A bursa is a small sac that lies between tissues to allow tendons to move smoothly over other tissues. A normal bursal sac is usually collapsed with little or no fluid in it. When overuse occurs the bursa can become inflamed and filled with fluid. The area can be exquisitely tender to touch and very painful to move the corresponding body part. Treatment is directed toward decreasing the inflammation. This can be achieved by oral anti-inflammatory medications, local application of ice, or through different modalities in physical therapy. These might include ultrasound, phonophoresis/ iontophoresis (cortisone applied topically via ultrasound or electrical current). The strongest anti-inflammatory is cortisone given by injection directly into the bursa. It is imperative to stop the aggravating activities that led to the bursitis to allow for adequate healing. Exercises are also prescribed to rehabilitate the involved muscles and tendons and help prevent recurrences.
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