Elbow bursitis does not deflate. Bursitis of the elbow joint: causes, symptoms, treatment

is an aseptic or infectious inflammatory process in the periarticular synovial sac. It can be acute, subacute or chronic. A soft local seal appears in the area of ​​the elbow joint. In the acute period, pain and signs of local inflammation occur. Chronic bursitis is characterized by mild to moderate pain and difficulty in movement in the absence of inflammation. With suppuration, edema appears, sharp pains and signs of general intoxication. The diagnosis is made on the basis of clinical signs, if necessary, a puncture, MRI and radiography are performed. Treatment of acute bursitis is conservative, chronic and purulent - operational.

ICD-10

M70.2 M70.3

General information

Elbow bursitis is the most common type of bursitis. It can be aseptic or purulent, acute or chronic. More often it develops due to overload and microtrauma of the elbow joint. It is observed in athletes and people of hard physical labor (miners), as well as in workers who are often forced to lean their elbows on the table. It mainly affects young and middle-aged patients, men are affected more often than women. Traumatologists-orthopedists treat chronic aseptic bursitis, surgeons treat acute aseptic bursitis and purulent bursitis.

Causes

The cause of chronic bursitis of the elbow joint is permanent microtrauma due to increased load or body position. The localization of inflammation in a particular bag is due to the characteristics of the load. So, in wrestlers, miners and office workers, the subcutaneous ulnar bag is more often affected, in tennis players - the radioulnar bag, etc. With rheumatoid arthritis, gout and some other diseases, bursitis develops as a reaction to the deposition of salts in the synovial bag.

Infection is possible when microbes enter through a small wound, abrasion, abscess or boil in the elbow area. With erysipelas, boils, carbuncles, bedsores, osteomyelitis, and purulent wounds, the infection can enter the bursa with blood or lymph flow. Risk factors that increase the likelihood of developing purulent bursitis are a general weakening of the body as a result of past illnesses, metabolic disorders, diabetes mellitus, immune disorders and taking steroids.

Pathoanatomy

Bursa is a slit-like formation containing a large number of fluid and located near the protruding areas of the bone. Acts as a shock absorber, protecting surrounding tissues from excessive pressure or friction. With overload or repeated microtraumas in the bag, aseptic inflammation occurs, inner shell bursa begins to actively produce fluid. As a result, the bag takes on the appearance of a tightly filled bag and begins to bulge.

Subsequently, the liquid gradually stretches the bag, it increases and can reach significant sizes. With a long course, adhesions are formed with surrounding tissues, foci of fibrosis appear in the capsule and sometimes areas of calfification. When an infection enters the bursa, it develops purulent inflammation, which can spread to neighboring organs and tissues.

There are three bursae in the area of ​​the elbow joint: ulnar subcutaneous, interosseous ulnar, and radiohumeral. Most often (in approximately 70-80% of cases), the subcutaneous bursa is affected, which is located on the posterior surface of the joint in the region of the olecranon.

Classification

Diagnostics

With the defeat of the subcutaneous bursa, the diagnosis of bursitis of the elbow joint does not cause difficulties. Suspicion of nonspecific and specific infected bursitis is an indication for puncture of the bursa, followed by examination of the punctate. In purulent processes, the sensitivity of isolated pathogens to antibiotics is determined. With specific inflammation, special serological and bacteriological research. The defeat of the radioulnar and interosseous synovial bags is sometimes more difficult to diagnose due to their deep location. In doubtful cases, an MRI of the joints is performed. If a specific bursitis is suspected, the patient is referred for a consultation with a venereologist or phthisiatrician. If gout is suspected and rheumatoid arthritis appoint a consultation with a rheumatologist.

Treatment of bursitis of the elbow joint

Treatment of acute bursitis is carried out on an outpatient basis in a surgical office. A tight bandage is applied to the elbow joint, anti-inflammatory drugs are prescribed, it is recommended to keep calm and apply cold to the affected area. In some cases, perform a puncture of the synovial bag. With purulent bursitis, treatment is carried out in a clinic or in a surgical hospital, depending on the severity of the process. The patient is prescribed antibiotics, anti-inflammatory and pain medications. Perform a therapeutic puncture of the bursa, followed by washing and administration of antibiotics. In severe cases, the synovial sac is opened and drained.

Traumatologists are engaged in the treatment of chronic aseptic bursitis. Conservative therapy in such cases is ineffective. Punctures also do not bring the desired result, because after removal the fluid accumulates again. The best result is provided by surgical excision of the bursa. The operation is carried out in a planned manner in the conditions of the trauma department. Local anesthesia is used.

The doctor performs an arcuate incision along the edge of the bag, injects novocaine into the tissues for better visibility of the border between the bursa and surrounding tissues. Then bluntly (with a clamp) peels off the bag all over and excised, making sure that no pieces of the capsule remain in the wound cavity. Then the skin is sutured and the wound is drained with one or two rubber graduates. When excising large burs, a rubber half-tube can be used. The arm is bent at the elbow joint and tightly bandaged to prevent cavity formation and ensure skin contact with underlying tissues. AT postoperative period appoint UHF. The sutures are removed on the tenth day, after which the patient is discharged for outpatient follow-up care at the emergency room.

Forecast and prevention

With timely treatment, the prognosis for all types of elbow joint bursitis is favorable. With purulent bursitis with the spread of infection to the surrounding tissues (especially into the joint cavity), the prognosis worsens. The outcome in such cases can be contractures and stiffness of the joint. Prevention includes limiting the load on the joint, preventing infection.

Content

Inflammation of the subcutaneous connective tissue or elbow bursitis responds well to home treatment. The symptoms of this lesion appear gradually, which interferes with their diagnosis, therefore, if treatment is not started, over time this will lead to the loss of working capacity of the hands. Often the disease develops in middle-aged men. The disease is also typical for students, athletes, people who, by the nature of their profession, overload their elbows: watchmakers, office workers, accountants.

What is elbow bursitis

The inflammatory process that appears in the tissues of the synovial sac (bursa) surrounding the olecranon is called bursitis. To understand how inflammation proceeds, you should know that there are synovial bags (bursa) filled with fluid around the joints. AT normal condition they play the same role as lubricants in an engine, preventing parts from touching.

Specifically, the elbow is surrounded by interosseous, subcutaneous ulnar and interosseous ulnar bursae. Synovial bags in the normal state do not allow joint friction during movement. Sometimes inflammation occurs in the cavity of several or one bursa at once, while the fluid in the elbow joint increases, its composition changes, the arm may swell and start to hurt. This condition is called bursitis. Common is the disease of the knee, elbow and shoulder joint.

Symptoms

Elbow bursitis sometimes appears for no apparent reason, it is absolutely painless, while it does not interfere with the movement of the hands. The doctor during the examination can only detect one or more formations. The chronic form of the disease occurs in the absence of treatment. Any signs of inflammation can be easily confused with gout and polyarthritis, so even with a slight ailment, you should seek help from a specialist. Olecranon bursitis has the following symptoms:

• redness of the skin around the elbow, a sharp filling;
• the occurrence of swelling;
• increase lymph nodes;
• swelling, which may increase in volume over time;
• feverish state;
• limitation of joint mobility;
• intoxication, accompanied by sweating, headaches, loss of appetite, apathy;
• heat body;
• the formation of pus;
• severe pain when bending the arms;
• with an increase in the joint bag, the mobility of the arm becomes limited.

If not start timely treatment elbow bursitis and continue to ignore the damage to the synovial bag, then the disease will turn into a purulent form, and subcutaneous phlegmons and fistulas will appear at the site of inflammation. If you find any of the symptoms, you should not try to diagnose and start treatment on your own, it is better to immediately seek help from a specialist.

Causes

Elbow chronic bursitis can appear for several reasons:

• with diabetes;
• as a result of arthritis of any nature - gouty, rheumatoid, psoriatic;
• due to idiopathic inflammation of the synovial bag;
• if an infection got inside;
• with a mechanical injury to the elbow;
• the cause of suppuration can be a metabolic disorder, weakened immunity, taking steroid drugs;
• due to microtrauma;
• in the presence of purulent foci (boils, abscesses, abscesses).

Classification

Elbow bursitis has several forms, each of which is characterized by specific changes appearance and pain intensity. The most common classification is the division of the disease into the following forms:

• Chronic. Accompanied by mild pain that persists long time. In this case, there is no tumor, but a dense formation of a small size is probed.
• Acute. Symptoms of the disease are intoxication and fever. Often this form is called traumatic bursitis.
• Recurrent. It occurs when the integrity of the affected area is repeatedly violated. The symptoms of recurrent bursitis are similar to the acute form.

In addition, it happens:

• Specific bursitis (post-traumatic). This type of illness appears in people engaged in monotonous power work.
• Non-specific. It is observed in patients who have tuberculosis, treponema, syphilis.

Based on the composition of the synovial fluid, it can be:

• hemorrhagic bursitis. With this type of disease, blood enters the fluid.
• Serous. The safest form. It is characterized by slight pain and swelling, elevated temperature. Serous fluid acquires the consistency of serum.
• Purulent. A person begins to feel bursting pains, there is a strong swelling. The presence of pus indicates inflammation and the presence of pathogenic bacteria. Purulent bursitis requires emergency treatment antibiotics.

Diagnostic methods

If the first symptoms of infection of the cavity of the elbow bag are found, it is urgent to consult an orthopedist-traumatologist. Often the disease is determined with the help of an ordinary examination. Although there are cases when there is no exact certainty in the presence of the disease, therefore, the following methods are used to specify and clarify the disease:

• ultrasound. With help ultrasound you can find out exactly how much fluid is inside and whether there is a need for an operation.
• Puncture of the articular bag. It is carried out when the doctor does not understand the nature of the disease - inflammatory or infectious. The fluid taken during the puncture helps to identify its sensitivity to antibiotics.
• Radiography. After an x-ray, a specialist can accurately tell about the presence of an inflammatory fluid.
• MRI. Magnetic resonance imaging is used only in extreme cases, when it is necessary to know the degree of neglect of the disease. MRI determines the depth of the articular capsule.

Puncture

With purulent acute bursitis of the elbow, the doctor may prescribe a puncture of the exudate of the bag. During this procedure, the contents of the bursa are removed. In addition, with a puncture, it is possible to administer corticosteroids and antibacterial drugs, which have an anti-inflammatory effect. Before starting the procedure, the arm is bent at an angle of 90 degrees. The needle is passed between the lower edge of the outer epicondyle and the outer edge of the olecranon.

Treatment of bursitis of the elbow joint

If the pathology is the result of a bruise, then the disease can go away on its own by restricting the movements of the sore spot and applying a compress using Dimexide. At an early stage of the disease, rest should be organized for the joint. In other cases, anti-inflammatory therapy will be needed. To begin with, the specialist may prescribe nonsteroidal drugs(Ibuprofen, Diclofenac). If bacteria are the cause of inflammation, then antibiotics are needed. With a large accumulation of fluid, a puncture should be made.

In addition, the treatment of ulnar bursitis involves the imposition of immobilizing (pressure, scarf, plaster) bandages. If the damage is open, then the wound is surgically treated, after which an antiseptic dressing is applied on top. Treat infectious inflammation should only be a specialist. Conservative therapy in such cases is ineffective. After healing, the patient should undergo physiotherapy. If, due to the neglect of the process, the treatment is not successful, then an operation is prescribed.

Medications

With severe inflammation of the elbow, it is necessary to treat the disease with antibacterial, antiseptic, anti-inflammatory drugs. In addition to this, homeopathic ointments are used. Local treatment at home with Dimexide helps. Severe pain is stopped by glucocorticoids, analgesics, anti-inflammatory nonsteroidal drugs.

Elbow bursitis is accompanied by pain and severe inflammation. To relieve such symptoms, the doctor may prescribe non-steroidal anti-inflammatory drugs. All of them have antipyretic, analgesic effect. With bursitis nonsteroidal drugs used systemically. This group includes the following drugs:

• Diclofenac. It can be used in the form rectal suppositories and injections. It has an analgesic and anti-inflammatory effect. Suppositories are administered as a whole, 50 mg twice a day. Diclofenac should be used with caution in the presence of stomach diseases.
• Ibuprofen. The tool has antipyretic, analgesic and anti-inflammatory effect. For cupping pain syndrome the drug is prescribed in the form of injections. The course of treatment is 10 days. The remedy can cause side effects: nausea, allergic reactions, dizziness.

Antibiotics for elbow bursitis

Initially, with hemorrhagic and purulent bursitis, the patient is prescribed antibacterial treatment. Antibiotics should be prescribed by a physician after laboratory research- sowing the synovial cavity in order to identify the pathogen and determine its sensitivity to antibiotics. Depending on the infection that triggered the inflammatory process, the following antibiotics may be prescribed:

• Lincomycin. The agent slowly develops resistance, quickly distributed in the tissues. The daily rate of the drug is 2 g. The duration of therapy is 2 weeks. Taking the medicine is contraindicated during pregnancy and lactation due to penetration active substance through the placental barrier.
• Amoxiclav. Combined antibiotic drug. Refers to pharmacological group penicillins. It is used in the form of tablets. The average course of treatment is 14 days. Amoxiclav is prescribed with caution in liver failure and severe kidney disorders.

Ointment

The modern pharmaceutical market offers a large number of ointments successfully used against inflammation of the elbow joint. The preparations in their composition have specific components that increase the permeability of capillaries: pepper extract, bee or snake venom, essential oils. They locally increase blood flow, cause tissue hyperemia, and perfectly cope with the symptoms of inflammation of the articular bag. All medicines can be used at home, but only a doctor should prescribe them. The most effective are:

• Collagen Ultra. Ointment or cream for external use. Thanks to the free amino acids contained in the preparation, inflammation disappears faster when using the ointment. Collagen anesthetizes, strengthens connective tissue, eliminates muscle tension. It is necessary to rub the ointment with massage movements, without pressing on the affected area. By-effect: Allergies may develop.
• Voltaren. The drug is considered the most effective in eliminating pathological processes in joints and muscles. The ointment is quickly absorbed, especially if applied under a bandage. In addition, the effect of the drug on tissues lasts more than 12 hours, which helps to use Voltaren only 2 times a day. Side effects: anxiety, insomnia, headache.

