Bursitis of the elbow joint: causes, symptoms, treatment. Diseases of the elbow: purulent bursitis and epicondylitis Tumor of the elbow bursitis

Bursitis is a disease that is not common, but it occurs quite often in representatives of some professions. It affects people who perform movements with a load on the same area (tennis players, etc.), or who are constantly in an uncomfortable position.

• Bursitis - what is it
• Causes of the disease
• Symptoms
• Types of bursitis
• elbow joint
• hip joint
• Fingers
• Heel
• Treatment at home
• "Hardening" of the joints
• Cocktail
• Compress for elbow bursitis
• Compress from Kalanchoe
• Cabbage
• Medication treatment
• Puncture
• Treatment with folk remedies
• Vegetables
• Propolis
• Sugar
• Pine needle baths
• Prevention of bursitis

Bursitis - what is it

In the area of ​​​​the joints, due to the active movement of the ligaments and bones, friction almost always occurs. Synovial fluid, which improves gliding and reduces friction, acts as a lubricant for the joints. It is located in periarticular bags - bursae, which are cavities lined with glands. It is the inflammatory process that begins in them that is called bursitis. There are several types of this disease.

It is interesting! In total, there are about 160 synovial bags in the body.

1. Purulent. In this case, pus forms in the bag. The disease is bacterial in nature.
2. Serous. This form is considered the easiest, but if left untreated, there is a risk of transition to a purulent or hemorrhagic form.
3. Hemorrhagic. In this case, bleeding occurs in the joint.

In addition, there are acute and chronic forms of the disease.

Often there is bursitis in the elbow, shoulder, knee, hip joints, in the heel and Achilles tendon.

Causes of the disease

The reasons for the development of bursitis are different.

1. Injuries. This can be a professional constant load on the knees or elbows, uncomfortable shoes, frequent running and long, fast walking, long sitting on a hard surface (for example, long cycling).
2. Infections. There is a risk of infection entering the synovial cavity during trauma or with a decrease in immunity (in this case, the virus "travels" through the blood or lymph flow).
3. Chronic diseases, due to which salt deposits occur in the synovial bag, are gout, systemic scleroderma, rheumatoid arthritis.

In addition, the cause of the development of bursitis can be diathesis, which in itself is not a disease, but facilitates the development of inflammatory processes, which include bursitis. Sometimes the causes of the disease cannot be established - it occurs unexpectedly on its own.

Important! The older the person, the higher the risk of bursitis, which is associated with a decrease in the elasticity of the walls of the synovial bag, an increase in its density.

Symptoms

The first manifestation of bursitis is swelling and swelling in the area of ​​​​inflammation of the synovial bag. In this case, the patient is disturbed by pains of a shooting or aching nature, persistent redness of the skin. Limb movements are limited, in case of palpation pain appears. Especially, pains and puffiness amplify at night.

If bursitis is complicated by an infection, the immune system reacts to it with an increase in temperature, from 38 to 40 degrees. This indicates the development of a purulent form of the disease. In this case, the pain in the limb intensifies, becomes pulsating, there are signs of general intoxication of the body with nausea, headache, and fever. Nearby lymph nodes may be enlarged.

Important! If left untreated, bursitis can turn into purulent arthritis. In this case, the movements of the affected limb, even minimal ones, cause severe pain.

In the chronic course of the disease, the resulting swelling has a soft texture, and the mobility of the limb is not limited. The skin over the edema is mobile.

Types of bursitis

Bursitis of the shoulder joint is dangerous because it is difficult to identify it until you suddenly find soreness in the arm when making any movement. Even swelling may not be too conspicuous. Rotational movements and raising the arms up causes pain.

Attention! Learn about knee bursitis in our article.

elbow joint

Bursitis of the elbow joint is a very common disease and among all varieties of bursitis it ranks first in terms of frequency of occurrence. Often, like other types of the disease, it appears due to permanent, occupational injuries, therefore it is diagnosed mainly in athletes, especially tennis players.

hip joint

Hip bursitis is considered the most difficult, as the joint is hidden deep inside, making it a difficult task to treat. In addition, the disease can cover the joint completely.

Fingers

Bursitis of the big toe is bent, it is deformed. The so-called "bone" on the leg, which occurs in many elderly people. It is believed that the disease is hereditary, but it is known for certain that taking care of the legs will not allow it to develop. The degree of curvature can be initial, moderate and severe.

Attention! Women who frequently wear high heels have an increased risk of developing bunions.

Heel

Calcaneal bursitis develops on the calcaneus due to constant physical stress on the Achilles tendon. The patient is worried about severe pain in the joint, especially at night, and movements in the ankle joint are limited.

Treatment at home

First of all, it is recommended to provide the affected joint with relative rest, reducing movements to a minimum. It is best to provide the patient with complete bed rest. However, it should not last more than 10 days - after stopping acute inflammation, you need to start doing gymnastics, at first light, over time complicating the exercises.

Remember! The damaged joint needs reliable fixation - for this, use a tight bandage, which will help to avoid swelling of the tissue. Compresses are also placed on the joint using Vishnevsky ointment.

"Hardening" of the joints

Take ice cubes and apply to sore joints for 10 minutes. When the pain subsides, change the ice for a warm compress. A warm compress can be based on potatoes or a decoction of herbs (yarrow, burdock, St. John's wort, chamomile).

Cocktail

Take a glass of pre-boiled water, still warm, and stir in it a teaspoon of honey and vinegar. It is best to use natural vinegar. Drink a cocktail for 2 weeks, 2 glasses daily.

Compress for elbow bursitis

You will need sour milk and eggshells.

1. The shell, having been cleaned of the film and dried, must be crushed into powder.
2. Pour it with warm sour milk to make a homogeneous mass, and make a compress out of it.
3. It is important to keep the compress warm, so place some cellophane over the compress and secure it with a terry cloth.
4. Apply the compress at night for 5 days, but if the pain does not go away, repeat the course after 5 days of break.

Based on honey, vodka and aloe juice (in a ratio of 2: 3: 1), a similar compress is made.

Compress from Kalanchoe

Pick 3 fresh leaves from the plant, wash them, and refrigerate overnight. In the morning, pour boiling water over the leaves to release the juice. Make a compress out of them on the inflamed joint. Change the compress frequently. Within a few days, you will notice tangible results.

Cabbage

Take fresh cabbage leaves and apply them to the joint with the inside, changing the compress every 4 hours.

Medication treatment

The basis of treatment includes medicines, exercise therapy, massage, physiotherapy. Treatment is necessary both internal and local, therefore, when treating with drugs, it is not at all necessary to refuse compresses from ointments or medicinal plants.

Important! The main task during treatment is to relieve inflammation, relieve pain, and restore the functioning of the joint.

Often, antibiotic therapy is indicated for bursitis. If bursitis was caused by microbial flora or it appeared as a result of an infectious injury, antibiotics are prescribed. Moreover, not one, but several drugs at once:

• Lincomycin;
• Ceftriaxone;
• Amoxiclav and others.

They are administered intravenously and intramuscularly, as well as directly into the area of ​​​​the inflamed bursa.

Puncture

About a puncture (puncture) of a bursa responses are very inconsistent. Some believe that this procedure can cause irreversible changes in the structure of the joint. Yes, and the risk of developing sepsis is present. However, on the other hand, without removing the exudate, the diseased joint will not recover.

Steroid hormones that provide anti-inflammatory drugs are injected directly into the joint cavity - Diprospan, Kenalog. True, they also have their drawbacks - they inhibit the recovery processes in tissues. But without anti-inflammatory drugs, the inflammatory process cannot be stopped, therefore their use is necessary.

Non-steroidal anti-inflammatory drugs help, in addition to relieving inflammation, to eliminate pain, swelling and hyperemia. These means include:

• ibuprofen;
• Diclofenac;
• Voltaren;
• Indomethacin.

They are used both externally (ointments) and inside (injections, tablets).

Important! These drugs adversely affect the functioning of the gastrointestinal tract and blood clotting, so be sure to consult your doctor before using them.

When bursitis is accompanied by fever and intoxication of the body, glucocorticosteroids may be prescribed. They are administered intravenously, into the joint or drunk in the form of tablets. The course of treatment is up to three months.

Ointments

Also, ointments are used for bursitis (Levomikol, Vishnevsky ointment, Collagen Ultra). A very popular compress from Vishnevsky's ointment and alcohol or cologne.

1. Apply ointment on a piece of cotton fabric, and then vodka.
2. Compress do with an interval of a couple of days. You need to keep it for a day.
3. It will help reduce the swelling.

With a purulent form of the disease, it is necessary to remove pus and clean the joint from fluid. This fluid is examined to determine the pathogen in order to select the most appropriate antibiotic. Then the bursa is washed with an antiseptic solution and appropriate antibiotics are administered.

Physiotherapy procedures

They are prescribed to improve blood circulation, reduce swelling and improve joint mobility. The procedures are indicated after the relief of an acute inflammatory process.

1. Ultrashortwave therapy (UHF).
2. Irradiation is ultraviolet.
3. Phonophoresis (along with analgesics).
4. Magnetotherapy.
5. Laser treatment.
6. Paraffin or mud applications are especially effective for chronic bursitis.
7. Acupuncture.
8. Mineral baths.

When bursitis goes into remission, doctors advise using therapeutic exercises and manual massage.

You can also massage the damaged area yourself, but remember that you need to do this carefully - an incorrectly done massage can only worsen the patient's condition. Massage the inflamed area at night, using oils for plants - eucalyptus, vaseline and lavender.

Therapeutic exercises are especially important for bursitis. It helps to improve blood flow and, as a result, tissue nutrition, restore the motor function of the joint. Exercises are selected and individual taking into account the age of the patient and the type of bursitis. As a rule, the initial exercises are very simple - just swing your arm back and forth.

Treatment with folk remedies

Advice! It is important to coordinate the use of folk recipes with a doctor - bursitis should not be treated on its own.

Vegetables

It is effective to make compresses from vegetables, alternating them with each other. Vegetables such as potatoes, beets, cabbage are best suited.

1. For example, on the first day, cut potatoes into circles and, laying them out on a cloth, wrap them around the damaged joint. Do not forget to fix the compress with something warm (scarf or towel).
2. The next day, use beets or finely chopped cabbage as raw materials.

Propolis

Make compresses and based on propolis. To do this, pour vodka (100 g) propolis (10 g) and leave to infuse in a dark place for 5 days. Apply a compress to the swollen joint until it goes away.

Sugar

Take a glass of sugar and lightly heat it in a pan. Try not to melt the sugar under heat. Sugar should be poured into a bag of dense fabric and applied to the joint, and then wrap the compress with polyethylene and a towel.

1. A tablespoon of celery seeds should be poured with a glass of boiling water and insisted for 1.5 hours. After strain and drink 2 weeks 2 times a day.
2. Grapefruit juice. Drink ½ citrus juice 3 rubles / day.
3. Pluck the lilac leaves and squeeze them. Use for compress.
4. Aloe juice, honey and alcohol (take parts in a ratio of 1:2:3) mix and apply in the form of compresses.

Compress for chronic bursitis

Melt teaspoons of honey and soap shavings in a water bath. Spread the mixture on a clean cheesecloth and sprinkle it with finely chopped onions. The compress must be insulated and left overnight. This old method is proven and effective.

Remember! Chronic bursitis can lead to adhesions in the joint that impair function. In the chronic stage, this disease is effectively treated with folk recipes.

Pine needle baths

Gather needles, cones and pine branches, cover with cold water and boil for 30 minutes. After that, leave to infuse for 12 hours in a closed vessel. About 1.5 kg of raw materials should be used per bath. Take a bath for 20 minutes. If bursitis has affected an arm or leg, limit yourself to a bath. In this case, pine needles will need only 300-500 g.

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What it is?

In order to understand what this Latin term means, let's briefly consider the anatomy of the elbow joint.

So, the elbow joint has the following structure:

It is formed by one large bone - the humerus - from above, from below, two smaller bones participate in it - the radius and ulna (they also form a joint between themselves);

Between the radius and the humerus, between the beam and the elbow, as well as between the elbow and the skin, there are synovial bags (“bursae” in Latin), which are filled with a small amount of a special “lubricating” (synovial) fluid.

They are “invented” in order to maximally mitigate friction during movements in the joint and to reduce traumatization of surrounding tissues during the performance of the articular function.

Inflammation of one of the joint bags, accompanied by the accumulation of an increased amount of pathological fluid in it, is called bursitis.

