Fish oil or flaxseed supplement: Take 1,000 mg two or three times a day. Other non-medicinal treatment methods are elevation and compression. The most common examples of this condition include: Prepatellar bursitis, “housemaid’s knee”Exercise for bursitis in the shoulder. Gout’s symptoms are caused when sharp uric acid crystals collect in your joints. Shoulder bursitis is inflammation or irritation of a bursa (shown in blue) in your shoulder. Bursitis is characterized by swelling,. Tendinosis refers to hardening, thickening, and scarring of the tendons. 95 *. 1. Scapulothoracic Bursitis. Shoulder Bursitis. The medications will help to reduce the swelling […]Shoulder bursitis can cause dull, achy, or sharp pain or merely mild tenderness. First of all, rest is the fundamental basis of this treatment. Treatment typically involves resting the affected joint and protecting it from further trauma. What is Shoulder Bursitis - Bursitis shoulder pain will sometimes be called a rotator cuff injury, however this is a general term that also includes shoulder tendonitis pain. The risk of this condition may increase due to the overuse of any joint owing to the occupation of the person. If you keep pushing on into the pain, the friction over the bursa continues and the inflammation doesn’t get a chance to settle. Recommended dosage: The recommended daily dose of fish oil is 2-3g, comparable to the FDA’s recommended dietary intake of 8 ounces of seafood per. Swelling in the joint. . Treatment includes rest, ice, medicines and gentle physical therapy. Resting, using ice packs and taking over-the-counter painkillers are all recommended by conventional health professionals ways of treating mild cases of bursitis. Shoulder bursitis, a frequent source of shoulder discomfort, is characterised by the inflammation of the bursa in the shoulder joint. This may sound painful, but acupuncture needles are extremely small and, when inserted, have could the effect of. Bursitis. Don’t ignore this sign. Many of us know that castor oil is quite effective for constipation, so many healers worldwide have treated several health conditions (such as bursitis) by using castor oil. 6 Dimethyl Sulfoxide. Subdeltoid bursitis is the condition that results when the subdeltoid bursa becomes inflamed. 1b. Bellis perennis: Take this after a bruising bursitis injury. 2273 Akron General: 330. Compression: Try wrapping your elbow with an elastic medical bandage. Herbal Medicine for Bursitis -- Arnica oil, comfrey, turmeric, and willow may be helpful. Rotator cuff injury includes tendinitis and partial or complete tears; subacromial bursitis may result from tendinitis. The redness may be accompanied by tenderness or may be warm to the touch. 2. It causes pain and swelling like bursitis, but it usually affects your big toes. Your other hand can grab the outer portion of your thigh. Olecranon Bursitis: This is associated with pain and swelling of the elbows. Some common signs indicating that you might have tendonitis include: feeling pains and aches around a specific ligament, joint or muscle. Hold this pose for at least 6 seconds. When you have bursitis in your shoulder, the pain can be almost unbearable. Ice Therapy. Conventional radiography of the shoulder is the most appropriate imaging approach. Learn about bursitis treatments, including natural treatment options. It usually comes along with rotator cuff tendonitis (the inflammation of the tendons in the shoulder, known as the. Shoulder pain may also be caused by: Arthritis in the shoulder joint; Bone spurs in the shoulder area; Bursitis, which is inflammation of a fluid-filled sac (bursa) that normally protects the joint and helps it move smoothly; Broken shoulder boneClinically, calcific tendinitis is characterized by severe, disabling pain which occurs spontaneously, usually in the morning. * Plus fixed price worldwide P&H. 3. While ice numbs the pain it also prevents healthy blood flow which is essential to providing oxygen and nutrients to the area to heal it, and remove waste products and CO2. This will reduce the amount of swelling and help expedite the recovery time. Ice it a couple times per day, or more if this is acute. Luetmer, M. Trochanteric is a specific type of hip bursitis. Find answers to common questions such as; are there any exercises or foods to help relieve bursitis pain?. Resting, using ice packs and taking over-the-counter painkillers are all recommended by conventional health professionals ways of treating mild cases of bursitis. Eat healthy sources of protein. The most common cause of shoulder pain occurs when rotator cuff tendons become trapped under the bony area in the shoulder. Contact. over-the-counter medicines and natural products. #3 Static shoulder flexor strengthening. . Powerpoint slides. Disclaimer: The information on this page is intended for individuals who have been medically diagnosed with pes anserine bursitis. Bursitis is a very painful condition which is known to afflict the bursae, i. I: Ice the area 10. Bursitis is a frequent condition that affects key joints such as the shoulder, elbow, thighs, elbow, hip, and knee. Don't try to work or play through the pain. joint swelling. Traumatic injury — Shoulder injuries, such as a hard fall, could lead to inflammation in your bursae. Bursitis may be correlated to Peshi Sopham in ayurvedic terms, a condition of inflammation of connective tissue of the joints, with respect to their Doshic predominance. Bursitis is a common age-related joint inflammation that often strikes the knee, elbow, hip, shoulder, or heel. Face your palm towards you. Icing the area of hip bursitis often helps to alleviate the symptoms. Tenderness of the inflamed shoulder joint will occur with bursitis, as well as a pinching pain or impingement when moving the arm. While too much. Return to your daily activities as directed. Infrapatellar bursitis, also known as clergyman’s knee occurs due to the swelling and inflammation of the infrapatellar bursa located just below the kneecap (patella). Ice packs can help to reduce inflammation from the tendonitis and can be very helpful to reduce pain associated with this condition. The procedure, rooted in the body’s natural healing mechanisms, comes with minimal downtime and has shown a track record of reducing pain and improving function. Rochester, MN. Ice packs to reduce inflammation. Wear & Tear: Shoulder pain can also be caused wear & tear. Tennis elbow is, for the most part, caused by bursitis. stiffness. This essential oil contains analgesic and anti-inflammatory properties that may help reduce the symptoms of bursitis. Certified nutritional consultant Phyllis A. Bursitis treatments include the RICE method (rest, ice, compression, elevation), nonsteroidal. Herbs. 16. 10 /15. It may extend to the neck. It is often caused by repetitive motion. It causes pain and swelling like bursitis, but it usually affects your big toes. Use an ice pack, or put crushed ice in a plastic bag. Olecranon bursitis - students elbow. Here are some symptoms to look out for: Pain: You may feel a deep, aching pain in the shoulder joint. So, try to ice the affected joint as soon as possible after noticing pain and inflammation. Hot and Cold Packs. I don't wanna give you false hopes, but if you can do a shoulder MRI then you could tackle the problem better. tender or warmer than surrounding skin. Ice/Cold Compress: Applying ice or a cold compress to your bursitis within the first 24 to 48 hours is crucial to the speed at which it heals. Bursitis in the shoulder, hip, knee or ankle commonly occurs due to a problem in a tendon. Calcific tendonitis is caused by calcium buildup in your tendons. Bursitis is a condition caused by the inflammation of the bursae. Short-term use of an anti-inflammatory drug, such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), can help relieve pain. Shoulder Bursitis can be frustrating and painful. #4 Static shoulder extensor strengthening exercise. If you suspect that you have suprapatellar bursitis then it is important to visit a qualified medical professional in order to rule. Elbow Bursitis Treatment - For the first 24-48 hrs after the initial onset of elbow pain or the visible swelling due to elbow bursitis (olecranon bursitis) it may be appropriate to apply ice and then immobilize and rest the elbow (This should hopefully help minimize the initial swelling). Stand/sit with your arms at your sides. Ice should not be left on for more than 15 minutes at a time. When you are in the early stage of bursitis, or it is your first time having this condition, you can use ice as a natural treatment for it. Active motion involving the injured bursa also causes discomfort, however, the position of. Acidity is an important factor in the development of bursitis. When the bursae around a joint or multiple joints become inflamed, affected individuals may see their joints become swollen or red. In most cases, you can treat tendonitis and bursitis at home with rest, ice and over-the-counter anti-inflammatories, such as ibuprofen or naproxen. Apply ice within the first two days after pain or swelling in the bursa begins. Aspirin, naproxen and ibuprofen are used to reduce swelling. This can be harder to see on brown or black skin. It is an anti-inflammatory agent. Special-Price. immobilize, and begin taking an anti-inflammatory and pain reliever, or try an all natural herbal balm and apply to the area which has. Causes of bursitis. 2 x 10 Pk OSMO Patch. This causes inflammation of the muscles and tendons. trouble sleeping due to pain. Bursitis caused by an injury usually takes some time to develop or due to overuse of the joints, tendons, or muscles near the bursa may have been overused. Subacromial bursitis occurs in the shoulder joint. In extreme cases surgery may possibly be recommended. Limited motions and cool applications are recommended. Avoid high glycemic index foods. These 2 exercises will help in open. Bursitis is acute or chronic inflammation of a bursa. Rest the shoulder. Strain out the cayenne through a couple of layers of cheese cloth and discard the cayenne. Bursitis of the shoulder (impingement syndrome) occurs when there is swelling and redness between the top of the arm bone and the tip of the shoulder. You can use certain methods to relieve bursitis symptoms. Bursitis occurs when the bursa beings to swell and becomes inflamed.  White Willow Bark Cures Bursitis Shoulder. You just need to apply some crushed leaves onto the shoulder on a regular basis. The best way to get rid of bursitis in the shoulder involves rest and protecting the shoulder joint, relieving inflammation and pain, treating any infection, preserving range of motion, avoiding complications, and preventing recurrence. Subachromial Bursitis: This refers to bursitis affecting the rotator cuff of the shoulder. Olecranon bursitis can occur due to several factors. Castor oil is one of the most effective natural remedies for bursitis. When there is too much friction, the bursa become irritated and inflamed leading to bursitis. Learn more about self-care tips for bursitis, including natural bursitis remedies. This is how you make a powerful anti-inflammatory remedy you can use throughout the day. Protect your skin by putting a towel or cloth between the ice pack and bare skin. Belladonna: This medicine is used for shoulder pain developed due to bursitis and experiencing extreme pain, heat, and shaking. . You can also just let the cayenne sit in the oil for a week, but that takes longer, obviously. Medically diagnosed Carpal tunnel syndrome (CTS) results from compression to the median nerve often caused by inflammation and swelling. Acid forming foods tend to bind to the alkaline. Some doctors suggest alternating between hot and cold. Keeping the affected joint out of use and resting on a soft surface will help relieve the pain. Bursitis is caused by the inflammation of a bursa. There are, however, no natural treatments specifically for this condition that have any solid scientific support. g. Trauma: Direct trauma, such as a fall or a blow, to the tip of the elbow can cause the bursa to produce excess fluid and. Bursae, tendons, and ligaments are considered soft tissue although they are also very dense. A bursa is a small fluid-filled sac that acts as a cushion between bone and soft tissue (muscles, tendons and skin). Apply ice 10 to 15 minutes at a time, as often as twice an hour, for 3 days (72 hours). Do not carry out the repetitive movement at least for 3 weeks; let the damage heal. When the bursae become inflamed, they can cause pain in the joints. Ice. Symptoms. Abstract. American Roentgen Ray Society Images of. 2. Advertisement. increased pain when moving or exercising. Hip bursitis can also affect the other bursa in your hip joint — the iliopsoas bursa near your groin. According to the Mayo Clinic, bursitis commonly affects the shoulders and hips but can also lead to pain in the elbows, knees, heels, and the base of the big toes. It helps to reduce the inflammation of the bursa and give symptom relief. Bursitis pain can be farther away from a joint that arthritis, which is in the joint itself. 1. Repetitive overhead activities/movements cause micro trauma to the bursa which then worsens over time, resulting in bursitis. Primary Remedies Arnica montana. CME Programs. Use pain relievers. Cold compress. Rest and cold compresses for treating bursitis. Keeping the affected joint out of use and resting on a soft surface will help relieve the pain. Bursitis can affect any joint, but it's most common in the shoulders, hips, elbows or knees. 