Ointment Vishnevsky with bursitis of the elbow joint

The composition of the well-known ointment includes Castor oil, xeroform, tar. The drug belongs to effective antiseptic, antimicrobial and anti-inflammatory agents. In addition, Vishnevsky's ointment is an excellent mixture for the treatment inflammatory process, because it quickly dissolves the exudate. With bursitis this remedy, due to its structure, is well absorbed into the skin. The ointment is easy to apply and make various compresses. This remedy can be cured of a disease accompanied by an accumulation of pus. Contraindication - a pronounced tendency to allergies.

Nutrition Features

To help the body fight the disease, you need to eat foods with vitamins C, A, E, eat more gelatin (at least 3 times a week). Therefore, you should eat more:

• products plant origin: cereals, cabbage, viburnum, carrots, beets, sea buckthorn, currants, citrus fruits, nuts;
• you can still include jellied fish, jelly, jelly, jelly in the diet;
• animal products: beef, chicken, liver, fish, seafood, dairy products.

Surgical intervention

With bursitis, surgery is performed in extreme cases, when all traditional methods are ineffective. As a rule, surgical treatment is necessary for purulent-hemorrhagic inflammation, recurrent or persistent serous bursitis. During the operation, in some situations, purulent exudate or part of the bursa can be removed, and if the disease is running, then the entire bag can be completely removed. There are the following ways:

• drainage;
• bag puncture;
• bursectomy.

Treatment with folk remedies

You can not self-medicate with bursitis, because. this will lead to complications. It is necessary to coordinate all therapy with the doctor. Although folk remedies are not able to completely get rid of the disease, they can alleviate the symptoms of inflammation of the connective tissue. As a rule, the treatment of elbow bursitis at home involves the use of an ointment from aloe juice with honey. For its preparation, you will need the juice of the plant, several parts of alcohol and honey. All ingredients are thoroughly mixed and applied to the affected area 2 times a day. Some more popular recipes:

• Salt compress. To prepare it, it must be dissolved in 0.5 liters of water. big spoon salt, moisten a cloth with a solution and put it on a sore spot. From above it is necessary to wrap with a film and a warm scarf. The duration of the procedure is approximately 8 hours. Such treatment well draws excess fluid from the inflamed bag.
• onion mix with laundry soap and honey. To prepare the recipe, you will need a medium onion, a bar of soap and 500 g of honey. All ingredients must be thoroughly mixed and used as a compress. Do it before bed for three weeks.

Prevention

To avoid the occurrence of bursitis, you should adhere to the following rules:

• suppress inflammation in a timely manner;
• avoid heavy loads;
• disinfect scratches, abrasions, minor wounds with antiseptics;
• adhere to dietary nutrition;
• correct deformed joints in time;
• exercise;
• use special bandages.

Video

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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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, in the background acute inflammation fluid begins to accumulate in the cartilage itself or in the synovial bag, 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. It can also serve as an infectious cause of bursitis when bones and soft tissues fingers. 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 receiving mechanical injury 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.

Among the risk factors leading to the occurrence of inflammation in the elbow joint, there are some chronic diseases, For example, diabetes. 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 for 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 low temperature body, 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 bringing 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:

Lymphangitis	Inflammation of the lymphoid ducts, which become more pronounced in the form of a grid or red lines directed from the site of a purulent formation.
Lymphadenitis
	It is formed as a result of infection of the lymph nodes, to which lymph flows from the focus of inflammation and an abscess is formed.
Purulent arthritis	Characteristic is the transition of the disease to the joint, which is located next to the victim and its restriction in movements.

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 passing the acute period of bursitis to the complex medical procedures added physiotherapy. Painful symptoms subside on 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 from above with a woolen scarf 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 ether tea tree. Mix the components thoroughly, put half the mass on gauze or bandage, fix it on the inflamed area. wrap up problem area not worth it. Aloe 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. A complex 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 turns into chronic stage, seizures 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 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 - dangerous disease. The disease should not be left to chance, as complications can be deplorable. You can not bring the disease to severe forms.

Our joints perform a lot of work every day and cope with the huge loads that we place on them in view of our life activity. With such a high level of stress, very often the joints can be exposed to a wide variety of pathologies and diseases. One of the common diseases affecting the articular bag is bursitis of the elbow joint.

It is the elbow joint - this is the most favorite place of the disease. Synovial fluid, which is secreted by synovial cells lining special articular bags - bursae, cushions the load on bones and joints, and also lubricates them. Fluid accumulates in the joint bags and as a result of its excess, inflammation can occur, which is called bursitis.

The mechanism of the occurrence of pathology

Due to the content of the lubricating fluid in the bag cavity, the friction of bones and tissues against each other during mobility is minimized. The elbow joint is anatomically surrounded by three articular bags: subcutaneous, interosseous and radiohumeral. Thanks to them, a person does not feel any discomfort and can perform any function with his hands. Normally, the ulnar bursa is smooth, flat, and ideally contributes to the work of the elbow joint. When inflammation occurs, an excess of synovial fluid appears in the bursae, which presses on the surrounding tissues and causes pain. In this case, we are talking about bursitis of the elbow joint.