Symptoms of the disease

In the area of ​​one of the synovial bags, a swelling appears, which looks like a seal, rather soft when palpated, having a size of about 70-100 mm.

At the same time, you feel:

• fluctuation of fluid inside the joint;
• pain in the area of ​​the affected joint;
• pain on movement in the elbow.

A distinctive feature of bursitis specifically - movements in the elbow are painful, but possible - this differentiates this disease from arthritis.

If the effusion in the bag becomes infected and becomes purulent, then this pus can begin to melt the surrounding soft tissues (phlegmon).

In this case, the following symptoms appear:

• body temperature rises;
• weakness, fatigue;
• nausea and/or vomiting;
• the joint area is red, very painful, tense;
• there may even be confusion and a delusional syndrome with a sufficient amount of effusion caused by an aggressive pathogen.

Kinds

According to the nature of the course, the disease is divided into several main types.

Spicy

This is a first-time disease that usually occurs as a result of a joint injury, which is often later joined by an infecting microorganism (this will be called acute purulent bursitis).

At the same time, the synovial bag sharply increases in size, becomes hemispherical in shape.

Initially, with acute bursitis, a serous (clear and sterile) fluid accumulates in the bag, but with sufficient trauma, blood or blood plasma (hemorrhagic bursitis) also gets there.

Blood stimulates fibrin deposits in the cavity of the synovial bag, then fibrin is organized, blocks the vessels of the synovial membrane.

As a result of this process, the wall of the bag thickens, the surface of its inner shell is covered with connective tissue, which, growing, begins to divide the cavity of the bag into additional pockets (acute proliferative bursitis).

Purulent

It develops when bacterial microorganisms enter the cavity of the synovial bag.

These microbes can get there:

• along the lymphatic pathways from the foci of purulent inflammation (boils, carbuncles, erysipelas, bedsores);
• through the bloodstream (with angina, influenza, brucellosis);
• contact - with a direct wound of the bag with an infected object or with a purulent process in the joint, when the shell of the synovial bag is in direct contact with pus.

By the nature of the microbe that caused the process, bursitis can be:

• specific: gonorrheal, brucellosis, syphilitic, tuberculous;
• non-specific: such bursitis is caused by the "usual" coccal flora.

Chronic

Occurs due to frequent (constant) mechanical irritation of the bag.

This is especially common in people of such professions, who, by the nature of their activities, often make movements at the elbow (“tennis player’s elbow”) or rub their elbow against the surface of the table (“watchmaker’s elbow”, “jeweler’s elbow”).

recurrent

Occurs when, after the inflammatory process subsides, areas of dead tissue or inflammatory fluid remain in the bag of the elbow joint.

Because of this, at the slightest mechanical injury to the bag or conditions unfavorable for the joint, the disease flares up again.

Causes of the disease

The factors provoking the development of bursitis include:

• entry of a microbe into the cavity of the synovial sac: through the lymph, by blood flow, by contact;
• bruises, wounds, abrasions of the elbow joint;
• permanent joint injuries in certain professions;
• long static position with support on the elbows (when performing certain work, in a state of alcoholic or drug intoxication);
• due to some systemic diseases: rheumatoid arthritis, scleroderma, gout.

Diagnostic methods

Diagnosis is usually easy to make on the basis of examination data from an orthopedic traumatologist.

But to clarify the prevalence of the process and exclude complications, there are a number of methods of instrumental diagnostics:

• X-ray of the joint: allows you to establish the presence of an inflammatory process in the joint.
• Ultrasound of the joint: helps to clarify the size and localization of the inflamed bag, the amount of exudate in it
• Joint MRI: allows to diagnose bursitis of deep articular bags.

How to treat?

This disease should be diagnosed as early as possible in order to start adequate treatment in a timely manner.

Therapy of acute and chronic forms has differences.

Treatment of acute and purulent bursitis of the elbow joint

First aid

In the case of an acute non-purulent process, it is important to do the following:

• apply a tight pressure bandage to the joint, which will not stop arterial circulation, to reduce tissue swelling;
• form a fixing scarf (orthosis), which will support the hand in a physiological position.

Medications

For the treatment of bursitis, various types of drugs are used.

The choice depends on the type of acute pathological process occurring in the bag - whether it is serous, hemorrhagic or purulent.

Antibiotic treatment

In the event of bursitis, a puncture of the bag is performed.

According to the results of the analysis of the punctate, antibacterial treatment is prescribed:

• with purulent bursitis the contents of the inflamed bag are sown on nutrient media to determine the type of microbe and its sensitivity to antibiotics. Until the results of the culture are obtained, treatment with broad-spectrum antibiotics in the form of injections is prescribed. After receiving the results, the drug can be changed taking into account antibiotic sensitivity;
• with serous or hemorrhagic bursitis antibiotics are prescribed to prevent suppuration. Tablets may be used.

Video: puncture technique for ulnar bursitis

Dimexide therapy

Compresses are used with this preparation, which itself, diluted 1: 4 with boiled water, is an excellent antiseptic.

Dimexide draws out pus and prevents its appearance in the joint bag.

If such a diluted drug is sprinkled on top with a dry antibiotic (for example, Ceftriaxone), then it will not act on its own, but will conduct the antibiotic through the skin, delivering it to the joint.

injections

In the treatment of bursitis, both intramuscular or intravenous injections (antibiotics, anti-inflammatory, analgesic and absorbable drugs) and the introduction of drugs into the bag of the elbow joint are used.

In this case, the joint is injected:

• antibiotics;
• anti-inflammatory hormones ("Hydrocortisone", "Kenalog");
• antiseptics.

iodine

This antiseptic is used to treat superficial wounds and abrasions in the area of ​​​​the inflamed joint bag - only if there is no allergy to this drug.

There is also a prescription for the "folk" treatment of bursitis with iodine (should be used in combination with the therapy prescribed by the doctor), for which they take:

• 1 small bottle of iodine;
• 1 bottle of triple cologne;
• 1 bottle of valerian extract;
• 6 powdered tablets of Analgin.

All components are mixed, insisted in a dry, dark place for 5 days, then used as rubbing on the joint.

Ointments

For the treatment of bursitis, the following ointments can be used:

• traumeel C (homeopathic anti-inflammatory agent);
• dimexide (it is already available in the form of a gel for external use only);
• anti-inflammatory ointments: Voltaren, Diclofenac, Indomethacin and others.

Tablets

In the form of tablets can be used:

• anti-inflammatory drugs: "Nimesil", "Diclofenac", "Analgin";
• "Prednisolone" in tablets (only for serous inflammations, in exceptional cases);
• antibacterial drugs - as prescribed by a doctor.

Other conservative treatment

In the treatment of bursitis, "all means are good", so traditional medicine methods must be combined with complementary therapy.

Treatment with leeches

In this case, when placing leeches in the area just above or below the elbow joint, the following occurs:

• improvement of microcirculation in the "sick" bag;
• venous stasis decreases (hence, the cavity of the bag is cleared faster);
• tissue ischemia is eliminated;
• tissue trophism improves.

The leech acts on the diseased joint with several enzymes at once, the main of which is destabilase - an enzyme that "cuts" blood clots and clots in the cavity of the bag.

Folk remedies

• Tear off several sheets of Kalanchoe, beat them off. Apply them to the area of ​​​​the diseased joint, wrap it well with a woolen scarf.
• Soak gauze with a decoction of burdock root, put it on the joint, cover it with polyethylene on top, wrap it with a woolen scarf.
• Cut raw potatoes into thin circles, put them on a cotton cloth, wrap the joint. Cellophane is placed on top, then wrapped with a woolen scarf or scarf.

At home, you can also use the following methods:

• Baths for a diseased joint (if the process is not purulent) from a decoction of branches and cones of needles. To do this, branches and cones are poured with 5 liters of cold water, the mixture is brought to a boil, boiled for about half an hour, infused for 12 hours.
• Three times a day, half an hour before meals, take half a glass of freshly prepared grapefruit juice.
• Mix 30 grams of propolis with 20 grams of soft butter. One hour before meals, three times a day, take a teaspoon of this mixture.

Physiotherapy

The following methods are used:

• ultrasound;
• diathermy;
• ultraviolet irradiation;
• when inflammation subsides - paraffin applications, balneotherapy.

Surgical treatment

In acute purulent bursitis, the inflamed bag is opened, its walls are excised, and treated with antiseptics. Next, the wound is carried out in an open way.

With a recurrent purulent process, the inflamed bag is completely excised, the wound is washed with antiseptic solutions, then the person receives antibiotics in the form of injections, painkillers, and UV irradiation of the wound.

Treatment of chronic and recurrent forms of the disease

After the first course of treatment of an acute process, it is important to undergo physiotherapy procedures.

If the process has developed as a result of professional activity, the patient is recommended to change the type of work.

Periodic thermal procedures, compresses with Dimexidum, application of anti-inflammatory ointments to the joint area are also used.

If the purulent process recurs, the main type of treatment is surgical, when the synovial sac is completely excised.

After that, a person receives antibacterial and anti-inflammatory therapy for about 7 days.

Prevention measures

It consists in eliminating stress on the joint.

Sometimes - in the chronic course of the process - it is recommended to wear special orthoses.

Also, the concept of "prevention of bursitis" includes:

• timely treatment of wounds and joint injuries;
• treatment of common inflammatory diseases;
• wearing protective bandages on the area of ​​the subcutaneous bag, if your work is associated with constant external trauma to the tissues of the joint.

Thus, the treatment of elbow bursitis should be comprehensive, including both local and general therapy, the use of folk and physiotherapeutic agents.

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Distinctive features of the treatment of acute bursitis

The acute form of this disease can be treated on an outpatient basis. It is necessary to fix the diseased joint. This is best done with an elastic bandage. In especially acute cases, the doctor can fix the joint with a plaster splint.

To relieve an intense inflammatory process, ointments based on non-steroidal anti-inflammatory drugs are usually used. Such drugs as Diclofenac, Nikoflex have proven themselves in the treatment. With severe pain syndrome, glucocorticosteroid drugs are used. Most often, the doctor prescribes hydrocortisone ointment to patients. In the same cases, the introduction of Novocain is indicated.

Joint punctures are prescribed if treatment with ointments does not bring a pronounced result within a week. Antibacterial agents are indicated only if an infection joins the inflammatory process.

After conservative treatment of bursitis with ointments, provided that the main symptoms subside, physiotherapy is indicated. Irradiation with ultraviolet rays, phonophoresis, electrophoresis are prescribed. Showing alcohol compresses, dressings.

Use of antibiotics

Local antibiotics for bursitis are prescribed only by a doctor. It is strictly forbidden to independently prescribe such medicines for pain in the joints and their inflammation. Usually, Levomycetin or another antibiotic-based ointment is used, which is prescribed after a thorough diagnosis of the inflammatory process in the joint bag.

For treatment, ointments with non-steroidal anti-inflammatory drugs can be used in parallel. Is it Ibuprofen or Diclofenac. However, in the treatment of NSAIDs, the use of an antibiotic is mandatory: in this way, it is possible to significantly reduce the severity of the inflammatory process in the elbow.

Along with creams, antibiotic injections may also be prescribed. This type of treatment is required for purulent complicated bursitis.

Application of Diclofenac

Ointment or cream Diclofenac is widely used to treat inflammation of the articular bag. Among the advantages of such a medicine, one can name not only its excellent analgesic effect, but also an affordable price. This drug is not suitable for self-medication: the patient should in any case consult a doctor before starting therapy.

Ointment has the following contraindications:

• diseases of the digestive organs at the stage of exacerbation;
• aspirin triad;
• violations of hematopoietic processes, especially of unknown origin;
• sensitivity to Diclofenac or to any other drugs of a similar group.

During treatment, the dosage prescribed by the doctor must be observed. The patient cannot determine it on his own. Sometimes a higher dose is prescribed by a doctor for severe pain.

When treating with Diclofenac, care must be taken, as the drug can cause the following side effects:

• nausea, vomiting and other disorders of the digestive tract;
• liver dysfunction (very rare);
• headaches, dizziness and increased nervous irritability;
• increased fatigue;
• sleep disorders;
• feeling of "doubling" in the eyes;
• depressive states;
• blood disorders: a drop in the number of red blood cells, leukemia, thrombocytopenia;
• skin disorders: rash, itching, hair loss;
• burning and redness at the site of external application.

It must be remembered that joint treatment with Acetylsalicylic acid significantly reduces the effectiveness of the ointment for knee bursitis.

