Bursitis

A bursa is fluid-filled sac that acts as a cushion; and lies between a tendon (or muscle) and bone, which allows for virtually “frictionless” movement between these structures. When a bursa gets inflamed, it can lose it’s ability to create a smooth gliding surface and become irritated. The result will be pain (sharp or dull) and decreased range of motion. The pain can occur with or without movement. Bursitis (inflammation of a bursa) is a relatively common condition that I see in patients.

There are several ways a bursitis can occur. The most common would be due to structural imbalances and faulty calcium metabolism. Typically I see these two occur together. An infected bursa will also get inflamed, but that is much more rare, though still usually treatable with conservative, non-invasive methods. There are bursa all over the body, so to speak, but the common ones that get inflamed are in the shoulder, “hip” (outside of the upper thigh), and spine.

Treatment directed towards balancing the muscles, tendons, ligaments, joints, and sometimes even skin will resolve the structural imbalances. Because “everything is connected”, it’s not uncommon for muscle and joint dysfunction in one part of the body to result in a bursitis in another. For example, the most common structural reason for “hip”, or trochanteric bursitis is excessive foot pronation (or “flat feet”). [the (greater) trochanter is bony eminence on the upper, outer part of the femur, or thigh bone] A bursitis of the shoulder can be caused by neck, TMJ, or pelvic dysfunction, and sometimes even foot dysfunction. Bursitis in the spine can occur for any number of reasons including postural distortions (due to muscle dysfunction) and spinal, pelvic or extremity structural imbalances.

When a bursitis is the result of faulty calcium metabolism, nutritional supplements are almost always indicated. Keep in mind that structural imbalances will almost always accompany a calcific bursitis. Therefore, treatment should be directed towards correcting both issues. The reason a bursa gets calcified may be two-fold. First, anything that is chronically inflamed will usually begin to calcify. Second, calcium won’t be directed properly if there is a nutrient imbalance. I’ll discuss calcium metabolism in relation to bursitis in this article. Click here if you are interested in reading my article about inflammation.

Typically the person with a calcific bursitis will have stiffness upon waking and feel better after movement. This type of pain pattern will usually be the case with any type of “calcific pain”. As far as nutrients go, the main ones to consider are vitamin D and essential fatty acids or EFA’s (usually omega-3’s). This is because the problem usually begins with an excess amount of blood calcium that gets deposited in the bursa instead of the bone. Vitamin D raises blood calcium levels by absorbing it from food (or supplements) in the digestive tract, or by extracting it from bone. [Having calcium taken up from the bones is never a good idea as it can lead to osteoporosis.] Omega-3 fatty acids (or oils) will take calcium out of the blood and deposit it in the bones. The problem arises when there is an excess amount of vitamin D, or a lack of EFA’s; either of which can cause excess levels of calcium in the blood. The former is less likely, unless you’ve spent a fair amount of time in the sun or supplement excessively.

The next factor that plays a role is when the body is overly alkaline. This will cause any excess blood calcium, assuming there is an insufficient amount of EFA’s to drive it into the bone, to precipitate into the tissues, bursae in this case. So the solution is two-fold. Adequate amounts of EFA’s and an environment that is NOT overly alkaline. The remedy would be to make sure you get adequate amounts of EFA’s and possibly supplement with an acidic type of calcium. I often use both with great success.

Keep in mind that you will not always have a calcific bursitis show up on an x-ray for there to be a calcium metabolism problem. If it does show on an x-ray, the problem is quite chronic. Fortunately, in my experience with patients, bursitis (calcific or not) is usually something that resolves completely with conservative care.

There are many other potential calcium metabolizing nutrients that may be necessary, with the most common being magnesium and vitamin B6. Lastly, if these don’t work, one needs to consider further complicating factors including: infections, digestion, general pH balance, and chemicals that may be affecting calcium metabolism.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology