Your bones are (or should be) cushioned by fluid filled sacks called bursae that provide a cushion that dulls the impacts of your daily movements. When these sacks become inflamed and the act of cushioning your movements becomes painful you are then suffering from bursitis. The pain will persist until the inflammation goes down. Bursitis self-care usually involves resting the affected area and anti-inflammatory medications. However, food and nutrition can also play a role in bringing down inflammation.
In the following excerpt from the book The Green Pharmacy by James A. Duke and Bill Gottlieb CHC the authors explain what causes bursitis, and how aniti-inflammatory foods and supplements can play a role in bursitis self-care.
Between our bones and the muscles or tendons near joints are fluid-filled sacs, which help cushion the joints. These are called bursae, and if they become inflamed, the result is bursitis, a painful condition that affects about 9.3 million Americans. Bursitis is most often caused by overuse of particular joints, often the wrists and shoulders. I know that from personal experience, having been stricken with bouts of bursitis due to physical activities such as hunching over a computer, driving long distances, mowing the aisles in my Green Farmacy Garden, and playing guitar and bass fiddle in a bluegrass group.
If you get a diagnosis of bursitis, your doctor is likely to recommend over-the-counter nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen or a prescription COX-2 inhibitor such as celecoxib (Celebrex). However, all of these medications can cause side effects, some of them very serious. Instead of taking that chance, you may want to try some foods from nature’s pharmacy instead. Below are some that I recommend.
Turmeric. This yellow curry spice is a rich source of curcumin, a strong antioxidant that protects against free radical damage. Curcumin contains natural pain-relieving COX-2-inhibitors, which makes it an attractive and safe alternative to prescription COX-2 inhibitors. It also reduces inflammation by lowering histamine levels and possibly by stimulating the adrenal glands to produce more cortisone, the body’s natural painkiller. Lately, I’ve had two students who switched from Celebrex to either curcumin or curried celery and thought it was a good tradeoff. (See my Curried Celery COX-2 Inhibitor recipe)
Human studies of curcumin have found that it can reduce the pain and stiffness associated with rheumatoid arthritis as well as help relieve postsurgical inflammation. I prefer a whole-foods approach whenever possible because as I’ve said elsewhere, I believe you get more healing power from whole foods than from individual components. I often add liberal amounts of curry to rice and other dishes and would consider adding other anti-inflammatory foods such as pineapple and papaya.
Unfortunately, it’s difficult to get a medicinal dose of curcumin from your diet alone. According to many naturopaths, that dose is 250 to 500 milligrams of pure curcumin a day, which translates into 5 to 25 teaspoons of dried turmeric daily. That’s a good deal more than even a curry fan like me would want to add to my food, so I would recommend adding as much turmeric as possible to your diet to help prevent pain and, to help relieve it, take turmeric supplements standardized to 90 to 95 percent curcumin.
One note: Curcumin isn’t very efficiently absorbed, but you can increase absorption significantly by taking your dietary turmeric with freshly ground black pepper. As for supplemental curcumin, there are five formulations that scientific research shows are well-absorbed and effective. They include Theracurmin, Meriva, Curcumin C3 Complex, BCM-95, and CurcuWin. Follow the dosage recommendations on the label or work with a holistic health professional to determine the best dose for you.
Celery. It wasn’t long after Celebrex, rofecoxib (Vioxx), and other prescription COX-2 inhibitors were promoted as the new “miracle aspirin” that herbalists said, “Wait a minute. Many foods and edible spices contain natural COX-2 inhibitors, and they’re unlikely to cause any adverse side effects.” Two of the best sources of natural COX-2 inhibitors are celery and celery seed, which contain high amounts of painkilling apigenin. When I was diagnosed with gout and looking for an alternative to the prescription drug allopurinol (Zyloprim) as a way to reduce my uric acid levels, I found that either eating four celery stalks or taking two to four tablets of celery seed extract daily all but eliminated my gout attacks. If I were again stricken with a bout of bursitis, I know that celery would be a gentler medicine than the cortisone shot my doctor would want to give me. If you have bursitis, I’d recommend either trying the regimen I use for gout or sampling my Curried Celery COX-2 Inhibitor recipe. Alternatively, you might try preparing a tea by pouring boiling water over one teaspoon of freshly crushed celery seeds and letting it steep for 10 to 20 minutes before drinking.