Remedies with Ibuprofen

Ointment with Ibuprofen does not have a pronounced systemic effect on the body. Its components are selected in such a way that it is active only in areas of inflammation. The drug is effective not only in diseases of the elbow joint, but also in cases where a person, for example, has a knee pain.

The peculiarity of the ointment is that its active ingredient slowly penetrates into diseased tissues. This achieves the effect of prolonged action of the drug. Just in the affected tissues, it is possible to achieve increased concentrations of Ibuprofen. As a result, getting rid of pain and inflammation occurs quite quickly.

Ointment can be used in the following cases:

• pain in the joints;
• phenomena of inflammation in the elbow;
• limitation of active movements in it;
• edema and degenerative lesions of the periarticular bag;
• bruises of the elbow (without breaking the integrity).

Ointment or cream should be applied with a strip on the affected area of ​​​​the body and rubbed until completely absorbed. Usually, the doctor indicates to the patient in detail the duration of treatment. Based on the instructions or other information, it is impossible to determine the duration of therapy.

As a rule, subject to the rules of therapy and all the instructions of the doctor, side effects develop very rarely. In exceptional cases, allergic reactions may occur. This happens with increased sensitivity to the active components of the ointment.

It can not be used during pregnancy, violation of the skin, children (up to 14 years) age. It is unacceptable to treat bursitis of the knee joint during breastfeeding, as its active components enter the milk and have an adverse effect on the child. Such an ointment is especially carefully used for bronchial asthma, hay fever.

When to use Dolobene and its analogues

This is a combination drug, it consists of Dimethyl sulfoxide, Heparin and Dexpanthenol. It promotes the restoration of affected tissues and activates metabolic processes in them.

Dolobene can be used in the following cases:

• elbow joint injuries, including sports ones;
• muscle damage;
• inflammation of the articular bag of the elbow;
• sprain;
• sharp pain in the elbow;
• other degenerative disorders of the joint, leading to a pronounced impairment of mobility.

Dolobene gel should be applied to the affected area and then evenly distributed over the affected surface, rubbing into the skin. This must be done very carefully so as not to cause additional pain. You can additionally apply a bandage.

You need to be careful, because Dolobene can cause such side effects:

• local allergic reactions;
• itching and burning sensation
• the appearance of an unpleasant aftertaste in the mouth (this sensation passes quickly);
• sometimes there may be some change in the sense of taste);
• Quincke's edema can be observed very rarely.

It is forbidden to use Dolobene gel for severe disorders of the liver and kidneys, in addition, for vegetative - vascular dystonia. The drug is not prescribed during pregnancy and lactation. Children under the age of five are not prescribed such a medicine due to the lack of treatment practice. It must be remembered that this is still a non-steroidal anti-inflammatory drug, and it is taken with all caution.

The use of Vishnevsky ointment for bursitis

This ointment contains tar, castor oil and xeroform. Refers to antiseptics. However, Vishnevsky's ointment is an excellent mixture for the treatment of inflammatory processes, as it dissolves exudate well.

The action of the ointment is based on the properties of its components:

• xeroform has a strong anti-inflammatory effect and well relieves purulent inflammation of the articular bag;
• birch tar intensifies blood flow to diseased tissues;
• castor oil softens the skin and helps other ointments to be absorbed into the skin more quickly.

Such an ointment for bursitis is well absorbed into the skin due to its structure. It is very easy to apply, then it is quickly absorbed into the affected tissues.

Ointment from bursitis of the knee joint is recommended to be used only according to the testimony of a doctor. With bursitis, it is highly undesirable to self-medicate, since the disease can become chronic. Contraindication to the use of the drug is a pronounced tendency to allergic reactions.

Warming ointments for bursitis

They contain specific components that increase capillary permeability: snake or bee venom, pepper extract, essential oils. They locally cause tissue hyperemia and increase blood flow. The only remark regarding the use of such compounds is that they cannot be prescribed in the acute period or immediately after the injury, since in this case, on the contrary, cooling of the tissue is necessary.

Typically, these ointments include:

• Methyl salicylate;
• Ketoprofen;
• ibuprofen;
• Diclofenac.

The action of all ointments of this group is aimed at getting rid of unpleasant symptoms and the speedy restoration of active movements in the joints.

The modern market offers a huge number of warming ointments that are successfully used against bursitis. They perfectly cope with the symptoms of inflammation of the articular bag. All such drugs, despite the fact that they can be used at home, are prescribed only by a doctor. Self-treatment of bursitis is prohibited, since it is impossible to get rid of it under such conditions, and the risk of developing dangerous complications increases significantly. The vast majority of these drugs are sold in pharmacies without a prescription.

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Types of bursitis

Bursitis is divided by duration:

• spicy: it is manifested by sudden pain when making movements with a limb and a rapid accumulation of exudate. Perhaps an increase in temperature, the appearance of general intoxication and dysfunction of the main organs;
• chronic: manifested for a long time by aching pain in the elbow without disturbing the mobility of the arm. The pathology is characterized by a dense small formation, but there will be no large tumor;
• recurrent: manifested by exacerbation of chronic pathology with the presence of some part of the inflammatory exudate due to repeated trauma and violation of the structure of tissues by infection.

Depending on what inflammatory and pathological processes develop in the synovial bag of the elbow, the type of bursitis is distinguished:

• purulent: when filling the bursa with purulent exudate caused by infectious and pyogenic bacteria;
• serous: when filling the bag with a clear liquid that is not associated with infectious agents;
• hemorrhagic or post-traumatic with accumulation of blood. Manifested after injuries and due to specific infections;
• fibrinous with deposition of fibrin in the cavity of the bag. This indicates a tuberculous process in the body;
• calcareous with accumulation of calcium salts in the bursa capsule. At the same time, it loses its elasticity and cannot perform depreciation protection of the joint.

The video in this article shows an operation for purulent elbow bursitis:

Inflammatory pathology is also distinguished by two more classifications:

• specific bursitis: manifested against the background of syphilis, gonorrhea, brucellosis. His treatment begins after complex therapy that eliminates the underlying disease;
• non-specific infectious bursitis due to trauma: cut or open fracture. Through the wound, the pathogen penetrates, pus and blood accumulate in the bursa. The condition of the pain zone is dangerous with possible necrosis or blood poisoning.

The reasons

The main reasons for the development of pathology are as follows:

• injuries: blows, falls on the elbow, microtrauma due to the forced repetition of the same movements at work;
• overload of the elbow joint in sports competitions and training, when doing hard work, for example, in a mine, in factories or in auto mechanic workshops;
• penetration of infectious microorganisms into the blood and lymph: Staphylococcus aureus, streptococcus, as well as specific bacteria: tubercle bacillus, treponema pallidum, brucella, gonococcus;
• joint diseases: rheumatoid or gouty arthritis, systemic scleroderma, lupus erythematosus;
• allergy: the body can respond to allergens and their effects by developing inflammation in the bursa in children under 7 years of age and school age;
• unknown cause of the inflammatory process. Then this form of pathology is called cryptogenic.

Bursitis symptoms

Bursitis can develop against the background of psoriatic, rheumatoid or gouty arthritis, due to microtrauma resulting from constant reliance on the elbow on a hard surface during work. An old mechanical injury, a fall on the elbow can also manifest itself as inflammation of the elbow joint. In case of damage to the skin and penetration into the bursa of infection (bacteria), purulent inflammation develops.

The infection can spread through the bloodstream and lymph within the body from another infected organ. Weakening of the immune system, metabolic disorders, diabetes mellitus, and even treatment with steroid drugs can lead to inflammation in the elbow, for an unknown reason, symptoms of idiopathic bursitis may occur.

If local inflammation develops, then it will manifest itself with the following symptoms:

• redness of the skin;
• swelling and edema;
• an increase in local temperature;
• pain attacks during palpation and movement of the hand;
• dysfunction of the joint: a decrease in the range of motion and performance.

A slight puffiness gradually turns into a hemispherical or rounded dense and elastic formation, the size of which can reach 10 cm or more. Pain and symptoms of intoxication of the body appear: body temperature rises, weakness and malaise, nausea and vomiting are concerned. Before treating bursitis of the elbow joint, it is necessary to undergo diagnostics, including differential testing, to identify the nature of the causative agent of the pathology.

To confirm bursitis and/or a concomitant disease (such as arthritis), the doctor prescribes an x-ray and a puncture. Accurate confirmation of the etiology of the disease is confirmed by a general and biochemical blood test.

The size and localization of inflammation in the bags and the amount of exudate in them can be found in the study of ultrasound of the joint. Deep inflammation can be diagnosed by MRI results.

Treatment

Before treating chronic bursitis of the elbow joint, it is necessary to perform a puncture to remove exudate. In case of inflammation due to trauma, antibiotics and hormonal agents, such as Hydrocortisone, should be injected into the bag.

Treatment of bursitis of the elbow joint should be comprehensive and include surgical, medical, physiotherapeutic, non-traditional and folk methods.

Important! In order not to exacerbate inflammation even more, it is necessary to unload the joint as much as possible and reduce its work with a tight bandage, without disturbing blood circulation, put on a bandage or orthosis, and support the arm with a scarf or special belts.

The price for bandages for the elbow is from 200-150 rubles, for orthoses - from 500-900 rubles. If bursitis is associated with an extensive closed injury, then the limb is immobilized with a plaster cast or splint.

Surgical operations

If chronic, acute and purulent bursitis of the elbow joint is detected, the treatment involves opening the inflamed focus. Bursectomy is used: excision of the ulnar bag, then drainage. A special tube is inserted to remove all purulent exudate, rinse and inject antibacterial drugs and corticosteroids for inflammation.

Constant relapses lead to thickening of the walls of the bursa, the formation of folds and an increase in its volume. Conservative treatment does not always give the expected effect, so the bag is cut and excised using general or local anesthesia.

To ensure rest and speedy healing of the wound, a splint is applied for 5-7 days or more. During this time, the connective tissue grows, forming a new articular bag. Next, orthoses or bandages are used.

If it is possible not to operate, then the purulent contents are removed and the cavity of the bag is washed during the puncture.

Medicines

After a course of non-steroidal drugs for inflammation of Ibuprofen, Ketorolac, pain and temperature in the inflammatory epicenter decrease.

It's important to know. To reduce the negative impact of nonsteroidal drugs on the gastrointestinal mucosa, drugs of the proton inhibitor group should be taken simultaneously: Nexium, Esomeprazole, Omez and others.

In the presence of a purulent-infectious process in the bursa, broad-spectrum antibiotics are taken. The doctor prescribes an antibiogram, according to the results of which he individually selects the necessary medicine. In advanced cases, corticosteroids are injected into the joint. After removing the purulent exudate, Kenalog is injected into the bursa, the most popular steroid hormone for stopping inflammation.

Attention! It is impossible to prescribe antibiotic prophylaxis on your own for non-infectious bursitis! It will not bring benefits, but will only develop the addiction of bacteria to the drug.

If there are no wounds, scratches on the elbow joint and it is free of plaster or bandages, then the problem area is lubricated with anti-inflammatory gels and ointments, such as Nise, Diclofenac, Voltaren or Ibuprofen. Strengthen the body with vitamins, calcium preparations, immunostimulants.

Physiotherapy

In the post-acute period, in order to eliminate inflammation and improve metabolic processes, physiotherapy is prescribed for the elbow joint:

• UHF or ultrasound;
• magnetotherapy;
• phonophoresis for hydrocortisone;
• paraffin wraps;
• ozocerite applications;
• acupuncture;
• acupressure.

To physiotherapy add the treatment of bursitis of the elbow joint with folk remedies and / or natural natural remedies at home, like bischofite or stone oil.

Stone oil consists of aluminum alum with magnesium sulfate and water-soluble salts. It is collected from the surface of rocks. But it should not be confused with mumiyo, since oil is a mineral product, and mumiyo is an organomineral product.

These two mountain substances have a different composition. Stone oil boosts immunity and kills bacteria. It is sold in its pure form or mixed with cedar or fir resin, small sea buckthorn, extracts from medicinal herbs: nettle, sea buckthorn, mint, St. John's wort, as well as chaga, beaver stream and other medicinal substances.

Bischofite in the form of a natural brine is mined when drilling wells. It is saturated with bromine, iodine, chloride-magnesium-sodium complex, iron and other healthy elements. Bischofite warms and has a moderate anti-inflammatory and analgesic effect, restores elbow mobility.

Therapy with bischofite and stone oil

After removal of excess exudate from the synovial bag and in the absence of concomitant arthritis, the treatment of elbow bursitis at home can be supplemented with bischofite and stone oil.

