Treatment of shoulder bursitis

Treatment of bursitis of the shoulder joint is aimed at both relieving the symptoms of inflammation of the synovial (periarticular) bag of the joint (pain, swelling, local hyperthermia), and at the cause of the inflammatory process.

Complex therapy of this fairly common pathology of the musculoskeletal system includes local and injection use of drugs, as well as physiotherapy procedures. Depending on the etiology of the inflammation and its intensity, surgical treatment of bursitis of the shoulder joint may also be necessary.

Medication and other methods of treating bursitis of the shoulder joint

Treatment of bursitis of the shoulder joint should begin with ensuring maximum rest for the sore shoulder, for which it is recommended to apply bandages - fixing or pressing.

At the same time, to relieve pain (sometimes very severe), cold compresses are made: ice is applied for 15-20 minutes - three times a day. Remember that hot compresses for joint pain cannot be made, so as not to cause purulent inflammation.

But you can take painkillers. In orthopedic practice, it is common to use non-steroidal anti-inflammatory drugs for oral administration - Ibuprofen (Ibufen, Ibuprex, Nurofen, Brufen), Diclofenac (Naklofen), etc., which not only have an analgesic effect, but also fight inflammation. Standard dosage: one tablet 2-3 times a day (depending on the stage of the disease, the daily dose can be increased to 600-1200 mg of the active substance). However, one should take into account such contraindications for all NSAIDs as bronchial asthma, gastric ulcer and duodenal ulcer, arterial hypertension, heart failure, renal or hepatic dysfunction. These drugs are not prescribed to pregnant women and children under 6 years of age. There may also be side effects: headache, nausea, dyspepsia, urticaria and itching, increased heart rate, etc.

If the inflammation of the shoulder joint capsule is caused by an injury, then a time-tested periarticular drug blockade is used - the simultaneous introduction of local anesthetics (Novocaine, Lidocaine) and non-steroidal hormones (Hydrocortisone acetate, Diprospan, Dexaethasone) into the cavity of the capsule. With a minimal risk of side effects, this method is extremely effective, since it immediately relieves pain and helps stop inflammatory processes.

Treatment of bursitis of the shoulder joint of infectious origin is carried out with the help of injections into the periarticular bags of non-steroidal hormones in combination with antibiotics (most often these are Cephalexin, Dicloxacillin or Clindamycin). In case of serous and purulent bursitis, as well as in the chronic form of the disease, orthopedists necessarily perform a puncture - in order to remove the accumulated fluid from the synovial cavity by washing the cavity of the bag with antiseptics and antibacterial drugs. There may be several such procedures, and they are carried out until the periarticular bag is completely cleared of exudate.

Oral antibiotics are prescribed mainly for purulent bursitis. This is the same Cephalexin (tablets or capsules of 250 mg), which is taken every six hours, one tablet at a time. Hospitalization and intravenous administration of antibacterial drugs may be necessary - in case of weakened immunity, subcutaneous and intermuscular phlegmon or the threat of sepsis. Also, with purulent bursitis, it is possible to open the synovial cavity and install drainage to remove inflammatory effusion.

Radical treatment of chronic recurrent bursitis - surgical intervention in the form of excision of the synovial bursa (bursectomy) - is resorted to quite rarely.

After the acute stage of the disease passes, treatment of bursitis of the shoulder joint continues with physiotherapeutic procedures, among which are UHF therapy, phonophoresis with hydrocortisone, as well as paraffin or ozokerite applications.

Treatment of calcareous bursitis of the shoulder joint

The basic principles of treating calcareous bursitis of the shoulder joint - pain and inflammation relief - are the same as for regular bursitis. But there are some differences.

And they are associated with the fact that this type of inflammation of the periarticular bag of the shoulder joint is accompanied by the accumulation of calcium salts (in particular, calcium pyrophosphate) in the fibrin fibers and in the walls of the synovial bag and their subsequent calcification.

According to orthopedists, this may occur due to increased allergenicity of the body, hyperparathyroidism or, most often, due to a disruption of calcium metabolism and an increase in its content (which can be detected by a blood test). And an increase in calcium levels can develop with increased absorption of calcium in the gastrointestinal tract, with long-term use of heartburn medications or an excess of this element in the diet.

The diagnosis of calcareous bursitis of the shoulder joint can only be made after an X-ray of this joint. And in addition to the methods listed above, the treatment of calcareous bursitis of the shoulder joint should be based on a diet with a restriction of foods rich in calcium (milk, cottage cheese, cheese, nuts, soybeans, etc.)

Treatment of subacromial bursitis of the shoulder joint

Treatment of subacromial bursitis of the shoulder joint is carried out with injections of corticosteroids and the anti-inflammatory drugs mentioned above.

Subacromial bursitis is an inflammation of one of the four synovial bags of this joint - the subacromial, which is located between the forearm bone and the acromial process of the shoulder. With bursitis of this localization, pain occurs in the front and side of the shoulder joint only when raising the arm up above the head.

If conservative treatment does not produce the expected results within 3-6 months, an arthroscopic surgical procedure called subacromial decompression may be performed.

Ointments for bursitis of the shoulder joint

The most clinically effective effect is provided by ointments for bursitis of the shoulder joint based on non-steroidal anti-inflammatory drugs: they relieve pain, inflammation and swelling.

These include Diclofenac (Voltaren, Diclac gel, etc.), Ibuprofen (Deep Relief, etc.), Fastum gel (Ketonal, etc.), Piroxicam (Finalgel), etc. You can also use gels with NSAIDs - Nurofen, Nimesulide, Febrofid, etc.

These ointments for bursitis of the shoulder joint penetrate the skin and accumulate in the subcutaneous tissue, muscle tissue, joint capsule and joint cavity. They are used externally by applying to the skin and lightly rubbing - 2-3 times a day.

Traditional treatment of bursitis of the shoulder joint

The most famous folk treatment for bursitis of the shoulder joint is compresses. For example, you can make compresses from a cabbage leaf according to one of two recipes.

Recipe number one: wash a leaf of fresh white cabbage, beat it with a meat mallet and apply it to the sore shoulder, wrapping the shoulder with cling film and a woolen scarf on top. It is recommended to replace such a compress with a new one after 6 hours and wear it constantly.

The second recipe suggests soaping one side of a cabbage leaf with regular laundry soap and sprinkling baking soda on top. And then - as in the first recipe, but only the soaped leaf should be applied overnight.

Here is a recipe for a salt compress for treating bursitis of the shoulder joint: dissolve table salt in a liter of boiling water - two heaped tablespoons; soak a woolen scarf in the solution and wrap it around the sore joint; put polyethylene on top, and then a warm scarf (but dry) on top of the film. It is recommended to keep this compress for eight hours.

Doctors strongly recommend not to let the disease take its course and to start treatment of bursitis of the shoulder joint at the first symptoms. And it is best for this treatment to be prescribed by an orthopedist or traumatologist.