Chamomile. Although best known as a calming herb, chamomile also contains potent anti-inflammatory compounds such as apigenin, luteolin, and quercetin. If you sample my Curried Celery COX-2 Inhibitor, you might try chasing it with a cup of chamomile tea. Naturopaths recommend drinking three or four cups a day to treat painful conditions such as bursitis. You might also try taking two to three grams of the herb in tablet or capsule form or four to six milliliters of tincture three times a day between meals. You can also apply a topical chamomile cream or ointment to the affected area three or four times daily.
Chili peppers. Hot peppers contain a resinous and pungent substance known as capsaicin, which is number one among my painkillers. In fact, you’ll probably be surprised to learn that capsaicin is a potent COX-2–inhibiting anti-inflammatory. When applied topically, capsaicin temporarily depletes substance P, a chemical in nerves that transmits pain sensations. Without substance P, pain signals can no longer be sent. Dozens of studies show that capsaicin can temporarily relieve many painful conditions, including bursitis.
You can buy a commercial topical cream containing 0.025 to 0.075 percent capsaicin and apply it to your sore spots three or four times a day. Or you can do what people outside the United States often do: buy a chili pepper, mash it, and apply it directly. You can also mix mashed hot pepper with a skin cream such as cold cream. Either way, you’ll save money. A fresh pepper costs a few pennies, whereas a commercial capsaicin product such as Zostrix can cost up to $16.
No matter which route you choose, you may experience a burning sensation the first few times you use capsaicin, but it usually subsides with repeated use. Just be sure to thoroughly wash your hands after using it. If you get any in your eyes, nose, or mouth, it may be almost as painful as your bursitis.
I would recommend avoiding foods that contribute to inflammation. Some of the worst offenders are refined foods that contain lots of added fat, sugar, salt, additives, and preservatives. Snack foods in particular are likely to contain large amounts of pro-inflammatory trans fatty acids, omega-6 fatty acids, and high-fructose corn syrup, which is also a major player in our nation’s obesity epidemic.
Although capsaicin is best used topically, it may be helpful to add more peppers and pepper-derived hot sauces to your diet. Ingesting hot peppers increases your internal painkillers, called endorphins, and provides a bit of nature’s aspirin, salicylic acid.
Another option is taking a cayenne tincture (0.3 to one milliliter) three times a day. You can also make an infusion by stirring 1 ⁄2 to one teaspoon (2.5 to five grams) of cayenne powder into a cup of boiling water, letting it stand for 10 minutes, and taking one teaspoon mixed with water three or four times daily,
Ginger. Ginger contains high amounts of zingibain, a powerful anti-inflammatory enzyme that according to some experts is as powerful as the bromelain in pineapple or the papain in papaya. But ginger contains 180 times more anti-inflammatory enzymes than the papaya plant and may be even more effective at relieving the symptoms of bursitis. It’s easy to get enough ginger in your diet to help reduce pain. You can take it as an herb in tea by steeping three or four slices of fresh ginger in a cup of boiling water, or, if you prefer, you can get medicinal doses in tinctures or capsules. I, however, prefer ginger as a liberal and tasty addition to my daily diet. You can get medicinal doses by sprinkling 1 ⁄2 teaspoon of powdered ginger into your foods or by eating about an ounce (6 teaspoons) of fresh ginger every day.
In Asia, ginger has an extensive history as a treatment for bursitis. To get an added anti-inflammatory effect, try using it in combination with pineapple and licorice. In moderate amounts—up to three cups of tea a day—licorice is usually safe. But in larger amounts, long-term use can cause some serious side effects.
Leafy greens. Because many alternative practitioners suggest that magnesium-rich leafy vegetables may be effective for bursitis, I’ve created my own Magnesium Medley, which includes purslane (which contains nearly 2 percent magnesium by dry weight), green beans, poppy seed, cowpeas, spinach, snake gourd, licorice, lettuce, and nettle. For even more benefits, you might try drinking apple cider vinegar and honey after rising in the morning or taking one tablespoon of cod-liver oil an hour or two before meals. I confess, when I’m on the road, I take a supplemental magnesium pill if I have nighttime leg cramps, which annoy me more often than bursitis. In this case, one capsule does the trick, but a second capsule can give me a touch of diarrhea.
Mint. Peppermint, spearmint, Chinese mint, and other mint oils contain high amounts of menthol, which when applied topically can help relieve the pain associated with bursitis. Although you can buy commercial products containing menthol, it may be a better (and cheaper) bet to apply mint oils directly to your sore spots (but be aware that such oils are toxic when consumed internally in large quantities). Another option is to drink peppermint tea two or three times a day. Although many commercial mint teas are available, I’d recommend making your own by pouring one cup of boiling water over one heaping teaspoon (five grams) of dried peppermint leaves and steeping for 5 to 10 minutes; drink three to four cups daily. For extra benefits, consider stirring a delicious peppermint/chamomile tea with a licorice stick, which will give you a host of analgesic and anti-inflammatory compounds. Another option is taking three to six grams of peppermint leaf tablets or capsules a day.
