When typing this article I’m on the road for a 5 weeks backpacking trip and working while traveling as usual. And I suffer from bursitis. It is an old injury that remained after neglecting an earlier case of shoulder inflammation. I can tell you: it is a backpackers worst nightmare and a mega setback for working on the road when you get bursitis or anything like that.
You are forced to take it easy and rest your shoulder and that is simply not always possible when you are a digital nomad. So you are in doubt most of the time: What is wisdom: I only have one right shoulder, if I mess it up real bad I may have more serious problems in the future, but I do have to carry my backpack……work behind my laptop in not always the most ergonomic circumstances…….how to deal with this?
The symptoms of bursitis are: pain, limited range of motion, weakness, difficulties sleeping, sometimes swelling and tenderness, and possibly even a fever if the bursa is severe infected.
Shoulder bursitis can cause pain during activities requiring abduction of the rotator cuff.
Direct pressure on the bursa will exacerbate the pain and should be avoided if possible.
To diagnose your bursitis, the doctor may ask you to extend your arm out and he/she will apply resistance as you try to move it back towards your body. If the pain increases you may be suffering from bursitis, although other rotator cuff injuries and tendonitis can produce similar pain patterns.
The pain of bursitis starts gradually, originating deep inside your shoulder, and develops over a few days or even months. You will usually feel the pain on the outside of the shoulder and it may spread down the outer arm towards the elbow. If you raise your arm above your head, as you would when washing your hair or reaching high to get something off a shelf, the pain will worsen.
If you lift your backpack, the pressure on the shoulder will make the pain worsen and so will heavy lifting with the inflicted arm. You will experience limited range of motion that will increase over the days if you will not take precautions.
If your bursitis is caused by an infection in the bursa (septic bursa) you will usually feel feverish. If your shoulder feels warm and on touch very painful, or if the skin on and around your shoulder is red, you need to see a doctor that will prescribe antibiotics to kill the bacteria.
If bursitis is left untreated the inflammation can increase, causing more pain, limiting movement even more. Eventually weakness in the shoulder muscles and tendons can set in. A so called frozen shoulder, the inability to move your shoulder, is one of the long term damages than can occur when you ignore your bursitis and/or leave it untreated.
When you suffer from shoulder bursitis you may also have interrupted sleep patterns. Simply rolling over on the affected shoulder during the night can cause pressure on the inflamed bursa increasing the pain at the pressure point. The pain can range from mild to very sharp depending on the amount of inflammation in your shoulder. And sometimes even just laying down is unbearable.
How to treat Bursitis when you are on the Road?
Let me start by saying I’m not a doctor and I do not have any medical experience other than my own experience with my bursitis. So the tips I give in this article are from own experience and found on the internet. Therefor I give you the advice that you should always see a physician when you think you have bursitis.
I mainly focus on keeping the pressure off the inflicted shoulder, this means that I put the weight of my backpack on my other shoulder, by swinging it only on that shoulder, or, if bearable, adjust the straps that way, that the weight is mostly in the other shoulder.
This is not the best way to carry your pack and you must be aware that you can bring other injuries upon yourself by doing so. Sometimes, if travels allows it it is better to stay put for a few days and give your shoulder complete rest.
The most important factor in healing bursitis is resting your shoulder. This can be difficult when you have to carry on with daily activities like working on your laptop. But resting your shoulder whenever you can is recommended.
During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle, for me that means less work behing the laptop and a lot of over the counter pain medication.
I work for a set amount of time, and take regular breaks during which I try to do some exercise to keep my shoulder flexible, lifting my arm, rotating my shoulder a little, all not to much, just a few moves to relax from sitting in one position.
I love to cool my shoulder with ice, specially the first few days. And since I work in a tropical climate, I use the air-con whenever I can to keep a more cooler climate to keep the inflammation down.
Over the Counter Medication
I use Naproxen sodium for the first days when the pain is the worst.
Naproxen is used to relieve pain from various conditions such as headaches, muscle aches, tendonitis, dental pain, and menstrual cramps. It also reduces pain, swelling, and joint stiffness caused by arthritis, bursitis, and gout attacks.
The medication is known as a non-steroidal anti-inflammatory drug (NSAID). It works by blocking your body’s production of certain natural substances that cause inflammation.
The sodium prevents the body from holding on to too much water, which will have a negative effect on the joints, and therefor the shoulder. I can tell you: you will pee a lot!
Of course you also can take paracetamol or ibuprofen, whatever works best for you.
If in doubt: do ask a doctor or a pharmacist.
After that I start using Voltaren Gel. Voltaren Gel contains diclofenac,a non-steroidal anti-inflammatory drug (NSAID). Diclofenac works by reducing substances in the body that cause pain and inflammation.
Voltaren Gel is used to treat joint pain in the smaller joints and it is said that it does not work as effective in larger joints as the shoulders, for me it works just fine. But since diclofenac has a lot of side effects and can not be taken by everybody, you should check with a physician or pharmacist and inform them about any medication you are taking of diseases you have. Do specifically ask for the side effects, specially when you suffer from astma.
Cool it down!
Applying cold to your inflamed shoulder when you are experiencing shoulder pain, decreases the swelling and redness around it. Cold therapy will also help to numb the pain and help to control the inflammation.
You can use a cooling gel pack, that chills in the fridge or in the freezer. Or you can use some deep frozen product like a bag of pies to cool your shoulder. Ice cubes in a plastic bag or even your chilled can of coke will help. Cool the area no longer than 15-20 minutes!
Please note that when you use deep frozen products you wrap them in a cloth before applying to the bare skin!! This will prevent you from freeze burning your skin.
Aside from not working at all or working behind the laptop only short period of time during the bursitis, you may also watch your posture. I wrote on article on that subject to prevent back injuries. Take a look if you are interested, it comes with a free download for good posture.
My Healing Proces and Respecting My Boundaries
For me it takes weeks to recover, and I cannot stay away from my projects for weeks. So I have to administer regular breaks, I set my alarm to remind me.
Every now and than I take a warm shower and do some exercise all to keep the shoulder flexible.
Do not make the mistake of not using your shoulder at all, it will lock. Keep it moving within the pain-range and within what is bearable. Do some light exercise, cool and take over the counter medication but when you do feel feverish ar your skin is red and/or swollen go see a doctor.
Like me you have to accept that it happened, and that it will takes weeks to recover. After the first horrible pain is fading do not get overconfident, keep the calm and relaxed pace you administered and keep it up for a few weeks. Increase the exercise, google for more tips on how to heal your shoulder properly to avoid future damage or even an operation or something nasty as an injection in the bursa. For me the sheer thought of a needle going in that tender area is enough to keep me motivated to take better care of myself.
Please remember my warning: I’m not a doctor, you can not hold me accountable for any damage that you experience by interpreting my way of treating my bursitis as the perfect way for you to do the same. I am just an bursitis suffering nomad, with little to non medical expertise.
Please find your own way in your healing process and if in doubt go see a physician.
Talk to me: Do you suffer injuries while working from everywhere?
That nice lounge chair in the hotel lobby, or sitting on your hotel-bed, or from that cool hammock overlooking the beach? How do you stay healthy while traveling and working?