Treatment of bursitis of the shoulder joint

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

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

Medicated and other methods of treatment of bursitis of the shoulder joint

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

Simultaneously, to remove the pain (sometimes very strong) make cold compresses: for 15-20 minutes apply ice - three times a day. Remember that hot compresses with joint pain can not be done so that there is no purulent inflammation.

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

If the inflammation of the joint bag of the shoulder joint is caused by trauma, then a time-tested circumarticular medicated blockade is used - simultaneous insertion of locally anesthetic drugs (Novocaine, Lidocaine) and non-steroid hormones (hydrocortisone acetate, dipropan, and dexetazone) into the cavity of the bag. With a minimal risk of side effects, this method is extremely effective, as it instantly relieves pain and promotes cessation of inflammatory processes.

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

The intake of antibiotics internally is prescribed mainly in the purulent flow of bursitis. This is the same Cefalexin (tablets or capsules of 250 mg), which is taken every six hours for one tablet. Hospitalization and intravenous administration of antibacterial drugs may be necessary - in the 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 a drainage device to remove the inflammatory effusion.

The radical treatment of chronic recurrent bursitis - surgical intervention in the form of excision of the synovial bag (bursectomy) - is rarely used.

After the acute stage of the disease passes, the treatment of the bursitis of the shoulder joint continues with physiotherapeutic procedures, the media of which include UHF therapy, phonophoresis with hydrocortisone, and paraffin or ozocerite applications.

Treatment of calcareous bursitis of the shoulder joint

The basic principles of treatment of calcareous bursitis of the shoulder joint - the removal of pain and inflammation - are the same as with ordinary bursitis. But there are some differences.

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

According to orthopedists, this can occur due to increased allergenicity of the body, hyperparathyroidism, or, more often, due to a violation of calcium metabolism and an increase in its content (which can be detected by a blood test). A rise in the level of calcium can develop with increased absorption of calcium in the gastrointestinal tract, with long-term use of funds against heartburn or an overabundance of this element in the diet.

The diagnosis of calcareous bursitis of the shoulder joint can be made only after the 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 the 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 performed by injections of corticosteroids and those anti-inflammatory drugs mentioned above.

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

If conservative treatment does not yield the expected results within 3-6 months, then an arthroscopic surgical procedure such as subacromial decompression can be performed.

Ointments from bursitis of the shoulder joint

The most clinically effective effect is ointment from bursitis of the shoulder joint on the basis of non-steroidal anti-inflammatory drugs: they anesthetize, relieve inflammation and swelling.

These include Diclofenac (Voltaren, Diklak-gel, etc.), Ibuprofen (Dip Rilif et al.), Fastum gel (Ketonal et al.), Piroxicam (Finalgel), and the like. You can also use gels with NSAIDs - Nurofen, Nimesulide, Febrophide, etc.

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

Alternative treatment of bursitis of the shoulder joint

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

The first recipe: wash a sheet of fresh white cabbage, beat it with a hammer to beat the meat and attach it to the shoulder, wrapping the shoulder with a food film, and on top with a woolen scarf. Such a compress is recommended in 6 hours to be replaced with a new one and worn constantly.

The second recipe suggests soaping one side of a cabbage leaf with a usual household soap and sprinkling it with baking soda. And then - as in the first recipe, but only soaped sheet should be applied at night.

But the recipe for salt compress for the treatment of bursitis of the shoulder joint: in liter of boiling water dissolve table salt - two tablespoons with a slide; soak a woolen shawl in a solution and wrap around a sick joint; above - polyethylene, and over the film again warm scarf (but already dry). Such a compress is advised to keep for eight hours.

Doctors strongly recommend not to let the disease on its own and begin treatment of bursitis of the shoulder joint with the first symptoms. And it is best that this treatment is prescribed by an orthopedist or traumatologist.