30AM – 6. Acid forming foods tend to bind to the alkaline. Other Remedies Belladonna. Also therapeutic ultrasound, acupuncture, massage therapy, electrotherapy, and stretching and strengthening exercises. Diagnosis is usually clinical; however, ultrasonography may be needed. Mint Leaves. Use an ice pack or cold pack on your hip for 20 minutes on and 20 minutes off. Treatment for Chronic Bursitis. Bursitis is an inflammation of bursa, which is a tiny fluid filled sac that acts as a gliding surface between tissues of the body. Bursitis (bur-SY-tis) is a painful condition that affects the small, fluid-filled sacs — called bursae (bur-SEE) — that cushion the bones, tendons and muscles near your joints. Treatments for shoulder bursitis are generally fairly simple. It can be an effective treatment for shoulder bursitis because it can help reduce inflammation and pain while also improving range of motion. Methods such as hot or cold applications, electrotherapy, ultrasound therapy, exercises are used in physical therapy. Pitcher’s shoulder. As with bursae in general, they facilitate movement and reduce friction at tendon -tendon and tendon-bone interfaces. Hips Pain. Shoulder bursae refers to sacs surrounding the shoulder joint that are filled with synovial fluid. It may be characterized under a broader term Vatavyadhi, the diseases that occur due to an upsurge in the Vata entity combined with minor influence of the Kapha entity in this case. Bursitis is an acute or chronic inflammatory condition of a bursa. Shoulder bursitis can be felt as either right shoulder pain or left shoulder pain. Repeat the exercise between 6 and 8 times. In some few cases, bursitis can occur without any good reason. Bruising (from trauma) Numbness/tingling (if swelling presses on nearby nerves) Bursitis caused by infection can also cause: Warm skin. Deep Bursae separate bare areas of bone from overlapping muscles. Have been on various analgesics (on and off) since with varying degrees of success. Lime juice: Another great anti-inflammatory source, lime juice can help ease arthritis-related shoulder pain. Trochanteric bursitis, which is also known as greater trochanteric pain syndrome or GTPS affects bursae in the hip. Bursitis (bur-SY-tis) is a painful condition that affects the small, fluid-filled sacs — called bursae (bur-SEE) — that cushion the bones, tendons and muscles near. Subscapular recess 3.  Boswellia Tree Leaves Lower Bursitis Symptoms. $79. Doctors also suggest: Ice: Cold packs used on the bursitis area may reduce pain. NO Drugs or Steroids! Pain Free & Non-Invasive! Effective Relief of inflammation & associated pain. A person with septic bursitis may have the following additional symptoms: fever. , muscles, tendons, and bone) rub against each other. Needles are strategically placed in and near the area of inflammation around the bursal sac. Our Physiotherapist can also apply acupuncture because it is effective in providing relief of the pain of the bursitis. These over-the-counter medications provide effective, short-term relief by concurrently reducing pain and swelling associated with bursitis. ACV Is Best Bursitis Treatment. Take over-the-counter pain relievers. This test would help the doctor in making a better. A bursa is a small fluid filled sac that forms around joints in areas where there is a lot of friction between. The bursa’s role is to reduce friction between moving parts within the shoulder, but when inflamed, it leads to symptoms such as pain on the outer side of the shoulder, pain. 2 x 10 Pk OSMO Patch. Bursitis is an inflammation of the bursa, most commonly caused by repetitive motion. A bursa is a small, fluid-filled sac that acts as a cushion between bones, tendons, and muscles near joints. When the pain occurs when you aren’t even moving the affected joint, it is almost a dead giveaway that you are suffering from a severe case of bursitis. Bursitis may be caused by injury, infection, or a rheumatic condition. The shoulder, elbow, hip, knee and heel are the most common sites of bursitis. If the affected joint is compared to one on the opposite side of the body, it will be larger and more filled with fluid. The shoulder, hips, knees, and elbows are the most likely culprits. Hip Bursitis Treatment - A correct diagnosis from a qualified health care professional is important to properly identify that your hip pain is due to hip bursitis and not another condition. Note: Not suitable for individuals with seafood or shellfish allergies. More specifically bursitis in the shoulder is the inflammation of a small fluid filled sac known as a bursa. Subdeltoid bursitis occurs under the deltoid and is located under the AC joint (acromioclavicular) which. 