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Doctors' Answers to "Frequently Asked Questions" - Bursa


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Treatments
Question: If a bursa has been aspirated with almost no success and the bursa remains swollen to almost golf ball size, what are other treatments or medications. I have already had iv antibiotics which reduces swelling around the swollen bursa which is still hot and very red.

Answer: After the aspiration comes injecting of steroids. This will help only if there is no infection in the bursal fluid. Infection is a contraindication for intrabursal steroids. If the problem persists and/or reoccurs surgery to remove the bursa is occasionally necessary.

Cushion Displacement
Question: A portion of the bursus Cushion in my shoulder has been damaged and now sits on top of my shoulder instead of inside the socket. Is there a way to get the Cushion back to where it belongs. It causes a lot of discomfort.

Answer: Bursal sacs are structures that put out and absorb fluid, and thereby serve to cushion and/or provide a lubricating mechanism between skin, bones, ligaments, tendons and muscles. There are over 150 bursal sacs throughout the human body, but a new one can form in any area subjected to repeated stress or friction. This is especially the case if the normal anatomic structures or their relationship to one another has been altered, for example, after an injury. Injury or inflammation of the bursa (ýbursitisţ), can cause extreme pain (particularly with movement in the affected area), redness, swelling, and on occasion, symptoms involving nearby nerve structures. An important part of a physicianÝs evaluation of a possible bursitis is to investigate the possibility that the patientÝs symptoms are truly due to the bursa, and not due to other conditions often seen along with a bursitis (such as arthritis, tendon or ligament injury muscle strain or sprain, or even fracture). It sounds like you may have either had a severe enough injury to alter the normal anatomy of one of the shoulder bursal sacs, or you have formed a new bursa entirely. In either case, there are treatment options, ranging from pain medication, anti-inflammatory therapy, to surgical repair. See your health care provider for a complete exam of the area. This, in addition to possible radiologic evaluation (x-rays or cat scan/MRI), can assist in formulation a treatment plan for your symptoms.
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