Instructions for treatment procedures are given in the table:

Physiotherapy

In the recovery (post-acute) period after surgery or a course of medications, they begin to develop the elbow with physiotherapy exercises. Initially, minimal loads are applied: they are taken away in different directions and the forearm is brought.

In physiotherapy and physiotherapy departments of medical centers, passive development of the elbow joints is carried out on the FISIOTEK HP robotic simulator.

Kinesitherapy and parterre gymnastics of Bubnovsky is an alternative to traditional medical methods of treatment and classical exercise therapy for elbow injury, ligament damage and bursitis. The elbow joint is developed on universal simulators in the post-acute and/or rehabilitation period after surgery.

Alternative treatment

With the diagnosis of "bursitis of the elbow joint", treatment with folk remedies becomes an important part of therapy, both when prescribing an operation, and when performing a puncture and using medications. Herbal treatment is recognized as official medicine and can save you from surgery and pain if you start using ointments and compresses, baths and applications in time.

Application from Kalanchoe

Large leaves are thoroughly washed and placed in the refrigerator overnight. In the morning, they are scalded with boiling water or crushed with a spoon until juice appears or crushed. Apply to the inflamed elbow and fix with cellophane and a scarf. Change the application 3-4 times / day, with purulent bursitis - more often.

Lilac flower applications

Pure flowers are crushed until juice appears and applied on linen to the elbow for 2 hours, then changed to a “fresh” bandage.

Aloe vera with honey

In acute bursitis: mix aloe juice (1 tablespoon) and honey (2 tablespoons). The composition is distributed over gauze (bandage), folded in several layers. Apply to the elbow, fix with cellophane and woolen cloth. Withstand 2 hours.

With purulent bursitis: mix alcohol (2 tbsp.) With pharmacy ox bile (1 bottle), ground horse chestnut fruits (2 tbsp.), Chopped aloe leaves (3 pcs.). Insist 10-12 days. Then the linen cloth is moistened and applied to the problem area, covered with a film and fixed with a woolen scarf. Course - 10 procedures at night, break - 10 days.

Lotions from tincture with propolis

Infuse propolis (15 g) in vodka or alcohol (100 ml) for 7 days. Lotions are applied until the expected effect is obtained.

Baths with pine extract

Cones and branches of needles (1.5 kg) are placed in a bucket of water, boiled for half an hour and infused for 1.5 hours. Separate the water from the thick and add 1-2 liters to the bath, 0.5-1 liters to the elbow bath.

Conclusion. Traditional medicine in a comprehensive program is used to strengthen the immune system, reduce swelling and inflammation, eliminate pain, and prevent complications. In this case, hypothermia of the elbow joint should not be allowed, and the load should be increased gradually.

prophylaxis

After surgery and in order to prevent bursitis, orthoses or bandages on the elbow joint of various designs and types are prescribed.

Prevention of elbow bursitis also includes:

• dosed loads on the joint;
• correct mode of work and rest.

The risk of injury should be excluded and traumatic effects on the elbow at work and during sports training should be prevented.

Effects

The consequences of elbow bursitis are treated longer and more difficult.

Bursitis provokes:

• phlegmon: the purulent cellular space under the skin melts down to the muscles. Inflammation and swelling extends to healthy tissue surrounding the bursa;
• lymphangitis: lymphoid ducts become inflamed, which take the form of red lines or a grid coming from a purulent area;
• lymphadenitis: lymph nodes become infected through the flow of lymph into them from the inflammatory focus. In this case, the formation of an abscess;
• purulent arthritis: when inflammation passes to the joint next to the purulent bursa.

Bursitis or inflammation of the synovial bursa of the elbow joint should be treated with conservative and traditional medicine methods in the early stages and surgical intervention in the later stages of advanced pathology.

Bursitis is a process of inflammation that develops in the bag of the joint. To understand the process, it should be said that around each joint there are several synovial bags that are filled with liquid contents. They are intended for depreciation (separation of one articular surface from another) and protection of the joints from traumatic damage.

Most often, the knee suffers from an injury, and the elbow joint is in second place in terms of the frequency of injuries. It has three bags, each of which contains a certain amount of clear fluid (interosseous, ulnar subcutaneous and interosseous ulnar). The inflammatory process in one of these bags is called bursitis.

What it is?

Bursitis of the elbow joint- inflammatory lesion of the synovial bag - bursa. Due to the proximity of the neurovascular bundle and a thin layer of fatty tissue, the joints of the elbows are vulnerable to various traumatic factors, reacting sharply to even the slightest damage.

Causes

Bursitis of the elbow joint can occur for a number of reasons, among which it is customary to single out the following:

1. In the first place, as a factor leading to the development of bursitis, is arthritis of any nature - psoriatic, or gouty. That is, against the background of acute inflammation in the cartilage itself or in the synovial bag, fluid begins to accumulate, which leads to the formation of bursitis.
2. It can also occur as a result of ingestion of an infection. This happens especially often when the skin tissue immediately next to the bursa has been damaged, and a certain microorganism or bacterium has got inside. As an infectious cause of bursitis, it can also serve when bones and soft tissues of the fingers are exposed to acute inflammation. Also, the infection can get into the synovial sac not from the outside, but “from the inside”, that is, it can be carried through the blood (hematogenous pathway) and through the lymph (lymphogenic pathway).
3. Bursitis can be the result of a microtrauma, but this is somewhat less common. The elbow is injured due to constantly repetitive monotonous movements, therefore this disease is unofficially called the "professional" illness of all those people whose activities are associated with the support of the elbow on a hard surface. These can be students, engravers, chess players, draftsmen, etc. In such people, the subcutaneous ulnar bursa most often becomes inflamed, and, for example, in tennis players, the interosseous ulna. Such a difference is associated with the peculiarities of the distribution of the load on the elbow, and hence the place of occurrence of microtraumas.
4. Sometimes bursitis occurs some time after a mechanical injury to the elbow. In the event that a person hits or falls on this part of the body. Extremely rarely, however, there is an idiopathic inflammation of the synovial bag, that is, one whose etiological causes remain unclear.

Some chronic diseases, such as diabetes mellitus, are also among the risk factors leading to inflammation in the elbow joint. The cause of suppuration can also be a general weakening of the immune system, metabolic disorders, as well as taking steroid drugs.

Classification

Bursitis, like any inflammatory disease, can be acute, subacute or chronic. In addition, the specific type of bursitis depends on which of the bags is damaged. The quality of the fluid contained in the bursa in this disease is also taken into account.

In this regard, bursitis is distinguished:

• serous;
• hemorrhagic;
• purulent;
• fibrous;
• mixed.

If the disease is based on the introduction of coccal flora, then the process is considered non-specific. And with disorders associated with tuberculosis, gonorrhea or syphilis, we are talking about specific bursitis.

Symptoms and photos of elbow bursitis

Symptoms of acute serous-hemorrhagic or serous process:

• mild pain, swelling, redness, fever in the area of ​​inflammation.
• movements in the elbow are limited.
• possibly noticeable to the eye spherical protrusion, soft to the touch.
• the general condition, as a rule, does not suffer; only some patients have a low body temperature, accompanied by malaise and weakness.
• acute inflammation ends with recovery or becomes chronic.

Symptoms of a purulent type of disease:

• pain with purulent sharp, arching or twitching.
• the more acute the inflammation, the more intense the pain syndrome.
• the elbow is hot to the touch, edematous, the skin is overflowing with blood (hyperemic), on palpation there is a sharp pain.
• movements are severely limited, regional lymph nodes are enlarged.
• symptoms of general intoxication appear: the temperature rises to 38–39 degrees, weakness, weakness are felt, sweating, headache, irritability appear.

Chronic bursitis lasts much longer than acute bursitis, manifesting itself with the following symptoms:

• moderate pain on movement
• discomfort in the elbow area
• movements in the articulation are preserved almost in full,
• the area of ​​inflammation looks like a dense formation.

The photo below shows how bursitis of the elbow joint manifests itself in an adult.

First aid

In the case of an acute non-purulent process, it is important to do the following:

• Apply a tight pressure bandage to the joint, which will not stop arterial circulation, to reduce tissue swelling;
• Form a fixing scarf (orthosis), which will support the arm in a physiological position.

With purulent bursitis, this should not be done: pus under pressure can enter the surrounding tissues and blood vessels.

Diagnostics

Diagnosis is usually easy to make on the basis of examination data from an orthopedic traumatologist. But to clarify the prevalence of the process and exclude complications, there are a number of methods of instrumental diagnostics:

• X-ray of the joint: allows you to establish the presence of an inflammatory process in the joint.
• Ultrasound of the joint: helps to clarify the size and localization of the inflamed bag, the amount of exudate in it
• MRI of the joint: allows you to diagnose bursitis of deep articular bags.

This disease should be diagnosed as early as possible in order to start adequate treatment in a timely manner.

Effects

Complications of elbow bursitis are much more difficult to treat than the disease itself. They arise due to the failure to provide timely medical care and bring the disease to severe forms. There is a kind of melting of the walls in the synovial cavity and the spread of the pathogenic mass to the adjacent areas.

The result is:

Treatment of elbow bursitis

In the case of acute or chronic bursitis, anti-inflammatory drugs (such as voltaren, ibuprofen, diclofenac) and antibacterial drugs are used at home. The latter are selected taking into account the sensitivity of pathogenic microorganisms.

With a mild course of the disease, a variety of gels and ointments with an anti-inflammatory effect have a good effect, but they help only in conjunction with the oral administration of the drugs described above. For the treatment of a pronounced inflammatory process that is difficult to treat, glucocorticoid preparations are used. They are introduced into the cavity of the inflamed joint bag.

Please note that only a qualified doctor has the right to prescribe all medicines, you should not try to do it yourself or even with the help of a pharmacist, as this can be dangerous to your health!

Physiological Therapy

After the acute period of bursitis has passed, physiotherapy is added to the complex of medical procedures. Painful symptoms subside in the first procedures. Physiological procedures are well tolerated by patients, such as:

1. Massage;
2. laser therapy;
3. Paraffin heating;
4. Mud treatment;
5. Magnetotherapy;
6. Bischofite wraps;
7. Physiotherapy.

Treatment of bursitis of the elbow joint at home is recommended to be carried out in compliance with a certain diet. It is recommended to limit the use of table salt in food and reduce the consumption of meat broths, however, boiled meat is useful. It is advisable to eat fruits and vegetables according to the diet menu.

Folk remedies

Some patients, in addition to ointments and gels with anti-inflammatory action (Voltaren, Indomethacin, Traumeel C, Dimexide, Diclofenac) use alternative recipes for elbow bursitis. Comprehensive treatment at home lasts several weeks, requires regular use of home formulations.

• Method of application: 20 g of propolis per 1 glass of high-quality vodka. The resulting liquid must be mixed and allowed to stand for 1 week. After the mixture is applied to a clean gauze or bandage and applied to the inflamed area for 5-10 minutes. To achieve the effect, it is necessary to apply a compress every day for several weeks.
• Cabbage leaf compress. This method is effective not only for bursitis, but also for arthritis. Wash the sheet, remove the sinewy part, incise or beat off until the juice appears, attach to the sore spot, bandage, warm with a soft cloth. Cabbage perfectly "pulls out" inflammation, reduces pain. As soon as the leaf dries, becomes hot (after about half an hour), replace the compress with a fresh one. Keep the cabbage on your elbow longer: the product is harmless.
• A decoction of burdock helps relieve joint inflammation, especially in acute bursitis. How to use: you need 2 tbsp. tablespoons chopped burdock root per 1 liter. boil water for about 5 minutes. Then let the broth brew for 10-15 minutes and apply a compress to the epicenter of inflammation. For complete warming up, it is recommended to warm the compress with a woolen scarf from above and let the joint warm up for 1.5 hours. Course of treatment: once a day for a month.
• Ointment from honey and aloe. An excellent tool for removing puffiness, healing microcracks and wounds on the elbow. Take 3 des. l. tender pulp, add 1 tbsp. l. liquid honey, 2 drops of tea tree ether. Mix the components thoroughly, put half the mass on gauze or bandage, fix it on the inflamed area. Wrapping up the problem area is not worth it. Aloe vera ointment with honey is suitable for the treatment of purulent bursitis of the elbow joint, while heating is prohibited. Keep the mixture for 50 minutes, change the compress, wait the same amount. Course - 20 procedures (or less, depending on the result).