Causes of the disease

Often this disease people who make multiple active movements with their hands and in particular flexion - extension of the elbow are susceptible. This may be due to the performance of certain monotonous work or the participation in certain sports, such as golf, hockey or tennis.

In some cases, bursitis can be provoked by an injury in which the blow falls on the very edge of the elbow. One more probable cause development of bursitis are diseases of the joints such as arthritis or gout, as well as getting inside the bag of infection. When synovial fluid becomes infected, acute purulent bursitis develops inside the bursa.

Classification by type

Depending on the nature of the exudate, bursitis can be one of three types:

• serous, in which the effusion is not infected;
• hemorrhagic, in which there are blood impurities in the joint bag, most often occurs as a result of injury to the elbow joint;
• purulent, in which infection of the synovial fluid inside the joint bag occurs.

Purulent bursitis can be specific and nonspecific. A specific type occurs against the background of syphilitic, tuberculous or gonococcal etiology. As for the non-specific form, the causes of its occurrence are infection with streptococci, staphylococci and other non-specific microflora. Often it occurs with various injuries, when the infection gets inside through skin lesions - abrasions, scratches. Also, infection can pass through the lymphatic vessels from neighboring tissues when there are foci of purulent abscesses, boils, etc. in the human body.

Depending on the nature of the course, the disease is classified into the following forms of bursitis:

• chronic;
• spicy;
• subacute;
• recurrent.

Characteristic signs and symptoms

Symptoms of elbow bursitis can develop in different ways depending on its form and cause. So, in acute they appear suddenly and have a fairly intense character. In the chronic form, symptoms may appear and be observed steadily for several weeks, after which they subside again.

In the place of the inflamed articular bag of the elbow joint, a seal, swelling is formed, and the tissues increase in volume. Visually, bursitis can be quite difficult to determine, since inflammation is not visible through the skin. Only in some cases, when the affected articular bags are located close to the outside, there is reddening of the skin over it, as well as a local increase in temperature.

It is possible to find out that the patient develops bursitis of the elbow joint by the presence of a specific swelling, soft in texture on palpation. The size of the swelling can be 7-10 centimeters. All manipulations of the patient's hand are accompanied by painful sensations, possibly general malaise and in some cases sharp uplift body temperature. However, movements, unlike arthritis of the elbow joint, are not at all limited.

With a purulent form of bursitis, the inflammatory process can also affect nearby tissues. In this case, patients may develop a fever. In view of the acute deterioration of the patient's condition, very often he has to be urgently hospitalized for treatment in a hospital.

Diagnostic methods

Most often, the diagnosis of the disease occurs by examining and studying the symptoms, without any additional methods research. Bursitis is most often indicated by a specific edema formed around the elbow bend. However, in some cases, a clarification of the diagnosis is required, for which a puncture can be performed. In this case, the synovial fluid is taken for examination to clarify the nature of the exudate and its bacteriological examination is performed.

In some cases, it is advisable to use x-ray examination, which allows you to establish damage to the process of the elbow or the presence of osteophytes on it.

Existing treatments

Treatment of bursitis of the elbow joint is reduced to the elimination of pain and localization of the inflammatory process. The tactics of treatment is determined by the form of the inflammatory process. In any course of the disease, patients it is necessary to ensure maximum peace injured elbow. This can be done quite effectively with a fixing bandage. Dry heat also helps very well at home.

Treatment in a hospital setting may include:

• drug therapy;
• physiotherapy;
• surgical intervention;
• non-drug therapy.

Drug treatment methods can treat bursitis, both in acute and in its chronic form. To do this, anti-inflammatory drugs are very effectively used today, including locally, for example, Voltaren, ibuprofen, diclofenac. Also, drug treatment includes antibiotic therapy, which is necessary in the presence of infections. Preparations are selected for patients depending on sensitivity to certain microorganisms, causing inflammation. With a clearly manifested inflammatory process, glucocorticosteroids are used, which are injected into the inflamed bag.

Surgical treatment, most often it is advisable for purulent inflammation and in some cases with chronic forms. In this case, apply the following types operations:

1. Puncture of the inflamed bag. Suitable for purulent forms of bursitis. During the manipulation, a purulent formation is removed, followed by washing the joint bag with an antiseptic. At the same time, antibacterial and anti-inflammatory drugs can be introduced into the cavity of the bursa.
2. Drainage of the inflamed bag. It is also indicated for purulent bursitis. In this case, the cavity is opened and drained with a tube. The procedure is carried out until the signs of the inflammatory process disappear.
3. Bursectomy. Most radical operation, during which the inflamed ulnar bag is excised. Often this method used in chronic bursitis of the elbow joint, when there is a thickening of the bursal walls, which affects the quality of life of the patient and makes it difficult for him to live normally. This operation may be carried out under local or general anesthesia. After the operation, a splint is applied to the patient for several days, thanks to which rest is provided to the elbow joint and wound healing. In the future, a new articular bag is formed from the connective tissue of the patient.