2. Apply a cold compress or ice packs wrapped in a thin towel to the area for 15 minutes at a time, a few times a day. This material is provided for educational purposes only and is not intended for. Compared to medications, surgery and other treatment methods - icing and heating have been around for centuries and have always been used. Carpal Tunnel. You can also just let the cayenne sit in the oil for a week, but that takes longer, obviously. Bursitis (bur-SY-tis) is a painful condition that affects the small, fluid-filled sacs — called bursae (bur-SEE) — that cushion the bones, tendons and muscles near your joints. Natural Treatment For Shoulder Bursitis. Posted by Rose (Oregon) on 03/08/2019. eg: a sling for shoulder or elbow. Home. Subacromial Bursitis (shoulder bursitis). The most common locations for bursitis are in the shoulder, elbow and hip. 4 Grab the Citrus. When they work normally, bursae help the tendons, ligaments, and muscles glide smoothly over bone. Shoulder (subacromial bursitis) — Shoulder bursitis causes pain in the shoulder and often extends to the upper arm . The cause is usually unknown, but trauma, repetitive or acute, may contribute, as may infection and crystal-induced disease. A bursa is a fluid filled sac that helps to reduce friction in your shoulder spaces and occur throughout the body not just exclusively in the shoulder. Subacromial-subdeltoid bursa 2. Anti-inflammatory pain medicines – i. 3. Other symptoms of shoulder bursitis include: Muscle weakness. Physical therapists help reduce pain, swelling, and stiffness caused by the condition. #5 Static shoulder abductor strengthening exercise. It is another effective home remedies for bursitis. Even shoulder pain at rest. Treatment at Queen West Physiotherapy and Acupuncture includes ice (initially), heat. The pain is often worse when you move your arm away from your body, lift it above your head, or lie on your affected side. Unfortunately this often is not sufficient to fully resolve shoulder bursitis. Ayurveda. , loss of motion in the shoulder is called "adhesive capsulitis" or frozen shoulder. 343. There are other options that are sometimes used to treat tendonitis and bursitis: Phonophoresis: This technique uses ultrasound to help anti-inflammatory creams absorb through the skin. Hold the stretch for 15 to 30 seconds. Never put the ice pack directly on your skin but wrap it in a cloth or towel. So, if the bones get jagged, the sharp edges will rub against the tissue of the bursae and leave them torn and inflamed. Using motion from the legs and hips, gently swing the hanging hand back and forth and side to side in a circular motion. Your initial treatment should involve decreasing any swelling, relieving any pain and stress on the bursa sac, correcting any bio-mechanical dysfunction, and then restoring strength and mobility to the area where your bursitis is located. Note: Not suitable for individuals with seafood or shellfish allergies. Bursitis is a type of inflammation that affects your joints, causing them to be painful, red and swollen. It is the next well indicated medicine for treating cases of shoulder bursitis. Bursitis is the inflammation of a bursa. Retaining range of motion in the joint is important, so certain exercises are a necessary part of bursitis treatment [source: University of Maryland Medical Center]. Subacromial Bursitis (shoulder bursitis). 2. When you are suffering from acute shoulder pain one of the first steps that you need to take is to decrease the inflammation that is occurring in the tendons of the rotator cuff. 5 Ginger. Overview. the small, fluid-filled sacs which pad the bones, tendons and muscles near the joints. Symptoms. Tea tree essential oil is an anti-inflammatory agent that can lower inflammation of the body and soothe the pain. Bursitis is an inflammation of a bursa, which is a small fluid-filled sac found around a joint. The symptoms include pain, stiffness, redness, tenderness and swelling in the joints. ibuprofen or aspirin; Antibiotics; Acupuncture treatments, Myotherapy treatments or Chinese HerbsMedically Reviewed on 5/10/2023. 90 $69. Alternate applying an ice or cold pack every 20 minutes to help with the inflammation. Also in the acute phase, ice can help calm inflammation and offer acute pain relief. If it starts to bother your stomach, take it less often. Now, place the heat pack on the same spot for 10 minutes. Posted by Rose (Oregon) on 03/08/2019. Bursitis can be caused by overuse. Swelling, pain, heat sensation, redness, and loss of function are the main symptoms experienced and it is your body's way. I put some 5% white vinegar (generic, cheap stuff) on a paper towel, on my knee for 10 minutes. View more treatment options. Simply stick the OSMO Patch over the lump or area of pain on the wrist just before going to sleep. According to medilexicon’s, bursitis is “inflammation of the bursa” The major bursae are located near. Horseradish. For individualised suggestions of homeopathic remedies for Bursitis, tick the relevant boxes below and press the Find Remedies button at the bottom of the screen. Such remedies include topical applications of home remedies like apple cider vinegar and castor oil, internal remedies like ginger root, and supplements like white willow bark. Bursitis Pain: Magnesium Oil (Magnesium Chloride Brine) rubbed deeply into