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Tuesday, Nov. 20, 2018

Healthy Geezer

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You can usually take care of bursitis yourself

Q. Is bursitis age-related?

Yes. Bursitis occurs more  often as we get older.

Repetitive motions are the worst things for people who tend to get bursitis. Other causes include joint trauma, rheumatoid arthritis, gout and infection.

Bursitis is inflammation of a bursa, which is a small sac filled with fluid. We each have about 160 of these bursae, which act as shock absorbers and grease for our joints. They are buffers between bones and overlapping muscles or between bones and tendons/skin. When bursae become inflamed, they can ache.

If you have bursitis, you may feel pain or stiffness in the elbow, hip, knee, shoulder, heel, big toe or other joints; stronger pain with movement or pressure; swelling, warmth and redness.

While repetitive motions are the usual culprits in bursitis, simple pressure can cause inflammation, too. A couple of examples: Pushing a vacuum cleaner can give you bursitis in your elbow. But sitting on a hard surface for a long time can inflame the bursa over a bone in your buttocks.

You can usually take care of bursitis yourself. Rest the affected joint. An ice pack will reduce swelling. To reduce pain and inflammation, take a nonsteroidal anti-inflammatory (NSAID) such as ibuprofen or aspirin, if your doctor approves. It usually takes a week or so for bursitis to go away.

You should go to your doctor if the symptoms don’t subside after 10 days; you have a fever; there’s excessive swelling, redness, bruising or a rash in the affected area; pain is sharp, shooting or disabling; you have a medical condition; or you take drugs that may increase your risk of an infection.

If you need professional care, your doctor may recommend physical therapy or a cortisone injection into the bursa to relieve inflammation.

Ultrasound treatment is often used by physical therapists and many other health-care providers to treat bursitis. Ultrasound relieves pain and inflammation, speeds healing, reduces muscle spasms and increases range of motion.

Ultrasound makes high-frequency sound waves. The sound waves vibrate tissues deep inside the injured area. This creates heat that draws more blood into the tissues. The tissues then respond to healing nutrients brought in by the blood.

Treatment is given with a soundhead that is moved gently in strokes or circles over the injured area. The procedure may be performed with the soundhead alone or with a topical antiinflammatory drug or gel.

(Personal note: My wife, Gale, swears by ultrasound for treating her occasional bouts of bursitis.)

However, if the bursitis is caused by a bacterial infection of the bursa, it will have to be drained, and you will need antibiotic treatment.

Here are some tips to help prevent bursitis:

• If you must undertake a job that requires repetitive movements, take many breaks.

• Avoid sustained pressure on a bursa. For example, don’t sit on hard chairs for long periods. If you have to do a job on your hands and knees, use knee cushions. Don’t rest your elbows on hard surfaces. Don’t wear ill-fitting shoes.

• Exercise the muscles in the joints that tend to get bursitis. You can protect these joints by strengthening the muscles around them. Of course, don’t exercise until all bursitis symptoms are gone.

• Before exercising you should always warm up and stretch your muscles.

Q. I usually get a bit light-headed when I stand, but this feeling is much worse when I get up from the dinner table. I don’t drink. Any ideas?

There’s a possibility you have “postprandial hypotension,” or, in layman’s language, low blood pressure after a meal. This is a senior malady; few younger people experience this. Other possible symptoms include dizziness, blurred vision, nausea and fainting. I recommend going to a doctor to have your symptoms checked.

When you eat, blood pours into your digestive system. To maintain your blood pressure, your heart pumps more often, and your blood vessels constrict. But these compensatory mechanisms don’t work for some people.

To help prevent postprandial hypotension, eat small portions several times a day and limit high-carbohydrate foods such as potatoes, rice, pasta and bread.

There’s another form of low blood pressure called “postural hypotension” that affects some people when they stand up. Also called “orthostatic hypotension,” this is especially common in older adults who are more likely to use high blood pressure drugs. When you experience postural hypotension, blood pools in your legs.

Low blood pressure is commonly caused by drugs for high blood pressure, surgical medications, anti-anxiety agents, diuretics, heart medicines, antidepressants, narcotic painkillers and alcohol.

Other causes of low blood pressure include dehydration, heart failure, heart arrhythmias, shock from infection, stroke, severe allergic reaction, major trauma, heart attack and advanced diabetes.

The effects of hypotension can lead to falls, which can be serious for seniors. Here are some pointers for avoiding the dangers of low blood pressure:

When arising, let your feet hang over the side of your bed. Then flex your toes up and down about a dozen times. Stand up slowly. Count to 10 before you start walking. This is a good idea whenever you get up from lying or sitting for more than 20 minutes. Crossing your legs while sitting upright may also help increase blood pressure.

Some experts define low blood pressure as readings lower than 90 systolic (the first number) or 60 diastolic (the second number). However, low blood pressure is relative, so doctors often define blood pressure as too low only if there are symptoms.

In many instances, low blood pressure isn’t serious. However, it is essential to see your doctor if you have hypotension symptoms because they sometimes can point to serious problems. Chronic low blood pressure may increase the risk of Alzheimer’s-type dementia in some older adults.

Low blood pressure without symptoms rarely requires treatment. In symptomatic cases, doctors address the primary problems such as heart failure. When hypotension is drug-induced, treatment usually involves altering the drug regimen.

It is possible to raise blood pressure when that is required. Here are some ways:

Eating more salt. However, too much sodium can cause heart failure, especially among seniors.

Don’t increase your salt without consulting with your doctor.

Drink more water. Fluids increase blood volume and help prevent dehydration.

Compression stockings used to treat varicose veins may help reduce the pooling of blood in your legs.

There are also medications your doctor may prescribe.

Fred Cicetti is a freelance writer who specializes in health. He has been writing professionally since 1963. Before he began freelancing, he was a reporter and columnist for three daily newspapers in New Jersey. If you would like to ask a question, write to fred@healthygeezer.com.

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