Oregano. This is a welcome weed in the Green Farmacy Garden. For almost any inflammatory condition, it’s a treasure house of active compounds—eight natural COX-2 inhibitors, more than a dozen analgesics and anesthetics, and more than two dozen anti-inflammatory compounds. Nowhere—not on PubMed or in any of my herbal reading—have I seen oregano prescribed or recommended for bursitis, but the chemistry tells me it is worth recommending. It’s a key ingredient in some anti-inflammatory medicines, and I now add it to my celery curries. Even in mid-winter, I can go out and strip old dry florets off my oregano, pour boiling water over them, add lemon and stevia, and have an Organic Oregano Anti-inflammaTea. Many of the herb’s useful phytochemicals are easily absorbed by the skin and can also be inhaled, so breathe in the wafting aromatics between draughts. You can make a poultice of the dregs and apply it topically near the sore bursa to get even more relief. By the way, everything I’ve said today about oregano can also be said about rosemary. You can stir Anti-inflammaTea with a licorice stick, thus adding some of the magic anti-inflammatories of licorice.
Flaxseed. Studies show that increasing your dietary ratio of anti-inflammatory omega-3 fatty acids to pro-inflammatory omega-6 fatty acids can benefit more than 50 common ailments, including inflammatory conditions such as bursitis. When I see such a long list for any nutrient or herb, I’m somewhat skeptical, but scientists I respect seem to think that omega-3’s can make an enormous difference in your health. Although the richest sources are cold-water fish and fish oil, many plant species also contain high amounts of omega-3’s. These include flaxseed oil, canola oil, chia oil, walnut oil, soybean oil, and wheat germ oil. So far, I haven’t been bold enough to concoct a fish-oil salad dressing (which might make sense if you like anchovies in your salad). In most cases, walnut oil may be more pleasing to the palate.
Pineapple. This exotic fruit is rich in a number of substances that can help people with conditions such as bursitis. Foremost among them is bromelain, a proteolytic enzyme that helps reduce the swelling and inflammation of many painful “-itis” (inflammatory) conditions. Its anti-inflammatory effects are so profound that the German government has approved its use for healing after injuries and surgical procedures. Pineapple also contains high amounts of manganese, which is essential for the formation of collagen, the tough, fibrous protein that builds connective tissues such as bone, skin, and cartilage. You can get 100 percent of the daily value for manganese (2.3 milligrams) from just a cup of fresh pineapple chunks or pineapple juice. Pineapple is also a rich source of vitamin C, also necessary for collagen formation, offering more of this important vitamin than apples, cranberries, or tomato juice. A cup of fresh pineapple chunks contains 131 percent of the Daily Value. To get the maximum antioxidant punch, try “Gold” pineapple, which is imported from Costa Rica and contains four times more vitamin C than other pineapples.
Unfortunately, research suggests that levels of both bromelain in fresh pineapple and papain, a related enzyme in fresh papaya, may be too low to relieve a bad bout of bursitis. While I would encourage enjoying these fruits—either whole or as juice—you’ll probably need to take supplements to get effective levels. Naturopaths suggest taking anywhere between 250 and 500 milligrams of bromelain three times a day. In human studies, a daily dose of up to 2,000 milligrams has not proven harmful.
From the Herbal Medicine Chest
I consider licorice to be the poor man’s herbal alternative to corticosteroids, mostly because it doesn’t cause nearly as many adverse side effects. It contains at least 24 anti-inflammatory compounds, five of which are natural COX-2 inhibitors. It’s also a potent antioxidant that’s rich in flavonoids and magnesium, a mineral that has proven benefits in treating bursitis. You might try taking five to six grams of licorice-root capsules a day or 500 milligrams of licorice extract three times a day. You also can make a tea by boiling 1 ⁄2 ounce (14 grams) of licorice root in one pint of water for 15 minutes and drinking two or three cups a day. But don’t use licorice for more than six weeks, since long-term use can cause high blood pressure. Avoid it entirely if you have high blood pressure; are taking diuretics; are pregnant; or have cardiomyopathy, diabetes, liver disease, or thyroid problems. I like to use a licorice stick to stir my chamomile tea, which adds bit more COX-2– inhibiting activity, but it’s probably not enough to cause worrisome side effects.
For additional advice on foods and supplements that can help with common health conditions, purchase The Green Pharmacy from Bottomlineinc.com.
