Certain areas of the musculoskeletal system experience significant stress from everyday living. Fluid filled sacs, called bursae (bursa) cushion the bones, tendons and muscles near your joints. Unfortunately bursae can become inflamed and irritated and this is call bursitis. Bursitis often occurs near joints that perform frequent repetitive motion. The most common sites for this to occur are the hips knees, shoulders and elbows.
Diagnosis
The patient with bursitis will complain of well-localized pain in the shoulder, hips or other joints. The pain may travel from one of these areas into the arm or thigh. When the doctor examines the patient, he or she will look for swelling and tenderness over the locations of the bursa. Doctor can often diagnose bursitis based on the medical history and physical exam. If further testing is needed, the doctor my order x-rays. X ray images can’t positively establish the diagnosis of bursitis but they can help to exclude other cause of your discomfort. The bulk of bursa inflammation occurs in the soft tissue, which cannot be seen on X-ray.
Treatment
There are many treatment for bursitis. In the early stages, an anti-inflammatory drug will frequently help the problem. Ice should can also be applied over the inflamed area several times during the day to assist with swelling. It is important to rest the affected area. For example, avoid elbow pressure by not leaning on the elbow or if the right hip is affected, try to sleep on the left side. If these treatment strategies fail to work, the doctor may inject an anti-inflammatory drug and /or corticosteroid directly and into the bursa. These drugs are very useful for the relief of inflammation. These drugs generally bring rapid pain relief and in many cases, one injection is all you need. Although if more than one injection is needed, these medications can only be used a few times each year. Physical therapy may be ordered to strengthen the muscles in the affected area to ease pain and prevent recurrence. The physical therapist may use ultrasound and soft tissue manipulation that can sometimes be helpful. Sometimes an inflamed bursa must be surgically drained.
The Priority Health Spine Centers of Excellence program was created to ensure that all patients with persistent neck pain, back pain or other spine-related problems receive a comprehensive, non-surgical medical evaluation for their condition. For patients whose condition does not require urgent or emergent surgical intervention, an evaluation by a certified Priority Health Spine Center of Excellence is required prior to any referral to an orthopedic or neurosurgeon for back or neck care.
Tri-County Pain Consultants, PC is honored to be recognized by Priority Health as a Spine Center of Excellence for West Michigan. Our team of pain management specialists have a proven track record providing high quality medical care that meets and exceeds the strict criteria required by Priority Health for a Spine Center of Excellence designation.
Acupuncture
Acupuncture is the practice of using small needles inserted at very precise points on the body to promote natural healing and improve functioning. Acupuncture stimulates nerves, muscles and connective tissues, prompting increased blood flow to injured areas of the body, boosting the body’s natural healing process. Acupuncture provides a low risk treatment option that can be beneficial for pain syndromes due to an injury or associated with chronic degenerative diseases.
Cryoablation
Cryoablation is a procedure done in office that utilizes a specially equipped needle guided under fluoroscopy to freeze the area surrounding a nerve that is causing pain or discomfort. The goal of cryoablation is to interrupt the nerve’s ability to send pain signals to the brain and provide pain relief.
Discography
A discography is a diagnostic tool your pain management specialist may use to help determine the disc or discs that are the source of your pain. For this procedure, a contrast dye is injected into the gel like center of the suspected disc or discs, allowing your pain physician to see cracks or leaks in the disc membrane. Typically a patient receiving a discography will be given a local anesthetic or numbing agent. All discographies are performed by a certified pain management specialists under fluoroscopy.
IDET
IDET, or Intradiscal Electrothermal Therapy, is a procedure used to treat discogenic back pain. IDET involves the use a heated probe inserted into the gel like disc which heats up the inside of the affected disc. Heating the inside of the disc can destroy pain causing nerve fibers and seals any cracks or holes in the disc.
Intrathecal Pump Therapy
An intrathecal pump is an implanted medical device that delivers pain medication directly to the intrathecal space surrounding the spinal cord. An intrathecal pump is indicated in cases where patients have difficulty with oral medications or where previous pain interventions have been ineffective.
Kyphoplasty
Kyphoplasty is a procedure designed to help relieve pain caused by compression fractures of the spine. During a kyphoplasty procedure, a small tube is inserted into the fractured area. Once the tube is in place, the physician inflates a small balloon within the fractured area to raise the area, returning the broken pieces to a more normal position. The balloon is then deflated and the space is filled with a bone cement, effectively stabilizing the fractured area.
Manual Therapy
Manual therapy, or manipulative therapy, is a direct contact physical treatment used primarily to treat musculoskeletal pain and disability, intended to restore joint or soft tissue mobility. Treatment may include joint mobilization and manipulation, muscle stretching, and resistance therapy to advance muscle timing and activation.
Medication Management
Mecication Management is medical care provided by your pain management physician to optimize the use of prescribed medication to improve therapeutic outcomes for patients.
Nerve Block Technique
A procedure in which an anesthetic agent is injected directly near a nerve to block pain. A nerve block is a form of regional anesthesia.
Occupational Therapy
Occupational therapy is a task orientated treatment program designed to help patients regain their ability to perform daily living and work activities after serious illness injury or disability. Therapy focuses on the facilitation of daily tasks of self-care, work, and play/leisure activities, to help patients regain the ability to perform daily living and work activities.
Radiofrequency Lesioning
Radiofrequency lesioning is an advanced procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for 6–9 months. The procedure is typically most effective in treating joint pain in the spine.
Spinal Cord Stimulation
A spinal cord stimulator is a small electrical device implanted just under the skin in the lower back that delivers low level electrical signals to tiny electrodes implanted in the epidural space of your spine. These electrical pulses interrupt the pain signal from reaching your brain, replacing them with a mild tingling in the area where pain is felt. The device is controlled through a magnetic remote control, which allows patients the ability to turn the device on or off, and adjust the intensity as needed.
Stress Management
Stress management is clinical therapy designed to help individuals cope with or lessen the physical and emotional effects of strain and anxiety. Stress-management may include relaxation techniques, time-management skills, counseling or group therapy, exercise, and maintaining an overall healthy lifestyle.
