Elbow bursitis

Elbow bursitis is damage to the olecranon, or rather the surrounding tissues, and an inflammatory process in the bursa of the olecranon, which is called the bursa. Bursa is a small cavity filled with lubricant, the bursa ensures normal sliding and reduces friction between layers of tissue. In essence, bursa is a synovial bag that acts as a kind of "lubricant".

The elbow joint is surrounded by three bursae - the interosseous ulnar, radiobrachial and ulnar subcutaneous bursa. All of them contain synovial fluid, which provides the elbow's motor range of motion. If an inflammatory process develops in the bursa, the amount of fluid in the cavity increases significantly and pain appears. Elbow bursitis is differentiated depending on the nature of the accumulated fluid, exudate. This can be serous bursitis, purulent serous-fibrous, purulent-hemorrhagic. According to the source of the pathogen that provokes inflammation, bursitis is divided into specific or non-specific - tuberculous, gonococcal syphilitic, in addition, bursitis is diagnosed as infected or aseptic.

What causes elbow bursitis?

Most often, elbow bursitis develops against the background of arthritis, which can be rheumatoid, gouty or psoriatic. Less often, bursitis is a consequence of industrial microtrauma, which is typical for regularly performed monotonous movements. Bursitis is an "occupational" disease of people whose work is associated with resting the elbow on a surface (engravers, draftsmen, students). Also, elbow bursitis can develop some time after a mechanical injury - a bruise, fall, blow. Infectious inflammatory diseases are one of the factors that provoke bursitis, especially when the skin tissue over the bursa ruptures and bacteria penetrate into the cavity - staphylococci, streptococci. There were cases when the factor provoking bursitis was a panaritium - fingers and hand. Infection can penetrate the synovial sac both through the blood - hematogenous route, and through the lymph - lymphogenous route. Idiopathic elbow bursitis, which develops without any specific etiological causes, is diagnosed extremely rarely.

How does elbow bursitis manifest itself?

The main symptom by which elbow bursitis can be diagnosed is a small, fluid-filled formation under the elbow, at the back. Bursitis appears just under the skin, it is elastic to the touch, sometimes hot to the touch, but not too painful. If bursitis develops over several years, then upon palpation the bursitis feels denser, since during this time scar tissue has already formed. An increase in temperature and severe pain are not typical for bursitis, they can appear only in the acute stage, if the bursa is filled with purulent contents. Bursitis differs from arthritis in that it does not limit or hinder the movement of the elbow.

Elbow Bursitis: Treatment

Uncomplicated bursitis that developed after a minor injury may go away on its own, provided that the elbow is not loaded and cold is applied, followed by absorbable agents (dimexide). Also, at home, elbow bursitis treatment involves dry heat and dressings with absorbable ointments (levomekol, solcoseryl). If the inflammation of the synovial bursa is accompanied by severe swelling and is caused by a serious injury, medical attention is required. How to treat elbow bursitis should be determined by a doctor, self-treatment can lead to activation of inflammatory processes and their spread to nearby periarticular tissues. Elbow bursitis treatment involves the most comprehensive, sometimes very long-term. As a rule, elbow bursitis is treated with conservative methods, but in the case of acute purulent inflammation and complications, surgical intervention is possible.

The first stage involves prescribing non-steroidal anti-inflammatory drugs that neutralize the inflammatory process and relieve pain - ibuprofen, diclofenac, nimesulide. Steroid drugs are prescribed less frequently and, as a rule, for a very short course (5-7 days) so as not to provoke an exacerbation of existing somatic diseases.

If bursitis has developed due to a bacterial infection, antibiotics are indicated; the modern pharmaceutical industry produces many latest generation drugs that have virtually no side effects or contraindications.

Inflamed elbow bursitis, accompanied by a significant accumulation of fluid, must be punctured. With the help of puncture, aspiration of the liquid contents of the bursa is performed, thereby reducing the pressure on the surrounding tissues and relieving the pain symptom. When punctured, as a rule, either an antibiotic or steroids (hydrocortisone) are injected into the cavity, relieving inflammation.

Serous bursitis of the elbow treatment involves radical - bursectomy. This is a traumatic operation, sometimes leading to long-term disability, indicated when all the tried methods are no longer effective. Recently, a treatment scheme for serous bursitis has been used in surgical practice, which is not inferior in effectiveness to traditional puncture and bursectomy, it is carried out as follows:

• The patient is prepared - the puncture site is injected with anesthetics.
• A puncture is performed using a fairly thick needle (a needle is a catheter for the subclavian vein), and the fluid is aspirated.
• A small amount of medical alcohol (2-3 ml) is injected into the cavity, a special catheter line is passed through the needle, and the needle is removed.
• After the needle is removed, the largest subclavian catheter, in which lateral holes have been prepared, is inserted into the bursa cavity along the line.
• The catheter is fixed to the skin, the outer end of the catheter is connected to a small bulb (the bulb should be compressed).
• The bulb, which gradually straightens out, creates a vacuum in the bag and helps remove exudate.
• Aspiration is performed until the contents of the synovial bursa are completely removed.

Recurrent, persistent serous or purulent-hemorrhagic bursitis of the elbow requires surgical treatment, when the inflamed, pus-containing synovial bursa is completely removed (excised). Such chronic bursitis is characterized by an unstable result after puncturing, when the exudate accumulates again, and thickenings gradually begin to appear in the bursa. Since surgical intervention provokes a long-term non-healing postoperative wound due to the anatomical features of the elbow structure, such intervention is carried out extremely rarely.

How to treat elbow bursitis in the remission stage will also be determined by the doctor. Physiotherapeutic procedures (ultrasonic heating, electrophoresis), which are aimed at relaxing tense, spasmodic muscles, are effective. Cryotherapy procedures help relieve swelling. After the main symptoms are neutralized, gentle massage and paraffin applications can be performed.

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