Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, May 7, 1990 TAG: 9005050224
SECTION: EXTRA PAGE: E-1 EDITION: METRO
SOURCE: Jane Brody
DATELINE: LENGTH: Medium
At times, in fact, the pain can be so bad that the sufferer may be unwilling or unable to move the affected joint.
Medically, the conditions are PERSONAL HEALTH JANE E. BRODY known as bursitis or tendinitis. Both involve inflammation of soft tissues surrounding a joint.
In the case of bursitis, the tissue affected is the bursa, a small sac that normally acts as a cushion under a muscle or tendon where it crosses another muscle or a bone.
In tendinitis, the inflammation affects a tendon, the fibrous cord that attaches muscle to bone.
As if trouble with one were not enough, both the bursa and tendon in a joint can become inflammed simultaneously.
Although the conditions are less likely to afflict people under the age of 30, those who actively pursue a particular sport or whose jobs involve repetitive movements (like continually operating a gear shift) can develop bursitis or tendinitis at any age.
These conditions are related to arthritis, but there are two important differences.
Arthritis tends to be a permanent condition that affects several or all parts of the body, but bursitis and tendinitis usually affect only one joint and result in only temporary discomfort, especially if the movement that caused them is stopped or modified.
Bursitis and tendinitis tend to be associated with occupations or activities that demand frequent repetitions of the same joint movement. In effect, they represent joint abuse.
Most tennis players are painfully aware of the risk to the elbow of their playing arm.
Many factors contribute to the form of bursitis known as tennis elbow, but some people's joints are naturally prone to injury, and if they play often or long enough, they will develop tennis elbow.
Sensibly handled, bursitis and tendinitis usually disappear within days or weeks and rarely leave lasting damage. However, even with proper treatment, they can recur in the same joint or in different joints.
Specific treatment is determined by the joint that is affected. However, for virtually all forms of bursitis and tendinitis, there is a standard remedy: aspirin or a comparable pain reliever with anti-inflammatory properties.
The medication is usually taken in the largest dose a person can tolerate (usually two tablets six times a day, but check first with your physician, since you may have other health problems that make such treatment hazardous).
If over-the-counter medication is not adequate, prescription drugs like a nonsteroidal anti-inflammatory or a cortisone-type drug can be used.
Sometimes cortisone is injected directly into the inflammed joint. Although the injection can bring dramatic relief, repeated injections can lead to joint deterioration, so they are best reserved for severely painful attacks or attacks that require immediate resolution.
At first, you would be wise to rest the painful joint for a few days, for example, by not playing tennis or by putting your arm in a sling to immobilize a painful shoulder. Then you should start specific exercises to maintain mobility of the joint and strengthen the muscles that support the joint.
A physical therapist can be a great help with exercises and, in the case of tennis elbow, a few professional lessons may be needed to improve your stroke and prevent a recurrence.
A physical therapist may also try deep massage to relieve tendinitis in the ankle, shoulder or elbow.
As for applying heat or cold, icing an inflammed joint for 20 minutes at a time three or four times a day is often recommended for the first 48 hours. Thereafter apply heat - moist heat is best, and even a hot shower can help - for 15-minute intervals three times a day. A physician or therapist may also recommend ultrasound, which is a deep-heat treatment.
People suffering from inflammed joints typically start with self-treatment.
But if no improvement is noted within a few days, a visit to the doctor is advisable.
Also see a doctor if the pain is severe and interferes with normal activities like work or sleep, if an inflammed shoulder becomes "frozen" and cannot be moved or if the affected joint is visibly swollen.
by CNB