Timely diagnosis and proper treatment of bursitis will keep the joints healthy. An integrated approach to the treatment of the inflammatory process with the use of medicines, folk remedies, physiotherapy will save the patient from painful symptoms. Do not postpone the treatment of bursitis "on the back burner": the disease often goes into a chronic stage, attacks cause significant discomfort.

Surgery

When complications of the disease develop and pus appears in the joint bag, an operation becomes relevant, which is quite simple, consists in pumping out fluid, introducing antibacterial and anti-inflammatory drugs into the joint.

Usually, bursitis is treated with drugs, but if complications occur, surgery is required.

Operations are also performed to remove the damaged bursa. They are very simple and highly effective. Patients soon return to their normal lives.

Prevention of bursitis

Preventive measures will help to avoid the risk of developing pathology:

• strict observance of the regime of work and rest;
• dosing of physical activity;
• immediate competent treatment of infectious diseases;
• timely initiation of treatment in order to prevent the transition of the inflammatory process to the purulent phase;
• prevention of traumatic influence on the area of ​​location of synovial capsules;
• use of protective equipment if there is a potential threat of injury;
• scuffs, scratches, cuts, abrasions must be treated with hydrogen peroxide, an antiseptic.

Bursitis of the elbow joint is a dangerous disease. The disease should not be left to chance, as complications can be deplorable. You can not bring the disease to severe forms.

Bursitis is an inflammatory process in the articular bag (bursa). The disease affects any of the joints, and one of the most frequent is precisely the bursitis of the elbow joint. It has a characteristic course: symptoms appear gradually, which interferes with timely diagnosis, and over time leads to disability of the hands, which is caused by the structural features of the joint. According to ICD-10, the disease is designated by the code M70.3.

The bursa is a sheath of connective tissue. Inside it contains a collection of cells from which synovial fluid is secreted. Joint fluid plays the role of a lubricant, preventing wear of the joint surface. Also, this fluid allows you to provide nutrition to the articular cartilage. The elbow joint is formed by the connection of the radius, humerus, and also the ulna, so that there are three joints and capsules for them.

The reasons

Elbow bursitis involves inflammation of the structures of the joint, as well as adjacent muscles, tendons, and nerve fibers. In this case, a pathological effusion forms in the bursa. The reasons for its appearance are:

• constant hand overload. It involves strong physical exertion or a long stay of hands in one position. Athletes, office staff and draftsmen are at risk here;
• injuries to bones, joints or tendons in the elbows;
• inflammation processes ( , ). This causes a decrease in the efficiency of the hands, ruptures of the bag may be observed, followed by its filling with lymphatic tissue;
• the presence of pyogenic viruses in the body. This causes the development of purulent bursitis against the background of infections that enter the joint with blood or lymph;
• the presence of autoimmune diseases;
• the presence of specific diseases -,;
• intoxication.

Often there can be several causes of the disease - for example, an open elbow injury can lead to infection of the joint capsule. The blood in the joint cavity acts as an excellent habitat for bacteria and viruses, which leads to the formation of pus.

Kinds

Bursitis of the elbow joint has several types and forms, each of which is characterized by the intensity of pain, the nature of the change in the appearance of the hand and the consequences. The most common classification is the division of the disease into the following forms:

• chronic. It is characterized by mild pain that persists for a long time. In this case, there are no restrictions on the mobility of the elbow, there is no tumor, but a dense formation of a small size is palpated;
• acute. Presented by sharp pains during movements. Often the symptoms are fever and intoxication, which causes problems in the functioning of not only the articular joint itself, but also the internal organs;
• recurrent. It occurs if the integrity of a previously affected area has been repeatedly violated or infection has occurred. The wall of the bag, even after recovery, contains exudate with pathogenic bacteria. The symptoms of the recurrent form are similar to those of the acute form.

In addition to the above forms, ulnar bursitis is:

• specific. It is typical for people engaged in power or long-term monotonous work, or with injuries to the elbow joint;
• non-specific. It is observed in patients who have treponema, tuberculosis, syphilis and other diseases.

Depending on the composition of the synovial fluid, elbow bursitis can be:

• serous. The fluid in the elbow joint takes on the consistency of serum. Doctors consider this species safe and treat it quickly. It is characterized by slight swelling and pain, fever in the diseased area with a slight violation of the condition;
• hemorrhagic. Blood enters the liquid with this type of disease;
• purulent. The presence of pus indicates the process of inflammation and the presence of pathogenic bacteria and viruses. In this case, the person feels arching pain, there is a noticeable redness and swelling. Purulent bursitis of the elbow joint is urgently required to be treated with antibiotics.

Symptoms

Elbow bursitis has the following symptoms:

• swelling in the elbow that occurs for no particular reason. Often it is completely painless and does not hinder movement at all;
• an increase in painless swelling on the arm;
• discomfort and pain in the joint;
• sharp reddening of the skin in the elbow area;
• high body temperature, even fever;
• general weakness, apathy;
• loss of appetite;
• high sweating;
• large lymph nodes;
• limited movement, inability to bend the arm;
• the formation of pus in the elbow joint, which will come out (fistulas, phlegmon will form on the skin).

The chronic form of the disease often occurs in the absence of treatment. Doctors during the examination will be able to find one or more solid formations. The chronic form is characterized by relapses.

If the patient finds one or more symptoms in himself, then you should consult a doctor and do not try to treat him yourself. Any signs of bursitis can be confused with gout or another disease, and these diseases are treated in different ways. If symptoms are present, before going to the orthopedist, an immobilizing bandage should be applied to the elbow, thus ensuring peace.

Diagnostics

Serous, hemorrhagic or purulent bursitis of the elbow joint can be diagnosed by an orthopedist as follows:

• examining the patient. The specialist can easily determine during the survey and palpation that the patient has bursitis;
• taking an x-ray. This happens if an assessment of the condition of the process of the elbow bone is required - sometimes osteophytes can form there. Also, this technique allows you to choose a way to treat the disease (conservative or operational);
• puncture of the articular bag. It is carried out if it remains unclear to the doctor what the nature of the disease is - infectious or inflammatory. The fluid taken during the puncture is sent to the laboratory, where, during the detection of its sensitivity to antibiotics and other medicines, the nature of the disease is determined, on the basis of which the doctor develops a treatment regimen.

Treatment

Limiting the motor activity of the elbow is what you need to start treating elbow bursitis with. Treatment involves the imposition of immobilizing (kerchief, pressure, sometimes plaster) bandages. If the damage is open, then the wound undergoes surgical treatment, after which it is fixed with an antiseptic bandage. The patient is prescribed antibiotics with a wide spectrum of action.

If there is exudate in the elbow bag, then it must be removed with a syringe in absolutely sterile conditions. To relieve the symptoms of inflammation, use the following methods:

• a steroid-type hormone (for example, Kenalog) is injected into the cavity of the joint bag;
• non-steroidal drugs are used, which are taken by the patient in combination;
• ointments are used ("Voltaren", "Ibuprofen");

Treatment of elbow bursitis involves the inclusion of immunostimulants with a variety of vitamin complexes in the treatment program. After the inflammation is cured, the patient must undergo physical procedures.

If conservative treatment is not successful due to the neglect of the process, then an operation is prescribed. The most efficient operations:

• drainage of the bag of the joint. Fluid is pumped out of it through a small incision;
• removal of the bursa. During rehabilitation, a new bursa will be formed in the body.

Treatment with folk methods

It should be noted right away that the treatment of inflammation with folk remedies, which may seem like an alternative to antibiotics, cannot be prescribed to yourself on your own - you need to coordinate the chosen folk remedies with your doctor. They are unlikely to be able to completely cure the disease, but they will act as an auxiliary tool for relieving pain and inflammation. The most effective folk remedies for the treatment of bursitis:

• lotions from alcohol tincture of propolis. The tincture is prepared from vodka and a few grams of grass. Folk remedy must be insisted for a week in a tightly closed container, and then applied to the skin;
• ointment from aloe juice with honey. Several parts of honey and alcohol are added to a part of the plant's juice, and the folk ointment itself is applied to the sore spot;
• a compress of lilac flowers. They are pressed a little and tied to the elbow with a bandage to eliminate inflammatory signs;
• granulated sugar heated in a frying pan. This folk medicine is placed in a bag and applied to the edema to eliminate it.

Along with treatment with medicines or folk remedies, it is required to take preventive measures: properly distribute things in the workplace, have more rest, reduce physical exertion on the sore spot, and do not overcool.

Or elbow bursitis is one of the most common diseases of the human musculoskeletal system.

What is an elbow?

This is the junction of three bones: the humerus, ulna and radius. A complex anatomical connection is “embraced” by 3 articular bags, inside of which there is a lubricant, or synovial fluid. Bags - in Latin "bursa" - are needed so that there is no friction between the bones.

The amount of synovial fluid in the bags is strictly limited, it should only be enough to lubricate the surfaces. Excess fluid is one of the signs of dysfunction. For any cause of the disease, the treatment of elbow bursitis is aimed at ensuring that the elbow joint moves without difficulty. When moving, there should be no crunching, pain and discomfort.

Why do elbow bags become inflamed?

In terms of frequency, the causes of inflammation are as follows:

• Constantly recurring same type of injury. Most often, the joint is damaged if the weight of the body is regularly transferred to the elbow. This applies to athletes, miners, porters, students. This is how "miner's elbow" and other inflammations associated with professional activities develop.
• Acute injury - for example, a fall on the elbow in ice.

• Inflammation of all joints of the body, arthritis of various origins, as well as gout.
• Abrasions or cuts in the joint area when the infection penetrates from the outside.
• For an unknown reason. In this case, the treatment of elbow bursitis begins with a clinical examination, which allows you to find the cause of the disease.
• With common severe infectious diseases - tuberculosis, syphilis, brucellosis, gonorrhea, erysipelas.
• In other severe systemic diseases - diabetes mellitus, rheumatism.
• In bedridden patients or at a very old age.

How does elbow bursitis manifest itself?

You can suspect this condition if:

• the joint area is sharply swollen, increased in size, the swelling gradually increases;
• worries about pain in the joint, which increases with movement;
• the joint is hot to the touch;
• redness is visible above it, which can spread far around;
• fever starts;
• weakness, malaise, chills appear, appetite disappears.

If at least one of these signs appears, you should immediately consult a doctor in order to start treatment of elbow bursitis in time. The sooner it is started, the greater the chance of a full recovery.

What happens if bursitis is left untreated?

There will be complications, since this disease cannot “pass” on its own. The blood supply to the articular bag becomes poor, the infection settles there firmly. There may be suppuration that spreads to neighboring tissues. Pus from the inside can break through all the tissues, resulting in a fistula or non-healing hole. At the site of the purulent process, adhesions may appear, due to which the joint will become immobile. Acute inflammation can take on a chronic form, in which pain and fever become constant. All this can be avoided if the treatment of elbow bursitis is started from the first days of the disease. You need to contact a traumatologist or orthopedist, they are the main specialists in bursitis.

Can bursitis be treated at home?

It is possible if the disease was the result of a bruise, and the general condition does not suffer. The first thing to do is to put a tight bandage on the joint. This is necessary so that the joint rests, and the movements in it are limited. It is recommended to bandage the hand in a bent state at an angle of 90 °. After bandaging, the hand must be fixed in a scarf thrown over the neck. The hand should hang on a bandage. When bandaging, it is important not to pinch the blood vessels. Fingertips should retain sensitivity. If they are numb, the bandages should be loosened. Ready-made sports bandages are great for this procedure.

At home, you can cure bursitis of the elbow joint. Treatment: anti-inflammatory and analgesic ointments. A napkin is applied to the joint with any anti-inflammatory ointment that can be found in a pharmacy. The range of such drugs increases annually.

Antibiotics can only be prescribed by a doctor

Sometimes the inflammation of the joint capsule is so aggressive that simple remedies cannot cope with it. There is a simple rule: inflammation should subside after 3 days from the start of treatment.

If this does not happen, and the condition only worsens, you need to urgently go to the doctor. When the doctor confirms elbow bursitis, antibiotic treatment should be started immediately.

The choice of this or that drug depends on many factors: the severity of the process, the age of the patient, concomitant diseases. The dosage form - tablets, injections, gels, ointments or irrigations - is also chosen by the doctor.

What factors influence the choice of drugs?

First of all, from the form of the disease, which can be as follows:

• Serous - a lot of fluid is formed in the joint, but there are no bacteria.
• Hemorrhagic - blood has poured into the cavity of the joint capsule.
• Purulent - the most severe form, when pyogenic bacteria have entered the joint.

