Acupuncture for Bursitis

How Chinese medicine understands bursitis

Chinese medicine does not have a word for the bursa. It looks at where the pain is, what it feels like and what makes it better or worse. Most bursitis fits the picture of Bi syndrome: pain from an obstruction of Qi and Blood in the channels that cross the joint. The outer hip lies on the Gallbladder channel, the point of the shoulder on the Large Intestine channel, and so on.

The common patterns are:

• Qi and Blood stagnation. The pain is fixed, tender to the touch and often follows overuse or a blow. Treatment moves circulation through the area.
• Damp-heat. The area is swollen, warm and more painful, and may flare quickly. Warmth or redness should always be checked by a doctor first (see below). Once infection is ruled out, treatment in Chinese medicine aims to clear heat and reduce swelling.
• Wind, Cold and Damp. The joint aches more in cold, wet weather and feels better with heat. Treatment warms and clears the channel.
• Qi and Blood deficiency. A dull, lingering ache in someone who feels tired or run down, often in older adults. Treatment also builds you up.

Where the pain sits tells you which bursa is involved. The pattern tells a practitioner how to treat it, which is why hip bursitis in two people may not be treated the same way.

What treatment involves

Your first visit includes a lot of questions: which joint, how it started, what you do all day, how you sleep, and your general health. I also look at your tongue and take your pulse. An assessment usually includes checking how the joint moves and which positions bring on the pain.

Acupuncture is usually the main treatment. Points are placed around the joint, not into a swollen bursa, and elsewhere along the channel and the body for the pattern. I treat the whole body at every treatment, not only the area that hurts. At the hip, for example, the low back and buttock muscles are often part of the problem.

Tuina massage and cupping can loosen the muscles that pull across the joint, such as the outer thigh at the hip or the upper back at the shoulder. For a Cold pattern, moxibustion adds warmth; it is not used over a hot, swollen joint. When a deficiency pattern is part of the picture, Chinese herbal medicine is a formula written for you.

Plan on 5–10 treatments to judge progress. The clinic is in Keswick, and treatment can run alongside physiotherapy or the care your doctor recommends.

Between visits

• Take the pressure off. Use a kneeling pad, avoid leaning on the elbow, and try not to sleep on the sore hip or shoulder. A pillow between your knees helps with hip bursitis.
• Ice a flare. A cold pack wrapped in a cloth for 10 to 15 minutes can ease pain after activity.
• Keep moving gently. Complete rest can stiffen the joint. Stay active within comfort.
• Look at the repeated movement. Changing how you kneel, reach or climb stairs often matters more than any single treatment.
• Strengthen the muscles around the joint once the pain settles. A physiotherapist can show you which ones.

When to see your doctor first

See your doctor promptly, the same day if you can, if:

• The area is red, hot and swollen, or you have a fever or feel unwell. An infected bursa, most often over the elbow or kneecap, needs medical treatment.
• There is a cut or scrape over the swollen area.
• The pain followed a fall or injury, or you cannot move the joint or bear weight.
• A joint suddenly becomes very painful, hot and swollen, which can be gout or another type of arthritis.
• Swelling keeps coming back, or you have several painful joints at once.
• You have diabetes, a weakened immune system or take medicines that lower immunity, and a joint becomes painful and swollen.