences mild discomfort in her hip, which radiates to her knee, she says it pales in comparison to the pain she originally felt. “It’s not keeping me from doing anything that I want to do, that’s for sure,” she says. “I spin, I lift, I walk, I train, I do [the] elliptical. I stay pretty active and I try [to] workout five to six times a week.”
In May, she joined more than 30,000 pedaling enthusiasts for a 50-mile bike ride in New York City: the Five Boro Bike Tour. “I had a great day … no issues,” Marinelli says. She was also able to hike and horseback ride when she traveled to Jackson Hole, Wyoming, over the summer. “I never would have been able to do that,” she says, had she not gotten treatment for her bursitis.
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Another Pain in the Joint: What to Do About Bursitis originally appeared on usnews.com
