An acute episode of bursitis is best managed by avoiding which measure that is least likely to help until the episode resolves?

• A. Rest the joint
• B. Apply ice or heat
• C. Active intermittent range of motion
• D. Elevate the limb

Answer: (C)

In acute bursitis, the bursa is inflamed and easily irritated, so the priority is to reduce irritation and swelling while protecting the joint. Resting the joint, using ice to dampen inflammation, and elevating the limb to lessen edema are the measures that help during the early phase. Heat is generally not used in the acute inflammatory period because it can increase blood flow and swelling rather than reduce them.

Active intermittent range of motion involves actively moving the joint in a way that can repeatedly stress the inflamed bursa. This kind of movement can worsen pain and swelling and may prolong the flare, making it less likely to help until the episode has resolved. Once the inflammation settles, gentle, supervised ROM can be introduced to prevent stiffness, but in the acute stage, it’s best avoided.