Bursitis of the elbow joint. Treatment

Photos of people suffering from bursitis of the elbow joint clearly show what complications can arise if treatment is not started in a timely manner.

Sometimes medicine is not enough. This happens when too much fluid has accumulated in the joint. The joint bag cannot be stretched, and the fluid pressure causes unbearable pain. To alleviate the condition, the doctor may perform a puncture. The bag is carefully pierced with a needle, and the inflammatory fluid is sucked off. In some cases, this fluid is sent to a laboratory for research in order to find out a more accurate cause of acute pain. Without removing the needle from the cavity, medicine is immediately injected into it, and the patient's condition is instantly relieved. Fast-acting drugs are usually administered.

Is it possible to completely cure purulent bursitis?

Not always, although every doctor strives for this. A lot depends on the general reactivity of the patient's body. When a purulent bursitis of the elbow joint is found, the treatment is always prescribed complex. Isolated bursitis, when the whole body is healthy, and the person is young and full of energy, most often can be cured without a trace. With concomitant diseases, the prognosis worsens.

If necessary, the doctor may prescribe the following studies:

• X-ray of the joint to determine the condition of the bones.
• Ultrasound of the joint to detect changes in the joint bag: the presence of cavities, the nature of their contents.
• General clinical examination: blood and urine tests, glucose levels, sensitivity to antibiotics, and so on.

During treatment, it is necessary to completely get rid of pathogenic bacteria in order to improve the general condition of a person. Quite often, with purulent bursitis, it is necessary to cut the joint cavity and install drainage there so that the purulent discharge has an outlet. Along the incision, the joint cavity is washed with antiseptics and antibiotics, accelerating recovery.

Bursitis of the elbow in general diseases

If elbow bursitis is a complication of another common disease, such as diabetes, tuberculosis, or erysipelas, then all efforts are directed to eliminating the symptoms of the underlying pathology. Elbow bursitis, the symptoms, the treatment of which is completely related to the overall clinical picture, requires immediate therapeutic action. Remember that a timely fight against the main pathogen and the main disorder always leads to recovery.

In all people with severe general diseases, it is better to prevent the development of bursitis than to try to cope with it later. Elderly people should be protected from injury, and bedridden patients should be turned over more often in bed. A good functional bed can significantly improve the quality of life of such patients.

Will folk remedies help?

Only with a mild form, when there is no pus or blood in the joint, wraps are carried out with fresh leaves of medicinal and vegetable plants, lotions with propolis, coniferous baths and other available warming and absorbing procedures.

The result will always be better if the treatment of elbow bursitis is started early. Medicines for this should be selected only by a doctor. To relieve inflammation, not only antibiotics are used, but also non-hormonal anti-inflammatory drugs, and in advanced cases, corticosteroid hormones are prescribed. Any folk remedies should be abandoned if a purulent process has begun.

What to do if bursitis has become chronic?

It is necessary to persistently continue treatment, achieving a stable and long-term remission. In the chronic form, the inflammation is less acute, most often there is no fever and severe swelling. But the chronic process causes stiffness of the joint, which is very difficult to cope with.

If chronic elbow bursitis occurs, treatment necessarily includes physiotherapy. To date, a large number of medical devices have been created that generate ultraviolet, ultrasonic waves or ultrahigh frequency current. All these methods of physical influence are successfully used in the chronic form of bursitis.

Phonophoresis also has an excellent effect, by means of which the medicine is carried into the thickness of the skin by ultrasound. Acupuncture gives a wonderful result, especially if it is performed by a highly qualified specialist.

In recent years, shock wave therapy has become very popular as a method of getting rid of chronic pain. The medical device generates an acoustic wave, the power of which is sufficient to destroy pathological formations. With shock wave therapy, adhesions, seals and scars are perfectly absorbed, and the mobility of the elbow joint is greatly increased.

Always after inflammation, the elbow joint must be developed; physiotherapy exercises are intended for this. They usually start with simple hand swings, gradually bringing the range of motion to the usual level. It is important to do simple exercises daily. Massage or passive physical education is very useful.

Proper, complete and specialized treatment helps to achieve either a complete cure or a significant improvement in the condition of the elbow joint.

Bursitis of the elbow joint is an inflammatory process that has arisen in the tissues surrounding the olecranon. In order to understand what we are talking about, you should know that around any joint, including the elbow, there are synovial bags filled with a small amount of fluid, which in Latin are called bursa. In their normal state, they perform the same role as lubricants in the engine, that is, they prevent the joints from rubbing against each other when moving. Therefore, they are not injured as a result of natural human activities.

If we consider specifically the elbow joint, then it is surrounded by three bursae:

Interosseous

Ulnar subcutaneous

Interosseous ulna

Each of them contains a certain amount of fluid, which normally performs its function, so a person does not experience pain when moving his hands. But sometimes, for a number of reasons, inflammation occurs in the cavity of one or several synovial bags at once, the fluid begins to arrive, its composition changes, and the elbow becomes painful. This condition is called elbow bursitis.

Doctors classify bursitis according to several parameters:

Depending on the place of localization (by the name of the synovial bags).

By the nature of the course of inflammation - acute, subacute or chronic type.

Depending on the composition of the fluid (exudate) accumulating in the synovial sac - purulent, serous, fibrous, hemorrhagic.

If bursitis is caused by any microorganism, then it may be called nonspecific (microorganisms from the group of strepto- and staphylococci) or specific (for example, caused by gonococci, spirochete pallidum, tuberculosis or syphilitic bacterium).

Inflammation of this slit-like formation on the elbow is a fairly common phenomenon and is in second place after inflammation of the shoulder joint.

Causes of elbow bursitis

Bursitis of the elbow joint can occur for a number of reasons, among which it is customary to single out the following:

In the first place, as a factor leading to the development of bursitis, is arthritis of any nature - psoriatic, rheumatoid or gouty. That is, against the background of acute inflammation in the cartilage itself or in the synovial bag, fluid begins to accumulate, which leads to the formation of bursitis.

Bursitis can be the result of a microtrauma, but this is somewhat less common. The elbow is injured due to constantly repetitive monotonous movements, therefore this disease is unofficially called the "professional" illness of all those people whose activities are associated with the support of the elbow on a hard surface. These can be students, engravers, chess players, draftsmen, etc. In such people, the subcutaneous ulnar bursa most often becomes inflamed, and, for example, in tennis players, the interosseous ulna. Such a difference is associated with the peculiarities of the distribution of the load on the elbow, and hence the place of occurrence of microtraumas.

Sometimes bursitis occurs some time after a mechanical injury to the elbow. In the event that a person hits or falls on this part of the body.




Bursitis can also occur as a result of ingestion of an infection. This happens especially often when the skin tissue immediately next to the bursa has been damaged, and a certain microorganism or bacterium has got inside. Panaritium can also serve as an infectious cause of bursitis, when bones and soft tissues of the fingers are exposed to acute inflammation. Also, the infection can get into the synovial sac not from the outside, but “from the inside”, that is, it can be carried through the blood (hematogenous pathway) and through the lymph (lymphogenic pathway).

Extremely rarely, however, there is an idiopathic inflammation of the synovial bag, that is, one whose etiological causes remain unclear.

Some chronic diseases, such as diabetes mellitus, are also among the risk factors leading to inflammation in the elbow joint. The cause of suppuration can also be a general weakening of the immune system, metabolic disorders, as well as taking steroid drugs.

As the main symptoms of bursitis of the elbow joint, it is customary to distinguish the following:

The occurrence of swelling in the corresponding area. Sometimes it can occur for no apparent reason, be completely painless and not interfere with the free movement of the hand.

If the swelling is left unattended, then over time it will become much more noticeable, increase significantly in volume and there will be a feeling of discomfort and pain.

Often there is reddening of the skin around the elbow and its sharp filling.

A person's body temperature may rise, up to the onset of febrile conditions. With a similar course of bursitis, severe pain occurs in the elbow region and the general condition deteriorates sharply.

There are accompanying symptoms of intoxication, which are characterized by headaches, general weakness, sweating, apathy and loss of appetite.

From the moment the joint bag increases in size, the mobility of the arm becomes somewhat limited, when you try to bend the arm, pain occurs.

If you continue to ignore such a condition and leave elbow bursitis without appropriate therapy, then it will turn into a purulent form, and fistulas protruding outward and subcutaneous phlegmon will appear at the site of inflammation.

Enlarged lymph nodes.

Depending on the form of bursitis, accompanying symptoms will also differ:

Acute serous inflammation of the synovial bursa is characterized by swelling, slight pain and an increase in skin temperature in the area of ​​swelling. The general condition is disturbed not too pronounced.

If serous bursitis is not treated, then it may either disappear on its own or become chronic. With it, pains, even not during the period of exacerbation, will continue to disturb a person, especially during physical exertion, the movement of the elbow is somewhat limited, on palpation, doctors detect a fluctuating formation, which can be both elastic and loose. If bursitis proceeds in a chronic form for quite a long time, then several seals can be found. Chronic bursitis often recurs.

If the bursitis is purulent, then the painful sensations do not cease to disturb the patient, they are twitching or bursting. The elbow itself becomes bright red, hot to the touch. The general condition of the person is disturbed.

If any of these symptoms occur, you should not try to diagnose yourself, much less start treatment. After all, the signs of bursitis are quite similar to those of arthritis, gout or polyarthritis. In each case, a variety of treatment is required, with the use of various drugs. Therefore, if there is a suspicion of the presence of bursitis, it is worth bandaging the elbow with an immobilizing bandage, providing it with peace and going to the orthopedic department to the appropriate specialist.

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Purulent bursitis is characterized by the formation of purulent contents in the joint bag of the elbow. It is caused by bacterial infections of this cavity.

Most often, purulent elbow bursitis is caused by streptococci and staphylococci, which penetrate the bag as a result of mechanical trauma to the skin in the corresponding area. It can even be a small scratch or abrasion, but if it damages the synovial bag, then in almost 100% of cases it leads to the formation of bursitis, which, in the absence of specialized therapy, becomes purulent over time. The presence of pustular formations on the skin near the elbow joint or directly on it will lead to an early infection and suppuration.

But sometimes microtraumas caused by professional activities can lead to the formation of purulent inflammation.

Symptoms of purulent bursitis are characteristic of any inflammatory process, the swelling is located at the top of the elbow and, depending on the severity of the disease, can have different sizes. The pain is intense, the skin is red and hot to the touch, the human body is weakened, the body temperature rises to high values.

If a purulent nature of the disease is suspected, the patient's blood is taken for a general analysis and to establish the level of sugar, it is also necessary to collect urine. If necessary, doctors can prescribe an ultrasound scan and take a puncture to determine the nature of the contents, but as a rule, such manipulations are rarely required.

Purulent bursitis should be distinguished from similar arthritis. With the last hand movement, it is almost impossible to make, the pain is felt directly inside the joint itself.

For treatment, surgical intervention is necessary in order for the pus to come out. After that, the excised surface is treated with antiseptics and a sterile bandage is applied. Often, healing is slow and a second operation is required.

This may cause the following complications:

Phlegmon muscular and subcutaneous.

Purulent arthritis, when the entire joint is involved in the process.

Inflammation of the lymph nodes or skin ducts (lymphadenitis and lymphangitis).

Prevention includes the exclusion of traumatic situations and the timely treatment of the onset of the inflammatory process.

If the bursitis is not complicated and is the result of a mild bruise, then it can go away on its own, with the restriction of the mobility of the sore spot and the application of a cold compress, followed by the use of dimexide as a resolving agent.

In all other cases, qualified medical assistance is required. To begin with, the doctor prescribes non-steroidal anti-inflammatory drugs, for example, ibuprofen in combination with nimesulide and diclofenac. If a bacterium has become the cause of the development of inflammation, then antibiotics are necessary. In the absence of effect and with a significant accumulation of fluid, it is necessary to perform a puncture. With its help, fluid is aspirated, which almost instantly helps to relieve pain symptoms and significantly reduces pressure on nearby tissues. During puncture, depending on the indications, either antibiotics or steroid drugs are administered orally to relieve inflammation.

Surgery for bursitis of the elbow joint

Surgical intervention is carried out only in extreme cases, when all the tried methods are ineffective. Most often, surgery is needed for recurrent bursitis, or purulent-hemorrhagic inflammation, as well as for persistent serous.