my increasingly painful shoulder & upper arm for about 5-10 minutes, reduced incapacitating pain 90%! Thanks to all who posted your experiences with bursitis improving with magnesium!Before applying the mixture, put on a layer of olive oil and a piece of cotton cloth to apply. Often hip bursitis is not considered at first as the diagnosis as it normally requires imagery such as an MRI to be conclusive. Getting an appointment with Cleveland Clinic bursitis experts is easy. With your other hand, gently press on the back of the affected forearm. One of the most common symptoms of bursitis is swelling in the hip, knee, or shoulder. Keep your shoulders down while performing the exercise to feel a greater stretch on the front. Buy Now. Redness and mild warmth in the area (it is important to note, this can sometimes be a sign of an infection not bursitis) Pain with activity and daily living. General symptoms of bursitis include: joint pain. Primary Prevention. * Plus fixed price worldwide P&H. Heat Or Ice For Hip Bursitis. 95 *. Buy Now. Adhesive capsulitis, also known as “frozen shoulder,” is a common condition of the shoulder defined as a pathologic process in which contracture of the glenohumeral capsule is a hallmark. Ice. #7 Shoulder pendulum exercise. The labrum is the attachment site for the shoulder ligaments and supports the ball. Traditionally, treatments for bursitis consist of temporary pain relief using anti-inflammatory medication, rest, and icing the area. #2 Door stretch for bursa shoulder. Apply ice. Bursitis. Ginger. Cost-Effectiveness of Therapy. Devour Turmeric Milk For Bursitis Symptoms. Bursitis is a common age-related joint inflammation that often strikes the knee, elbow, hip, shoulder, or heel. Subacromial bursitis is a common cause of shoulder pain that can be triggered by various factors, such as trauma, overuse, or infection. Bursitis occurs when the small sac (bursa) found inside joints becomes inflamed. There are upward of 150 superficial and deep bursae. swelling and tenderness. Increased pain at night, especially when lying on the affected arm. Apply ice to reduce swelling for the first 48 hours after. Listen Key facts Bursitis is a condition caused by the inflammation of the bursae. It helps to reduce the inflammation of the bursa and give symptom relief. The cause is not always clear, but it may be due to an infection, injury, or autoimmune disorder. Rest your joint. Mix the cayenne into the oil. Bursitis occurs when the small sac (bursa) found inside joints becomes inflamed. 2 x 10 Pk OSMO Patch. Bursitis is the inflammation or irritation of the bursa. This nutrient contains specific compounds that help reduce inflammation and, in turn, relieve pain. The speed with which you heal bursitis depends on its cause. to prevent. Heat may be better for deeper bursitis in. over-the-counter medicines and natural products. 4. 1. Shoulder impingement occurs when the top of the shoulder blade (acromion) puts pressure on the underlying soft tissues when the arm is lifted away from the body. 95 *. Typically, a needle is inserted into the bursa and drawn out through a syringe. Swelling in the joint. Ice. 1. Apply the ice pack first on the swollen parts for about 10 minutes. After that, heat is a better option. Bursitis has several symptoms. With your elbows at your sides and bent to 90 degrees, pull the band back. If the deposits grow bigger or become irritated, they can cause severe pain.  Castor Oil Compress Eases Bursitis Pain. There are in total 160 bursae in our body. An MRI test is usually carried out to detect if the bursae are swollen or any form of inflammation in the area. 4 Medical Treatment for Bursitis. Depending on the type of shoulder bursitis, treatment may include activity modification, immobilization with a splint, icing, injections, aspiration of the bursa (removing fluid with a. £27. 1. swelling. Elevate the affected joint as much as possible, and use a compression wrap to reduce swelling. Simply said, overuse injuries like this one are frequently brought on by tense and weak muscles. If this is the first time you’ve had bursitis, apply ice packs intermittently. Fish Oil. Lime is also rich in antioxidants. Elevating the joint above your heart will also help reduce swelling. Bursitis On the Web Most recent articles. 2. Carrot juice has always been noted for its healing qualities; therefore, it is a good idea to drink a few glasses of carrot juice every day to help with bursitis treatment. Olecranon bursitis causes inflammation in the elbow. Apply heat (like a heating pad or a hot water bottle wrapped in a towel). Bursitis causes pain and inflammation in the joints. Due to discomfort, the range of motion of the affected joint may be reduced.