Effective Remedies and Treatments for Ischial Bursitis Relief

Ischial bursitis?

Hello Doctor: I have been suffering from ischial bursitis for over three years.
I understand that I should not sit for long periods, and I have purchased a pressure-relieving cushion, but I still experience pain in my buttocks after sitting for 30 minutes.
The pain completely disappears only when I stand.
I have undergone physical therapy at a Western medicine rehabilitation department for over a year, but there has been little effect.
The rehabilitation treatments included heat therapy, electrical stimulation, ultrasound, and steroid injections, but they seem to have had no significant impact.
I live near Muzha in Taipei City; could you recommend a good orthopedic doctor close to that area? How long might it take to heal? Is it possible to fully recover? What exercises, massages, or methods can I do at home to accelerate recovery? Additionally, I came across an article online stating: "Ischial tuberosity bursitis: Take 60g of Job's tears, add 300ml of water, and boil until reduced to 200ml.
Divide into two doses for oral intake.
Treatment results: In 25 cases, local cysts were completely absorbed, and symptoms disappeared.
The shortest treatment duration was 26 days, and the longest was 45 days.
Follow-up after 3 to 10 years showed no recurrences." (Chinese Medicine Journal 1987; 1: 66.) Could taking Job's tears in this manner also help alleviate pain and accelerate recovery? Thank you very much.

li, 30~39 year old female. Ask Date: 2010/05/17

Dr. Lin Qingzhong reply Traditional Chinese Medicine

Dear Netizens,
1.
Ischial bursitis commonly occurs in patients who need to sit for extended periods.
It results from prolonged friction between the buttocks and the chair, particularly in elderly women with a lean physique and less adipose tissue in the gluteal region.
The onset of ischial bursitis is often due to vigorous hip joint activities that cause tendon injuries at the ischial tuberosity, leading to irritation of the bursa or surrounding structures.
A cystic mass can be palpated at the ischial tuberosity, accompanied by significant tenderness.
X-ray examinations of the kidneys, ureters, and bladder (KUB) typically show no abnormalities, but ultrasound imaging may reveal a fluid-filled cystic lesion.
Pain is often exacerbated by sitting on hard surfaces, which increases pressure on the affected area.
2.
You have been suffering from ischial bursitis for over three years, and you cannot sit for long periods.
Although you use a pressure-relieving cushion, you still experience pain after sitting for 30 minutes, and rehabilitation has not improved your condition.
In my clinical experience, I have encountered similar patients, and our orthopedic department prefers not to perform surgery.
I have treated such cases with acupuncture, which typically requires 1 to 2 months for improvement.
If you are unfamiliar with the area in Muzha, you may consider visiting the Traditional Chinese Medicine department at Taipei City Hospital or our outpatient clinic.
3.
It is advisable to rest for a period and avoid engaging in strenuous activities.
Be mindful of prolonged sitting, and choose chairs that are not too hard to prevent friction that could lead to bursitis.
4.
Using Job's tears (Coix lacryma-jobi) to alleviate pain may not be effective.
It is recommended to use herbal medicines that promote blood circulation, resolve stasis, and relieve pain.
It is best to consult a qualified Traditional Chinese Medicine practitioner for diagnosis and treatment, as this approach is generally safer and free of side effects.
In my clinical practice, combining herbal treatment with acupuncture has yielded favorable results and can help prevent the recurrence of conditions like ischial bursitis.
Wishing you all the best.
Sincerely,
Lin Ching-Chung, MD
Director, Department of Traditional Chinese Medicine
Fengyuan Hospital, Taichung City

Reply Date: 2010/05/17

More Info

Ischial bursitis, often referred to as "weaver's bottom," is a condition characterized by inflammation of the bursa located near the ischial tuberosity, which is the bony prominence of the pelvis that bears weight when sitting. This condition can be quite painful and debilitating, especially for individuals who spend long periods sitting, as you have experienced.
Given your situation, it seems that you have already taken several steps towards managing your condition, including using a pressure-relieving cushion and undergoing physical therapy. However, the persistence of your symptoms suggests that additional or alternative treatments may be necessary.

Effective Remedies and Treatments
1. Activity Modification: Since you have noted that sitting for extended periods exacerbates your pain, it is crucial to continue avoiding prolonged sitting. When you do sit, try to shift your weight frequently and take breaks to stand or walk around.
2. Physical Therapy: While you have undergone physical therapy for over a year, it may be beneficial to seek a second opinion or a different therapist who specializes in sports medicine or orthopedic rehabilitation. They may provide tailored exercises that focus on strengthening the muscles around the hip and pelvis, which can help alleviate pressure on the bursa.

3. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce inflammation and relieve pain. If you have not already discussed this with your physician, it may be worth considering.

4. Corticosteroid Injections: You mentioned having received steroid injections, which can provide temporary relief. If the injections were not effective, discussing alternative medications or a different injection technique with your doctor may be beneficial.

5. Alternative Therapies: Some patients find relief through acupuncture or chiropractic care. These therapies can help alleviate pain and improve mobility, although results can vary from person to person.

6. Home Exercises: Gentle stretching and strengthening exercises can be beneficial. Focus on stretching the hamstrings, hip flexors, and gluteal muscles. Strengthening the core and hip muscles can also provide better support to the pelvis. Consult a physical therapist for a personalized exercise program.

7. Weight Management: If applicable, maintaining a healthy weight can reduce stress on the bursa and alleviate symptoms.

8. Natural Remedies: Regarding the use of Job's tears (薏苡仁), there is some anecdotal evidence suggesting that it may have anti-inflammatory properties. However, scientific evidence supporting its efficacy specifically for ischial bursitis is limited. If you choose to try this remedy, it should be viewed as a complementary approach rather than a primary treatment.

Duration and Prognosis
The duration of treatment and recovery can vary significantly based on the severity of the bursitis and the effectiveness of the chosen treatment plan. Some individuals may experience relief within a few weeks, while others may take several months to see significant improvement. It is essential to maintain open communication with your healthcare provider to monitor your progress and adjust your treatment plan as necessary.

Finding a Specialist
Since you are located in the Muzha area of Taipei, consider seeking out orthopedic specialists or sports medicine physicians who have experience treating bursitis. They can provide a comprehensive evaluation and recommend a tailored treatment plan.
In conclusion, while ischial bursitis can be a challenging condition to manage, a combination of activity modification, targeted physical therapy, pain management strategies, and possibly alternative therapies can lead to significant improvement. It is crucial to remain proactive in your treatment and to seek out specialists who can provide the care you need.

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