Bursectomy is a rather traumatic intervention, which further disables the arm for a long time, depriving a person of his ability to work. That is why surgeons in their practice increasingly began to use the following, no less effective treatment regimen: the operation site is cut off, then a puncture is performed with a rather thick needle, which allows the liquid to be aspirated. Then, with the help of special manipulations, a catheter is inserted into the bursa, which has a compressed pear at one end. After that, it gradually straightens out and completely removes the entire contents of the cavity of the bag. Thus, its global excision is not required, and healing occurs in a much shorter time.

Sometimes bursitis requires treatment even at the stage of remission. The method of therapy is determined by the doctor; quite often and very successfully, ultrasonic heating and electrophoresis are used. These procedures allow you to relieve spasms and tension from sore muscles. Cryotherapy is used to relieve swelling. After the main symptoms are eliminated, massage and paraffin applications can be prescribed.

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Purulent bursitis of the elbow joint: symptoms, treatment

The elbow is surrounded by several membranes that are not connected to the articular cavity. The largest is superficial, from the side of the protruding part of the elbow.

Cause, types and type of ulnar bursitis

Prepare the ground for bursitis:

• Systematic arthritis of rheumatoid, gouty, psoriatic and other nature.
• Osteoarthritis with synovitis - accumulation of fluid leading to inflammation of the synovial membrane
• Constant irritation of the elbow when resting it on the surface, as a result of daily monotonous movements. The following are at risk:
  • Chasers, engravers, leather craftsmen
  • Diligent diligent students, etc.
• Frequent mechanical injuries of the elbow during a fall, sudden amplitude movements:
  • this is typical for professional tennis players, volleyball players, handball players

Causes of purulent bursitis of the elbow joint

Purulent inflammation of the bursa begins when the infection penetrates into the joint due to:

• Wounds of the elbow joint resulting from trauma
• Formed near the inflammatory focus:
  • erysipelas
  • subcutaneous phlegmon
  • pustular skin lesions, etc.
• Surgical intervention with hemorrhage in the joint
• Specific diseases (tuberculosis, gonorrhea, syphilis, etc.)

Types of ulnar bursitis

Inflammation of the articular bag of the elbow is classified according to three criteria:

• anatomical location
• type of inflammatory process
• the nature of the disease

Type of bursitis

• Serous - inflammation affects the intercavity and cavity surfaces and occurs without the formation of pus inside the cavities
• Purulent - pus and pathogenic bacteria accumulate in the bursa (streptococci, staphylococci, etc.)
• Hemorrhagic - the exudate of the articular cavity contains blood

The nature of the disease:

Acute, subacute and chronic.

Symptoms of purulent elbow bursitis

The usual serous form is accompanied by swelling of the elbow, painless on palpation. At the same time, the skin is not modified, and the elbow does not experience any special difficulties in movements.

Another thing is purulent inflammation. The following symptoms can speak of a purulent type:

• Slightly above the elbow there is a painful swelling and a feeling of twitching
• The skin in the area of ​​swelling turns red and feels hot to the touch
• Body temperature can rise to high levels
• Movement in the joint becomes difficult, but because of pain, and not because of a decrease in the true range of motion, as happens with deforming arthrosis:
  • pain with bursitis is superficial, and with arthrosis it is concentrated inside the joint
• You should also distinguish between synovitis with arthrosis and bursitis:
  • with synovitis (inflammation of the synovial membrane), the elbow swells evenly
  • with bursitis - clearly localized swelling
• There may be enlargement and inflammation of the lymph nodes (lymphadenitis) and skin lymphatic ducts (lymphangitis), as occurs with bacterial infections

Purulent inflammation of the capsule, if left untreated, leads to:

• To the symptoms of intoxication: nausea, headache, drowsiness and apathy
• The formation of fistulas and phlegmon
• To the chronic form of the disease:
  • Constant aching pain in the elbow
  • One or more lumps are felt under the skin
• To periodic exacerbations with all of the above symptoms

Treatment of bursitis of the elbow joint

Diagnosis of bursitis

For diagnosis, laboratory and instrumental methods are used.:

• Complete blood and urine tests
• Blood sugar test:
  • The presence of diabetes can complicate the course of the disease and require a different treatment regimen.
• A puncture is performed, the purpose of which is the collection of exudate:
  • Such an analysis is important for the selection of a drug for antibiotic therapy of purulent inflammation of the bursa.
• To differentiate arthrosis, x-rays or ultrasound can be performed.

If the serous inflammation of the membranes can somehow go away on its own, then this rarely happens with purulent bursitis.

But usually any form of this disease does not need to be left to chance.

Video: Puncture of the elbow joint with purulent bursitis:

Treatment of serous bursitis

With a non-purulent nature of inflammation, treatment is usually limited:

• Immobilization of the elbow with a scarf
• Removal of exudate accumulated between the shells by puncture and washing
• Applying a tight bandage
• Physiotherapy:
  • warming treatments
  • electrophoresis, UHF, ultrasound, etc.

Conservative treatment of purulent bursitis

With a purulent form of bursitis, first of all, it is necessary to eliminate the abscess of the articular bag

• Fluid is aspirated with a syringe, immediately facilitating the condition
• Prescribe antibiotic therapy
• Treat with non-steroidal anti-inflammatory drugs (nimesil, diclofenac, ibuprofen) and corticosteroids

Surgery for purulent bursitis

Surgical treatment is necessary for:

Operation types

• The usual operation for bursitis is simple and takes place under local anesthesia.:
  • A thick needle is inserted into the joint bag, through which the accumulated exudate is evacuated
  • Complete pumping of the liquid is performed using a catheter with a rubber pear at the end.
• Another type of operation - partial excision of the articular bag

• Radical surgery - complete bursectomy is performed in case of recurrence of purulent bursitis

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Varieties of bursitis

The elbow joint is surrounded by a radiocarpal, intercutaneous and subcutaneous synovial bursa. Inflammation in this area develops if a pathological process begins to occur in one of the bags.

In this case, symptoms such as pain appear due to friction, due to the fact that the bone tissue is dehydrated.

There are several types of bursitis, where the following factors play an important role:

• the duration of the course of the disease;
• the composition of the exudate;
• the reasons.

As a rule, types are distinguished by the duration of the course of bursitis:

1. chronic;
2. spicy;
3. recurrent.

The symptoms of each form manifest themselves differently - they differ in the intensity of pain, their duration and the appearance of the elbow.

The general well-being of patients also varies - in some cases, the patient feels normal, and sometimes his health deteriorates greatly.

Chronic elbow bursitis has the following symptoms: mild pain in the inflamed area, which persists for a long period of time. At the same time, the mobility of the joint is not disturbed, there are no tumor-like formations, but during the process of palpation, a slight induration can be felt.

Acute bursitis of the elbow joint is manifested by a sharp cutting pain that occurs during movement. The tumor in the affected area develops rapidly, and the temperature also increases. The disease is accompanied by intoxication and dysfunction of the whole organism.

Recurrent bursitis develops due to a secondary violation of the structure of the affected areas or their infection. Its origin is due to the fact that pathogenic exudate remains in the walls of the bags. Therefore, even minimal trauma can lead to a relapse.

In addition to the above phases, at least 2 more classifications are shared. The causes of the pathology make it possible to identify nonspecific or specific bursitis of the olecranon.

A specific form can develop in the case of prolonged physical work and even with minor injuries. A non-specific type of disease occurs due to damage to the joint by harmful microorganisms (treponema, tuberculosis, gonococcus).

In addition, according to the composition of the synovial mass, bursitis is divided into three types. The serous form is considered the most harmless, since it is easy to cure, because the fluid becomes serum, which is unlikely to entail serious complications.

With hemorrhagic bursitis, blood accumulates in the fluid. The purulent form is characterized by the accumulation of pus in the joint bag. This species is the most dangerous, so in this case, a medical consultation is necessary.

Causes

Elbow bursitis can develop as a result of infection, injury, and strenuous exercise. The primary causes of the appearance of pathology lie in the systematic, not necessarily strong, overstrain of the elbow joint. Often, athletes and workers of certain professions are subject to this.

Note! If breaks appear on the skin at the time of damage to the joint, then the person develops an acute form of bursitis. Its causes are non-specific.

The primary factors of specific bursitis include infection with streptococcus or staphylococcus aureus. Basically, this happens when sanitary standards are violated in the implementation of medical procedures.

Also, the causes of the disease lie in the presence of a patient with lupus, rheumatoid psoriatic arthritis or gout.

Symptoms

Bursitis of the elbow joint has the following symptoms:

• swelling or enlargement of the joint;
• heat;
• in a decrease in mobility of the elbow;
• discomfort in the area of ​​pathology;
• redness of the skin;
• weakness;
• reflex muscle contraction.

If the treatment of bursitis of the elbow joint is not done in a timely manner, then the disease will develop according to the following scheme. So, inflammation of the elbow always begins with the onset of swelling.

This sudden phenomenon initially does not bring pain and does not impede motor function. Therefore, many simply do not pay attention to swelling, which entails the appearance of complications. In this situation, home treatment will not be enough and the patient may need surgery.

Gradually, the size of the synovial bag increases and pain syndrome appears. In addition, there is no mobility of the arm, so every attempt to make any movement is very painful.

Also, swelling appears on the affected area and seals form. The tumor is visible visually, it is soft to the touch, and its dimensions reach 10 centimeters, as shown in the photo. At this stage of the development of the disease, the following symptoms may also be present: fatigue, lack of appetite.

If inflammation is accompanied by infection, then purulent bursitis of the elbow joint develops. When the infection spreads to other joints, the patient's health becomes more complicated - malaise appears, there is no appetite, and there are signs of general poisoning.

In some cases, bursitis of the elbow joint can be treated with folk remedies.

Complications

Inflammation of the elbow joint is much easier to treat than to eliminate its consequences. They appear in the absence of competent and timely therapy due to bringing the disease to a severe stage.

Complications lie in the specific melting of the walls of the synovial sac, due to which the pathogenic mass spreads to nearby areas. So, various pathologies are formed.

Lymphangitis is an inflammatory process that occurs in the lymphatic ducts. The latter become strongly pronounced (red lines, grid). Their direction originates in the field of purulent neoplasm.

Phlegmon is a purulent fusion of fatty tissue located under the skin and between muscle tissues. With inflammation, the skin around the affected area turns red and swells.

Purulent arthritis - in this case, the ulnar bursitis passes to the joint, which is located next to the affected joint, limiting its mobility.

Lymphadenitis - this complication develops due to infection of the lymph nodes, to which lymph flows from the inflammatory focus. Thus, an abscess is formed.

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Synovial bursa - what is it?

Name synovial bag comes from the Latin word bursa (bursa), which translates as "bag", "purse". It is a flattened cavity, inside of which there is a liquid (it is produced by cells lining the wall of the synovial sac from the inside).

In total, there are about 160 synovial bags in the human body.

There are four varieties of them, depending on the location:

• Subcutaneous: located under the skin in places of bony protrusions on the extensor surfaces of the joints. For example, there is a synovial bursa on the back of the elbow joint. They have one or more chambers. The subcutaneous bursa plays the role of a shock absorber, reduces friction between the skin and the joint, and ensures normal skin displacement.
• Subfascial. They are located under the fascia - connective tissue membranes that cover the muscles. They play the same role as the subcutaneous.
• Dry tendon. They are located under the tendons - bundles of connective tissue, with the help of which the muscles are attached to the bones. Often, dry synovial bags are connected to the joints. They may enclose tendons, in which case they are called tendon sheaths.
• axillary. They are located between muscle and bone, between muscle and joint. Helps cushion and reduce friction.

Where do bursitis most often occur?

The most common sites of bursitis (in descending order of frequency):

*Achilles tendon is a calf tendon that attaches to the heel bone.

What are the causes of bursitis?

Injury

Most often, chronic injury leads to the development of bursitis, when the same movement is repeated many times. With a direct traumatic effect, synovial bags in the elbow and patella area, which are located almost directly under the skin, are most susceptible to disease.

The most common injuries leading to the development of bursitis:

• « Priest's knees". Pressure on the knee joint with frequent kneeling.
• « tennis elbow". Chronic injury of the synovial bursa with repeated monotonous movements in the elbow joint.
• Wearing uncomfortable shoes and long intensive walking. Leads to the development of bursitis in the ankle. This type of injury is common among speed skaters and some other sports.
• Frequent intense running and thigh strains. lead to femoral bursitis.
• Prolonged sitting on a hard surface, cycling. Lead to the development of bursitis in the buttocks.

Intensive loads on the joints:

• Intense physical work, in which the same movements are repeated many times.
• Engagement in "big" sports.
• Preparation for the competition, enhanced training.