Traditional Treatments can be successfully combined with folk methods , which effectively treat such a disease as bursitis of the elbow joint. After treatment, patients are advised to limit their ability to work for some time and stop playing sports. At favorable outcome treatment, patients fully recover in a few weeks.

Among inflammatory diseases of the musculoskeletal system, bursitis of the elbow joint is often diagnosed. Many patients find this surprising because the elbow joint does not experience as much stress as the hips, knees, and ankle joints.

But the shoulder, and especially the elbow, can be loaded significantly, and the load can be both static and dynamic. Particularly harmful are cyclic or repetitive movements that are performed regularly, which leads to aseptic inflammation of the olecranon, and its surrounding auxiliary formations - articular bags. How does bursitis present, how is it diagnosed, and what are the treatments for elbow bursitis?

Definition

Any bursitis is called inflammation of the auxiliary apparatus of the joint, namely the bursa, or articular bag. In this case, we are talking about inflammation of the intra-articular bag of the olecranon.
The human elbow joint has a complex anatomical structure. Its function is to ensure the independence of brush movements and at the same time streamline them. The overlying joint (shoulder) is the joint with the maximum degree of freedom, and movement in the shoulder is possible in three planes. The elbow joint performs movements in 2 degrees of freedom, performing flexion-extension, as well as supination and pronation (rotation of the forearm inward and outward).

At the same time, the joint bags secrete synovial fluid, which facilitates the movement of articular cartilage, reduces friction, and also protects the joint from the outside. There are three such bags in the elbow joint.
Any allergic, infectious or traumatic process can disrupt the release of synovial fluid and lead to the development of acute or chronic inflammation of one or another intraarticular bag, and sometimes several at once. Consider the main causes of the development of bursitis.

Causes of the disease

Bursitis, like any inflammation, can be aseptic, that is, arising without the participation of harmful microorganisms, and infectious. The following reasons lead to the development of aseptic bursitis:

• metabolic disorders, for example, the accumulation of crystalline substances (urates) in the joint cavity and in the tissues of the joint capsules. These are bursitis, arthritis and bursitis with terminal uremia (urea). Such diseases are called crystalline bursitis;
• prolonged static tension in the elbow joint, with support on the surface. This situation occurs in people of certain professions, or when they are in a motionless position for a long time, for example, in a state of intoxication. In addition, there may be opposite situations associated with excessive stress on the joint, for example, in some sports. So, there is the concept of "tennis elbow". It is very harmful to work at a computer with constant support on the elbows;
• severe trauma, such as a bruise, can also lead to aseptic inflammation. Violation of tissue integrity does not occur here, but reactive aseptic inflammation with exudation occurs, as a result of which inflammation of the elbow joint develops, and then bursitis. Traumatic bursitis also often develops with chronic, minor impact, but permanent damage to the articular tissues. Such microtraumas must occur over a long period of time for symptoms to develop. The post-traumatic process is typical for athletes;
• sometimes the cause of inflammation of the articular bags is allergic reaction. This happens infrequently, but happens if the patient has a polyvalent allergy. Also pronounced toxic edema allergic origin can develop with bites, for example, wasps or bees.

infectious process

AT significant amount cases of bursitis of the elbow joint is infectious. Most often, infection occurs with cuts, open wounds, or with hematogenous and lymphogenous infection from distant foci.

Usually the second way of infection is typical for patients with a significant decrease in immunity, for example, undergoing chemotherapy, or suffering from HIV infection.

Infectious bursitis can be either specific or nonspecific. In the first case, we are talking about special pathogens, which are characterized by a bright, peculiar only to them clinical picture. Such diseases include tuberculosis, syphilitic or brucellosis bursitis. AT recent times often began to register arthritis and bursitis caused by the pathogen gonorrhea.

In a nonspecific infectious process, various pathogenic cocci, for example, hemolytic streptococcus or Staphylococcus aureus, are most often the cause of infection.

It is not uncommon for cases in which infectious lesions of the articular bags can be caused by a viral infection, for example, serous bursitis of the elbow joint in children can be a symptom adenovirus infection or the flu, although in rare cases.

In the event that the inflammatory process occurs in any other organs, and bursitis occurs as a reaction to the general process, then they speak of reactive bursitis.

Classification

can be classified ulnar bursitis by localization, by the nature of the exudate and by the nature of the inflammatory process. So, according to localization, three different bags are distinguished - the bag of olecranon, or the olecranon, intratendinous and supratendinal. The closer to the surface of the skin is the bag, the greater the risk of damage. Therefore, the bag of the olecranon most often suffers from bursitis in this joint.

According to the composition of the exudate, bursitis can be:

• serous;
• hemorrhagic;
• purulent;
• fibrinous.

