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Sunday, February 22, 2009

Some aspects of “Bursitis” with homoepathic mode of treatment

Bursitis is inflammation of a bursa. A bursae is a cushion like sac lined with membrane similar to synovium which is located between a tendon & a bone thus reducing friction between them & allowing the tendon to glide easily over the bone. When subjected to repeated pressure due to over & abnormal use it gives rise to bursitis.

Site of lesion-
Bursitis most often occurs in –
(1) Shoulder .
(2) Elbow.
(3) Knee.
(4) Hip.

Causative factors-
(1) Overexertion of a joint. The repeated motion of a joint causes friction in the bursa. Subsequently, with continuation of activity, the bursa becomes inflammed & filled with fluid. The bursa thickens & does not function well. Both the bursa & the tendon become irritated.
(2) Occasionally a bursa will become infected by haematogenous spread or due to open trauma to the overlying skin or blow to an area containing a bursa.

Clinical features-
Presentation -The patient presents with complain of pain, stiffness of a joint along with malaise & possibly fever.
(1)Pain, tenderness & redness of the area of the affected bursa .
(2) Swelling & warmth around the area of the bursa.
(3)Restricted movement of the nearby joint with the subsequent result of restricted function of the affected limb.

Differential Diagnosis- Bursitis has to be differentiated from acute exacerbations of rheumatism & flare-ups of gout both of which clinically manifest with significant erythema & swelling.

[A] General measures to be taken are-
(1)Rest to the affected area & protecting the area from any kind of trauma.
(2)Exercise & application of heat.
(3) Stopping of the activity causing pain if the bursitis is a chronic one.
Homeopathic medicines to be used are-
Benzoicum acidum ( It acts well when the pain is tearing with stitches & the adjacent joint cracks on movement.
Bryonia- It may be used when the adjacent joint is stiff & painful & the pain is of stitching or tearing type & becomes worse from even the slightest motion.
Belladonna (Bell)-It acts well when there is shooting pain along limbs.
Rhus tox -This remedy is particularly helpful where there is pain on initial movement which gradually improves with movement. The pain may also be worse during sleep & in the morning on waking.
Silicea (Sil)- It acts well when the pain seems to be tightly bound & the sensation seems to be suppurating. Ruta graveolens(Ruta) – This remedy is particularly useful for bursitis after any injury. It is also helpful in acute bursitis with great stiffness & aching pain.

Some points to be kept in mind-
(1) The potency & frequency of dosage varies with the severity of the condition & the individual. Usually a lower potency like 30C is to be used first for thrice daily & to be continued till the persistence of the symptoms. If improvement is seen, the same medicine is to be continued. But if there is no significant improvement or improvement has come to a standstill, the frequency of dosage should be increased. And in cases where there is no response within a reasonable amount of time, the medicine should be stopped & a different medicine is to be started.
(2) If bursitis is caused by an infection, the infection should be combated first in addition to treatment of bursitis.
(3) If bursitis is related to any inflammatory condition such as arthritis, or gout, the disease is to be treated also for control bursitis.

(1)Wearing of protective pads if participating in contact sports.
(2)No overdoing of any kind of sports & activities & that too to be done correctly.

Prognosis- In general, bursitis has a favourable result if treated early but if the underlying cause is not removed properly it may develop into a chronic condition.

In short, bursitis manifests itself as a tender, warm, swelling adjacent to a joint & can be treated by Benz।ac, Bryonia, Rhus tox, Ruta or Silicea.

But in every case, a doctor should be consulted.

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