DEAR DR. GOTT: I am an active 50-year-old man with chronic shoulder pain. My doctor, a sports-medicine surgeon, wants to remove the bursa sac and maintains that the sac is not necessary. Because I would like to remain active — especially in the gym — I am quite skeptical.
DEAR READER: A bursa is defined as a small, fluid-filled sac whose purpose is to reduce friction between bodily tissues. There are 160 bursae throughout the body, all of which are located in areas of large joints, such as the knees, elbows, hips and shoulders.
The main symptom of bursitis of the shoulder is severe pain, primarily on movement. Causes include arthritis, infection, injury to the site or, most likely in your case, overuse.
Symptoms are commonly treated by resting the affected joint, and with cold packs, anti-inflammatory over-the-counter medications, heat once any swelling disappears and antibiotic therapy for infection. Some cases don’t respond to simple treatment and require aspiration of the bursa fluid. This procedure is commonly performed in a physician’s office and may be followed by a cortisone injection into the affected area.
When inflammation in the subacromial bursa adds to pain experienced, the lubricating sack is often removed by a surgeon in a procedure known as bursectomy or debridement. Generally speaking, recovery is rapid, because range-of-motion exercises are begun soon after surgery in an attempt to accelerate rehabilitation.
Now comes the difficult part. You need to sit down with your specialist and explain that you want to remain physically active. Determine how long you might anticipate the recovery period to last and whether there will likely be any unwanted side effects. Your surgeon knows your case and should be able to predict the outcome based on your general health. Ask whether he plans to do arthroscopy, which will be less invasive and require less recuperation rather than make a larger incision, which will take longer to heal. You might also feel more comfortable requesting a second opinion.
To provide related information, I am sending you a copy of my Health Report, “An Informed Approach to Surgery.†Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, PO Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my Web site at AskDrGottMD.com.
Peter Gott practiced medicine in Lakeville for 40 years.