Serous bursitis is called if a transparent serous fluid has accumulated in the bag, which is little different from synovial fluid. Hemorrhagic bursitis of the elbow joint often occurs after an injury, and may be a manifestation of internal bleeding into the cavity of the bag, when blood is pumped out of the bag during a puncture. With infectious lesions, purulent bursitis most often occurs, which can be dangerous by melting the surrounding tissues, and with chronic lesions, fibrinous bursitis sometimes occurs. It often develops adhesive process associated with the chronic course of the disease.

Sometimes there may be a deposition of lime in the bag of the joint. Such deposition of lime salts rarely occurs as a primary process, and more often develops in old age against the background of significant metabolic disorders, such as renal failure and diabetes mellitus. In this case, we are talking about the accumulation of calcium salts in the walls and cavity of the bag. This leads to impaired secretion of synovial fluid, loss of tissue elasticity, and can occur not only as a primary lesion, but also as an outcome of chronic and long-term bursitis of any etiology.

The disease can be both acute, subacute and chronic. Acute bursitis is most often infectious and purulent, and chronic inflammation is characteristic of a systemic lesion of the connective tissue, for example, with gouty bursitis, or against the background of rheumatic pathology.
Also, a chronic course is characteristic of aseptic lesions against the background of an increased load on the elbow joint, for example, with occupational disease. What does bursitis look like, and what is the clinical picture of a typical acute lesion?

Clinic and symptoms of an acute process

Consider how a typical acute bursitis of the elbow joint proceeds. Take, for example, acute purulent inflammation, in which it is imperative to consult a doctor, since delay can lead to the need for a serious operation, and in some cases even amputation of the forearm.

The most characteristic signs of purulent inflammation of the ulnar bursa are:

• a few days after receiving a contaminated wound, scratch, or the onset of an acute infectious process, such as pneumonia, redness appears in the elbow area. Redness is the first symptom of inflammation;
• swelling occurs, when you try to press on the elbow, a seal is felt, resembling a pillow pumped up with water, or an elastic bump. This indicates the appearance of an effusion in the cavity of the bag;
• acute ulnar bursitis is manifested by a feeling of local heat: the affected elbow is much hotter to the touch than the joint on the healthy side;
• soreness. The affected elbow begins to "twitch", pain occurs, which intensifies with movement.

There may also be concomitant symptoms- fever, chills and fever, malaise.

In the event that only the bag is affected, there may not be any particular pain, but when the process spreads to the joint and surrounding soft tissues, signs of bursitis are replaced by symptoms of arthritis and even panarthritis. Then the purulent inflammation becomes extensive, and the pain becomes very strong. The consequences of bursitis of the elbow joint in the event of a secondary infection can be sad - total arthritis will occur, which can gradually transform into ankylosis with the development of disability and immobility of the joint.

To avoid pain at the slightest concussion of the joint, the patient is forced to wear his elbow with a healthy hand, or tie it to a scarf. As a result, there is a dysfunction of the joint, which ultimately affects a significant limitation of its mobility.

Signs of chronic bursitis are more subtle, with alternating exacerbations and remissions, and often do not have pronounced symptoms, except for a feeling of fatigue and swelling in the elbow.

Diagnostics

The primary diagnosis of elbow bursitis can be made by any doctor, since the signs are characteristic and indicate damage to a particular joint. Which doctor to go to for treatment depends on the process: for example, with gouty bursitis, you need to go to a rheumatologist, and with a purulent process, to a surgeon. First you need to contact the local therapist, he will refer the patient to the right specialist.

The following methods are widely used in the diagnosis of this disease:

• radiography of the joint;
• if you suspect a lesion of deep ligaments -;
• puncture of the elbow joint with bursitis allows you to determine the nature of the exudate, and often, after bacterial seeding, isolate the pathogen that caused the inflammation.

General clinical examinations such as general analysis blood, can show inflammatory changes in a pronounced process,

Treatment

How can bursitis of the elbow be cured, and what methods are there for this?
The defeat of the bag of the olecranon involves conservative or surgical treatment.
The operation is performed most often in a chronic process or with a pronounced accumulation of pus. First, a puncture of the synovial bag is done, not only from the diagnostic, but also from therapeutic purpose. b

Pus is pumped out, the bag is washed with antibiotics, and anti-inflammatory drugs, including corticosteroid hormones, are administered. Sometimes the puncture is performed several times.

In the event that there is a pronounced purulent process, after opening the bag, drains are left in its cavity. And only if the above methods are ineffective, a complete excision is performed and then the bag is removed. This operation is called a bursectomy, or "removal of the bursa."
But most often they conservative treatment using pills, injections and treatment with folk remedies.

Non-steroidal anti-inflammatory drugs

Treatment of any disease of the musculoskeletal system at home, first of all, involves taking medications that belong to the group.

They are used in various dosage forms, for example, Ibuprofen, Nise (Nimesil) - in tablets, and Movalis - in the form of intramuscular injections.

