Elbow bursitis

Bursitis of the elbow is damage to the elbow process, more precisely, surrounding tissues and inflammation in the bag of the appendage, which is called - the bursa. Bursa is a small cavity that is filled with lubricant, bursa provides normal glide and reduces friction between layers of tissues. In fact, bursa is a synovial bag that acts in a kind of "lubrication".

The elbow joint is surrounded by three bursals - the intercostal ulnar, the radiation-ray and the ulnar subcutaneous bursa. They all contain a synovial fluid that provides the motorial amplitude of the elbow. If the inflammatory process develops in the bursa, the amount of fluid in the cavity increases significantly and pain appears. Elbow bursitis differentiates depending on the nature of the accumulated fluid, exudate. It can be bursitis serous, purulent serous-fibrous, purulent-hemorrhagic. According to the source of the pathogen causing inflammation, bursitis is divided into specific or nonspecific - tuberculosis, gonococcal syphilitic, in addition diagnoses bursitis 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 a "professional" disease of people whose work is related to supporting the elbow on the surface (engravers, draftsmen, students). Also, elbow bursitis can develop some time after a mechanical trauma - a bruise, a fall, a stroke. Infectious inflammatory diseases - this is one of the factors that provoke bursitis, especially when rupture of skin tissues over the bursa and penetration into the cavity of bacteria - staphylococci, streptococci. There were cases when a factor provoking bursitis was a panacea - fingers and brushes. Infection can penetrate into the synovial bag both through the blood - the hematogenous way, and through the lymph - the lymphogenous pathway. It is extremely rare to diagnose idiopathic bursitis of the elbow, which develops without specific etiologic causes.

How is elbow bursitis manifested?

The main symptom by which to diagnose elbow bursitis is a small, fluid-filled formation under the elbow, at the back. Bursitis appears directly under the skin, to the touch it is elastic, sometimes hot to the touch, but not too painful. If bursitis develops for several years, then palpation bursitis is more dense, because during this time, scar tissue has already formed. The temperature rise and severe pain are not characteristic for bursitis, they can manifest only in the stage of exacerbation, if the bursa is filled with purulent contents. Bursitis differs from arthritis in that it does not restrict or impede the movement of the elbow.

Bursitis elbow: treatment

Uncomplicated bursitis, which developed after a small injury, can pass by itself, provided that the load on the elbow and applying cold, and then resolving agents (dimexide) are eliminated. Also at home, bursitis elbow treatment involves using dry heat and applying bandages with absorbable ointments (levomecol, solcoseryl). If the inflammation of the synovial bag is accompanied by severe swelling and is caused by a serious injury, medical attention is required. How to treat bursitis elbow should determine the doctor, self-activity can lead to activation of inflammatory processes and their spread to nearby periarticular tissues. Bursitis elbow treatment involves the most complex, sometimes very long. 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 consists in the appointment of non-steroidal anti-inflammatory drugs that neutralize the inflammatory process and relieve pain - ibuprofen, diclofenac, nimesulide. Steroid drugs are prescribed less often and, as a rule, very short course (5-7 days), so as not to provoke an exacerbation of the existing somatic diseases.

If bursitis develops due to a bacterial infection, antibiotics are indicated, the modern pharmacological industry produces many drugs of the latest generation that have virtually no side effects and contraindications.

An inflamed elbow bursitis, accompanied by a significant accumulation of fluid must be punctured. With the help of a puncture, aspiration of the liquid contents of the bursa is carried out, while the pressure on the surrounding tissues decreases and is removed by the painful sigmoid. When puncturing, as a rule, either an antibiotic or steroids (hydrocortisone) that reduces inflammation is injected into the interior of the cavity.

Serous bursitis elbow treatment involves a radical - bursectomy. This traumatic operation, which sometimes leads to long-term disability, is shown when all the tried methods are not effective. Recently, the surgical practice has begun to apply the treatment regimen of serous bursitis, which is not inferior to the effectiveness of traditional puncturing and bursectomy, it is carried out in this way:

• The patient is prepared - the place of puncture is treated with anesthetics.
• A puncture is performed using a fairly thick needle (needle - catheter for subclavian vein), the liquid is aspirated.
• In the cavity is introduced a little medical alcohol (2-3 ml), through the needle pass a special catheter fishing line, the needle is removed
• After the needle is removed, the largest subclavian catheter is inserted into the bursal cavity along the line, in which side openings are prepared.
• The catheter is fixed to the skin, the outer end of the catheter is connected to a small pear (the pear should be compressed).
• Pear, which is gradually straightened, forms a vacuum in the bag and helps to remove exudate.
• Aspiration is performed until the contents are completely removed from the cavity of the synovial bag.

Recurrent, persistent serous or purulent-hemorrhagic elbow bursitis treatment is operative when the inflamed, pus containing synovial bag is removed (excised) completely. Such chronic bursitis is characterized by unstable result after puncture, when exudate accumulates again, thickening gradually begins to appear in the seminal bursa. Since surgical intervention provokes a long non-healing post-operative wound due to anatomical features of the elbow structure, such intervention is extremely rare.

How to treat bursitis elbow in the remission phase will also determine the doctor. Effective are physiotherapeutic procedures (ultrasonic heating, electrophoresis), which are aimed at relaxing intense, spasmodic muscles. Cryotherapy procedures help to remove puffiness. After neutralizing the main symptomatology, it is possible to conduct gentle massage and apply paraffin applications.

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