-IBIS-1.7.6-
tx
musculoskeletal system
bursitis
Nutrition

dietary guidelines

eating principles:
» acute:

Short fruit and vegetable fast: This decreases the amount of saturated fats which provides less substrate to make PGE2. (Marz. p. 353, 1997)

increase fluids
» chronic:
• elimination/rotation diet, rotation diet, rotation diet expanded

therapeutic foods:
• foods that invigorate the Xue (Blood) and Qi, nourish the Xue (Blood), tonify the Liver
• foods rich in Calcium, Zinc, Selenium, bioflavonoids, Vitamins A, C and D
• foods rich in anti-inflammatory agents, especially oils, such as cold-water fish, seeds and some nuts
• sesame seed, kale, millet, celery, barley, okra, almonds, collards, turnip greens, raw goat milk (Jensen, 61.)
• pineapples, papayas

fresh juices:
• carrot, radish, and watercress (Walker, 129.)
• carrot, beet, and cucumber (Walker, 129.)
• carrot and spinach (Walker, 129)
• black mission figs, raw goat's milk (Jensen, 61.)
• black cherry (Jensen, 61.)
• green kale (Jensen, 61.)
• celery and parsley (Jensen, 61.)

avoid:
• minimize consumption of foods high in saturated fats (dairy and animal products) as these constituents, especially arachadonic acid, can exert a pro-inflammatory action by providing substrate for formation of PGE2.
• food intolerances
• dairy, potato (Zeff)


supplements

Vitamin B12, 1000 mcg per day, via IM or deep subcutaneous injection for 1 week; may also be combined with vitamin B3 as niacin. Several decades ago researchers found that such therapies not only demonstrated significant anti-inflammatory effect, but also reduced calcification in chronically inflamed bursae. Oral administration has not been investigated and is less likely to produce the same effects.
(Klemes IS. Indust Med Surg 1957;26:290-292; Kellman M. J Am Osteopathic Assoc 1962;61:896-903.)
Vitamin C with Bioflavonoids, 1,000 mg, three times daily, to reduce inflammation and facilitate connective tissue repair.
Vitamin E, 400-800 IU per day
Bromelain, 250-500 mg, three times daily, between meals, to reduce inflammation.
(Klein G, Kullich W. Wien Med Wochenschr. 1999;149(21-22):577-580.)
Omega-3 fatty acids, such as flaxseed oil, 500-1,000 mg, three times daily, for anti-inflammatory effect.

Topical DMSO and bromelain (Marz)

» drug interaction:
Prednisone/prednisolone:
- causes Sodium retention
- causes reduced activation of Vitamin D; 1,25(OH)2D3 can be measured to determine if supplementation necessary, with low levels can use calcitriol.
(Travato, 1991;44:1651-1658; Tuttle, 1982;126:1161-1162.)
- causes increased urinary excretion of Zinc, Vitamin K and Vitamin C (Buist, 1984; 4 (3):114.)


footnotes

Kellman M. Bursitis: a new chemotherapeutic approach. J Am Osteopathic Assoc 1962;61:896-903.

Klein G, Kullich W. [Reducing pain by oral enzyme therapy in rheumatic diseases]. Wien Med Wochenschr. 1999;149(21-22):577-580. (Review) [Article in German]
Abstract: Proteolytic enzymes have analgesic, effects, besides the wellknown antiinflammatory and edema-reducing properties. These analgesic effects are based on the inhibition of inflammation and in addition to that on direct influences on the nociceptors. All that explains the therapeutical effects of such enzymes in degenerative-rheumatic and soft tissue rheumatic diseases in which inflammatory or immunologic processes are not in the forefront. In recent years a significant reduction of pain in various rheumatic diseases, concerning these aspects, was shown in several clinical studies. The clinical trial in patients with periarthritis of shoulder showed statistical equivalence of pain reduction, whether they were treated with phlogenzym or diclofenac. Likewise in the trial of patients suffering from painful osteoarthritis of the knee, there was a statistical equivalence of the pain-scores, comparing diclofenac and enzymes. The study of painful vertebral syndromes again resulted in equivalence of the treatment with NSAIDs compared to therapy with enzymes.

Klemes IS. Vitamin B12 in acute subdeltoid bursitis. Indust Med Surg 1957;26:290-292.