How long is acute pain syndrome treated? Usually, these drugs are not given long-term, as many of them can adversely affect the liver and stomach lining. Drug treatment must necessarily be supported by the appointment of omeprazole in patients with peptic ulcer in history. The average duration of taking NSAIDs should not exceed 10 days, with injections at the beginning, and then the patient is transferred to tablets.

Hormones

In some cases, the appointment of corticosteroid drugs, such as Kenalog or Diprospan, is indicated. They are injected directly into the bag and have a long-term anti-inflammatory effect. This therapy is indicated for aseptic variants of inflammation, for example, for chronic occupational bursitis. Long-term therapy can lead to a weakening of connective tissue formations, so do not administer hormones for a long time and often.

Antibiotics

With purulent bursitis, the patient must be given antibiotics a wide range actions. They are used in the form of intramuscular or intravenous injections. If the sensitivity can be determined pathogenic microflora to antibiotics, prescribe a certain drug.

For non-purulent inflammation of the articular bag, apply antibacterial agents orally, in tablets, to prevent infection.

Local therapy

In the treatment of this disease, topical preparations are also used, which can cause activation of tissue metabolism, reduce edema, and also enhance the body's immune response. Treatment with Dimexide refers specifically to the method of exposure that activates and excites the tissue response. Dimexide for bursitis of the elbow joint is used in the following way: a napkin moistened with a solution of Dimexide diluted with water 1: 3 is applied to the area of ​​the elbow joint, and this compress lasts for about half an hour. The course of treatment is 10 days. Before starting treatment, you need to check if there is an allergy. For this, a 50% solution of Dimexide is exposed for 15 minutes on the inner surface of the elbow bend.

With bursitis, various creams and ointments are used that contain NSAIDs. These are Fastum - gel, Dolgit - cream, products with bee and snake venom. Apizartron and Nayatoks, or Viprosal are effective. Ointments for bursitis are applied at night, as they are slowly absorbed and have a fatty base. And creams and gels are good for daily use.

In the event that the patient has purulent bursitis, an operation was performed and drains were installed, then Levomekol, or Vishnevsky ointment, is indicated for the treatment of purulent wounds, which have a strong disinfecting effect and stimulate the formation of granulation tissue.

When can thermal treatments be used?

If the patient has chronic inflammation of the ulnar bursa caused by increased load, then folk remedies are often used, since the course of the disease is long, and the degree of dysfunction may be insignificant. In this case, thermal procedures can be applied. Patients often ask if it is possible to go to the bath with bursitis?

It is possible, but not in the phase of acute inflammation, but when you feel better. The heat treatment will promote blood flow and increase venous outflow. In the event that the patient has a clinic of acute bursitis, then procedures such as a bath or massage of the elbow joint can lead to increased swelling and increased pain. In the same case, if the patient has chronic bursitis of the elbow joint, during an exacerbation, the use of these methods will lead to the development of a relapse of the disease.
In this situation, you need to cool the affected area. Suitable for this essential oil mint, diluted in base oil in a ratio of 1:10; cooling gels, such as Ben-Gay or Bom-Bengue, based on methyl salicylate and menthol; or, finally, you can simply tie a cabbage leaf to your elbow. All this will cause relief and reduction of pain.

Recovery and rehabilitation

Rehabilitation in order to restore mobility in the joint should begin from the first days after the removal of pain. The rest time for the joint should be minimal, since immobility leads to wasting of the surrounding muscles and changes in the tendons. On the first day after the onset severe pain be sure to hang the limb to the neck, for this there are special bandages, or you can use an elastic bandage. In the event that the patient has signs of chronic bursitis and the history of the disease is long enough, it is necessary to use a brace for the elbow joint, or an elbow orthosis, during exacerbations.

The tasks of exercise therapy for elbow bursitis are to restore the mobility of the joint, improve the production of synovial fluid, reduce the production of exudate in the cavity of the bag, improve the blood supply to the joint capsule, and improve the outflow of venous fluid containing harmful substances. Physiotherapy exercises should be performed already at the stage of subsiding exacerbation, always under the guidance of an experienced instructor. So, you need to avoid exercises with a small amplitude of movements, and weights are prohibited.

Prevention

The basic principles for the prevention of elbow bursitis are to avoid situations of chronic and accidental injury. Athletes need to wear protective bandages, motorcyclists - elbow pads.

In the event that a microtrauma, wound or abrasion occurs, they must immediately be treated with antiseptics, for example, hydrogen peroxide, and a bandage applied. Pustular diseases should be treated in a timely manner, and if there are signs of acute arthritis, you should contact a rheumatologist without waiting for exacerbations.

In old age, great importance should be paid to hygiene of movement, since there is an age-related decrease in the production of synovial fluid, as well as a decrease in blood supply and nutrition. muscle tissue. You can not experience serious stress, and especially in conditions of hypothermia. Finally, when working at a computer, you need to reasonably alternate periods of work and periods of rest, during which you need to do a set of gymnastic exercises.