For example, elbow bursitis is common in tennis players and miners. Bursitis of the knees - in priests and people, often on their knees, in housewives.

infections

Bursitis can develop when the bursa becomes infected.

Causes of infectious bursitis:

• Infection in the bag during an injury (cut). The most common reason. The synovial bursa of the elbow joint is most often affected, as it is located directly under the skin.
• Weakened immunity. With a decrease in the body's defenses, the infection can enter the bursa with a blood or lymph flow. Conditions in which immunity is weakened:

• frequent, constantly recurring infectious diseases;
• acquired immunodeficiency syndrome (AIDS);
• malignant neoplasms, radiotherapy, chemotherapy;
• cirrhosis of the liver;
• alcoholism, drug addiction.

Types of bursitis depending on the pathogens that cause them:

• Non-specific. Occur in the form of a common purulent infection. In fact, the synovial bag turns into an abscess. This type of disease is more common, it is caused by microorganisms such as staphylococci, streptococci, etc.
• Specific. These bursitis have different symptoms and course. Inflammation of the synovial bag is one of the manifestations of a specific infection: tuberculosis, syphilis, brucellosis, gonorrhea.

chronic diseases

Chronic diseases that most often cause the development of inflammation of the synovial bag:

• rheumatoid arthritis;
• gout;
• systemic scleroderma.

In this case, the occurrence of bursitis is due to the deposition of salts in the wall of the synovial bag and the development of chronic inflammation in it.

Diathesis

Diathesis is a condition that occurs in children and is characterized by the body's readiness for the occurrence of certain diseases. But diathesis itself is not a disease. Most often, it is accompanied by a violation of the immune system, allergic reactions. This facilitates the occurrence of inflammatory processes, including in synovial bags.

Age

With age, the risk of developing bursitis increases. As the body ages, salts are deposited in the wall of the synovial sac, it becomes denser, less elastic, and the body's defenses decrease.

unknown reasons

In some cases, the cause of bursitis cannot be determined. It appears as if by itself. This form of the disease is called idiopathic.

Bursitis classification

Bursitis is classified depending on what pathological processes occur in the synovial bag:

• Serous bursitis- accumulation of clear fluid in the synovial sac. More typical for bursitis not associated with infection.
• Purulent bursitis. The synovial bag is filled with pus, in fact, it turns into an abscess. Purulent bursitis is associated with an infectious process.
• Hemorrhagic bursitis. Blood accumulates in the synovial sac.
• fibrinous bursitis. In the synovial bag, overlays of fibrin are formed - a protein that takes part in the process of blood coagulation. It is typical, for example, for the tuberculosis process.
• calcareous bursitis. In chronic bursitis, calcium is gradually deposited in the wall of the synovial sac, which then turns into lime.
• Calculous bursitis accompanied by the deposition of calcium and the formation of stones inside the synovial bag. They are clearly visible on x-rays.

Bursitis symptoms

Common Symptoms of Bursitis

Bursitis can occur in acute, subacute and chronic forms.

Signs of bursitis are characteristic of the inflammatory process.

Common symptoms of acute bursitis:

• Puffiness. In the area of ​​the affected joint, swelling is determined. It is caused by an increase in the synovial bag, the accumulation of fluid in it, stagnation of blood in the vessels as a result of the inflammatory process.
• Skin redness. The skin in the area of ​​the joint becomes hot to the touch due to stagnation of blood.
• Pain. As a result of the development of the inflammatory process and the increase in the size of the synovial bag, irritation of the nerve endings in the joint area occurs. There are pain sensations that intensify during movement, palpation.
• Joint dysfunction. Due to pain and swelling, movement in certain directions becomes limited.
• Violation of the general condition. Lethargy, increased fatigue, and sometimes an increase in body temperature are noted.

With chronic bursitis, the symptoms become less pronounced. The disease can proceed in waves: with periods of improvement and exacerbations.

Features of the symptoms of the disease depending on the affected joint

Features of the symptoms of shoulder bursitis

In acute shoulder bursitis, there is swelling and redness in the area of ​​the shoulder joint. The pain is usually not very strong, the general condition does not suffer (unless the bursitis is caused by an infection). It is characteristic that the patient cannot put his hand behind his back and behind his head. She gets tired quickly. Sometimes there is numbness and tingling in the joint area.

With an infectious lesion of the shoulder joint, there is a stronger swelling and redness, severe pain. Body temperature rises, chills, headaches, general weakness, weakness, nausea, vomiting occur.

Possible complications of purulent shoulder bursitis:

• abscess (abscess) in the area of ​​the shoulder joint;
• the transition of the infectious process to the joint and the development of shoulder arthritis;
• the transition of the infectious process to the humerus and the bone marrow located in it, the development of osteomyelitis.

Features of the symptoms of ulnar bursitis

Manifestations of acute elbow bursitis are typical: swelling (especially pronounced on the posterior surface of the joint), redness, pain, impaired flexion and extension. Under the skin, you can feel a soft formation - an enlarged synovial bag, inside which fluid has accumulated. The acute form can turn into a chronic one, which occurs with periods of improvement and exacerbation.

With purulent elbow bursitis, all symptoms are more pronounced, there is an increase in body temperature, a violation of the general condition. The lymph nodes located under the skin in the area of ​​the elbow joint are enlarged.

Possible Complications:

• purulent elbow arthritis;
• osteomyelitis (purulent inflammation) of the humerus, ulna or radius;
• abscess (abscess) in the area of ​​the elbow joint;
• the formation of a fistula - a tunnel that connects the abscess cavity with the surface of the skin.

Features of the symptoms of knee bursitis

There are three types of knee bursitis:

• Inflammation of the synovial sac located in the popliteal fossa, that is, on the back of the joint.
• Inflammation of the synovial bag located in the patella, that is, on the front surface of the joint.
• Inflammation of the synovial sac located inside the joint.

During the disease, there is swelling, pain, impaired flexion and extension in the knee. Swelling and redness may be more pronounced on the anterior or posterior surface of the joint, depending on which bursa is inflamed.

Infectious knee bursitis may be complicated by purulent arthritis. This is fraught with damage to the knee meniscus or cruciate ligaments located inside the joint. Osteomyelitis of the femur, tibia, and fibula may also develop.

Features of the symptoms of hip bursitis

In the area of ​​the hip joint there are three large synovial bags:

• Above the trochanter of the femur - the protrusion to which the muscles are attached.
• On the inside of the femur.
• In the thickness of the gluteal muscle.

The main symptom of this type of bursitis is pain in the hip joint. She gives in the leg, spreading along the outer surface of the thigh. Pain increases during flexion and extension in the joint, when a person lies on a sore side, while walking, climbing stairs.

Over time, the pain dulls, becomes weak. It is felt not in the hip joint, but, as it were, in the entire thigh. Some patients experience pain after prolonged sitting on a hard surface.

With purulent inflammation in the synovial bag, severe pain occurs. Because of it, the patient cannot unbend the thigh, turn it in or out, and take it away. The leg is in a bent and slightly retracted position.

The general condition is disturbed, the body temperature rises. The swelling may be poorly noticeable, as the joint is surrounded by powerful muscles.

Features of the symptoms of calcaneal bursitis

The most common cause of non-infectious calcaneal bursitis is wearing high-heeled shoes with a hard back. Therefore, symptoms most often develop in women. Swelling occurs on the back of the heel, which increases with time. Relieve pain. Mobility in the ankle joint is limited. When standing on toes, the pain is greatly increased.

Purulent calcaneal bursitis is accompanied by characteristic symptoms of an infectious process.

Possible Complications:

• the formation of an abscess (abscess);
• purulent arthritis of the ankle joint;
• impaired mobility as a result of damage to the ligaments and Achilles tendon;
• osteomyelitis of the bones of the leg.

Diagnosis of bursitis

Which doctor should I contact if I have symptoms of bursitis?

Bursitis is diagnosed and treated by an orthopedic traumatologist. This specialist is available in almost every polyclinic and multidisciplinary clinic.

Purulent bursitis is a surgical pathology and, accordingly, the surgeon is engaged in its treatment. Tuberculous bursitis is treated in a tuberculosis clinic. Bursitis caused by sexually transmitted infections is dealt with by venereologists.

Conversation with a doctor: what questions can a specialist ask a patient if bursitis is suspected?

In order to correctly establish the diagnosis, the doctor will ask the patient some questions:

• How long ago did the first signs of the disease appear? What, according to the patient, they were provoked?
• Was there an injury where the bursitis originated?
• What other illnesses have you had recently?
• What are the current concerns?
• Did your body temperature rise?
• Where does the patient work and what functions does he perform in the workplace? Does he play sports? What?
• What chronic diseases does the patient have?

It is necessary to give detailed and accurate answers - this will facilitate the tasks of the doctor.

How does a doctor conduct an examination if bursitis is suspected?

• The doctor feels the area of ​​the affected joint, trying to feel the enlarged synovial bag under the skin.
• The doctor presses at different points, performs various movements in order to understand in which cases the pain intensifies and how much mobility is impaired.
• The subcutaneous lymph nodes are palpated.
• You may be asked to take your temperature at the doctor's office.

Examination for bursitis

Bursitis treatment

Treatment of acute bursitis not associated with infection

* Information (names and dosages of drugs) is provided for informational purposes only. Self-medication is unacceptable and can lead to negative consequences, there are side effects and contraindications. Follow your doctor's orders. In the case of self-administration of drugs, the patient himself is responsible for all possible consequences.

Treatment of acute bursitis caused by infection

Treatment of chronic bursitis

The most reliable way to treat chronic bursitis is to surgically remove the bursa. The operation is carried out in a planned manner: the doctor appoints the patient an examination and the date of the surgical intervention. If the bursa was not infected, then healing after surgery occurs within 10 days.

Chronic infectious bursitis is often complicated by a fistula: it is a narrow passage, one end of which opens in the cavity of the synovial bag, and the other on the surface of the skin. During the subsiding of the pathological process, the fistula seems to close, and during the exacerbation of them, pus begins to secrete from it again, the patient's condition worsens. During the operation, the fistula must be completely excised.

Relapses after surgical treatment are rare: no more than three out of a hundred operated.

Treatment of bursitis with folk methods

In folk medicine, there are many recipes for the treatment of bursitis and inflammation of the joints. Below are the most common. Before using this or that method, be sure to consult your doctor.

Alternative treatment of bursitis with propolis

Required Ingredients:

• propolis - 10 g;
• vodka - 100 ml.

Pour vodka over propolis and insist for five days. Make compresses** on the area of ​​the affected joint until the swelling and pain disappear.

**Warm compresses should only be applied after body temperature has dropped and pain has subsided.

Alternative treatment of bursitis with cabbage and burdock leaves

It is necessary to take a leaf of cabbage or burdock, knock it down with a rolling pin. Lubricate the skin in the area of ​​the affected joint with vegetable oil. Apply the sheet to the affected area, bandage and wrap with a warm cloth. Walk like this during the day, change the bandage at night. Treat until swelling and pain disappear.

Alternative treatment of bursitis with honey and onions

Ingredients:

• shavings of laundry soap 1 part;
• honey - 1 part;
• onion - 1 piece.

Mix laundry soap with honey, melt in a water bath, then put on a piece of cotton fabric. Put chopped or grated fresh onion on top. Apply to a sore spot, cover with polyethylene on top and wrap in a warm cloth. Usually pain and swelling subside after 2 weeks.

Alternative treatment of bursitis with coniferous infusion

Twigs, needles and pine cones are needed. They need to be filled with cold water, put on a gas stove and boil for 30 minutes. Then remove, close the pan, wrap it in a warm cloth and insist for 12 hours.

Add the resulting infusion to the bath:

• for a shared bath - 1.5 kg;
• for a foot bath - 250 g.

Alternative treatment of bursitis with a decoction of burdock

It is necessary to pour a few tablespoons of chopped burdock with a liter of water, put on the stove, bring to a boil and boil for 15 minutes. Then insist for 15 minutes and cool so that the infusion is warm. You can do compresses with it. Burdock relieves inflammation and promotes healing.

Prevention measures for bursitis

• People prone to bursitis (athletes, some workers, etc.) should take precautions, give rest to the joints in a timely manner, and wear special protective bandages.
• It is necessary to carry out the treatment of wounds in the area of ​​​​the joints in a timely manner, to prevent their infection.
• Timely treatment of any infectious diseases, pustular skin lesions.
• For sports, you need to choose comfortable shoes in size.
• Before intense loads on the joints, you need to perform “warm-ups”.
• Athletes should never overtrain, violate the prescriptions of a sports doctor and coach.