Treatment of bunion with medications, ointments and surgery

Bunion of the big toe is an inflammation of the walls of the synovial bursa that occurs due to a violation of the anatomical structure of the joint. A bone growth forms at the base of the finger, which causes the joint to move to the side while walking. Such education is not only an aesthetic flaw.

When moving, the bone growth is compressed, subjected to friction and inflamed. The pathological process is accompanied by severe pain, swelling, and damage to the skin. Inflammation of the walls of the synovial bursa is determined by conducting a series of laboratory and instrumental studies. Conservative and surgical methods are used in the treatment of bursitis.

Causes

The main cause of the pathology is excessive accumulation of exudate in the synovial capsule. This leads to disruption of metabolic processes and the development of acute or chronic inflammation. Bunion is highly treatable, but without medical intervention, complications are likely to develop. The disease occurs under the influence of various external and internal provoking factors:

• congenital or acquired clubfoot, flat feet;
• joint hypermobility, connective tissue dysplasia;
• chronic or acute articular pathologies - gout, juvenile, psoriatic, rheumatoid arthritis, osteoarthritis;
• foot injury as a result of prolonged compression, strong impact, rupture of ligaments, tendons;
• penetration of pathogenic microorganisms into the cavity of the thumb joint;
• diseases occurring against the background of metabolic disorders;
• frequent acute systemic allergic reactions;
• progressive inflammatory process in the periarticular tissues.

Bunion often accompanies hallux valgus. This pathology is characterized by flattening of the foot and its “rolling” inward, the formation of valgus curvature in the ankle area. This pathology is easily diagnosed: when walking, the heel rests with the inner edge on the surface. Causes of hallux valgus:

• wearing narrow high-heeled shoes;
• excessive physical stress on the foot.

Bursitis of the thumb is often detected in people whose type of professional activity involves being on their feet for a long time. Infectious pathology can develop in people with weak body resistance to pathogenic pathogens.

Sometimes bursitis is diagnosed after or during respiratory, intestinal, or sexually transmitted infections. Pathogenic bacteria are transported by the blood stream from the primary inflammatory foci, forming secondary ones in the feet.

Why does bursitis occur?

The joint performs many movements every day, allowing flexion and extension of the fingers. To minimize friction during joint loading, a special fluid is produced. It is called synovial and is stored in the joint capsule. Under heavy loads, injuries, damage or other negative influences, the production of this fluid is disrupted and the joint capsule becomes inflamed. This process is very painful and is called bursitis.

The main cause of inflammation on the fingers is professional activity associated with constant stress on these joints.

Bursitis can also be a complication of chronic joint diseases, such as arthritis of the fingers. Rheumatoid arthritis is characterized by inflammation of small joints and, if not treated promptly, can spread to surrounding tissues, including the joint capsule and tendons.

Separately, infectious causes of the disease are distinguished. Bursitis can occur against the background of tuberculosis, syphilis, gonorrhea, and severe fungal infections of internal organs. In these cases, the infection spreads throughout the body and causes inflammation when it enters the joint capsule.

The cause of the development of bursitis in the fingers can be severe trauma. The disease often appears due to hypothermia.

Some forms of bursitis develop due to the deposition of calcium salts in the joint capsule. This disorder is associated with metabolic failures and can be observed with gout and other chronic diseases.

The joints of the hand are very mobile and are constantly exposed to stress.

Clinical picture

Deformation of the thumb provokes painful sensations, so a person who develops bursitis often does not understand the reason for the increased pain. One of the characteristic signs of pathology is the formation of edema, which quickly spreads to healthy tissue. A lump forms in the area of ​​the thumb, which causes discomfort when palpated. The following clinical manifestations become indirect confirmation of the development of bursitis:

• visible deformation of the big toe, its increase in size compared to the toe on a healthy foot;
• significant increase in pain while walking, especially when going up and down stairs;
• discomfort even when wearing comfortable low-heeled shoes;
• frequent formation of wet or dry calluses and corns on the thumb in the joint area;
• decreased sensitivity of the thumb.

Inflammation of the synovial bursa is difficult to determine independently if there is a history of chronic articular pathologies. The clinical picture of bursitis resembles the symptoms of gout or rheumatoid arthritis. If a person has a hallux valgus deformity, he often associates the occurrence of pain with this pathology.

Infection of the synovial fluid significantly increases the intensity of symptoms. In the absence of qualified medical care, signs of general intoxication of the body appear. The patient's body temperature rises several times a day, a fever and chills appear. Against the background of hyperthermia, the functioning of the gastrointestinal tract is upset, the person experiences dizziness and severe headaches.

Diagnostics

The doctor may suspect bunion during the examination of the patient. The initial diagnosis can be confirmed by a history of diseases associated with metabolic disorders and chronic pathologies of the musculoskeletal system. The most informative instrumental study is radiography. The resulting images clearly show the curvature of the finger and the complications that have developed. Radiography allows you to establish:

• degree of tissue damage;
• stage of the inflammatory process.

Computed tomography or ultrasound examination is performed only if necessary to clarify the diagnosis. Ultrasound also helps to detect pathological changes in periarticular tissues. The study is quite informative at the initial stage of bursitis. Laboratory tests can confirm or refute infection of the synovial fluid. The doctor uses a puncture to remove exudate from the synovial bursa. Based on the number of colonies formed in the nutrient media, the following is established:

• species identity of pathogenic microorganisms;
• their sensitivity to antibacterial drugs.

Clinical and biochemical tests of blood and urine are required. Based on their results, the overall health of a person is assessed. In the presence of chronic articular pathologies, the composition of the blood reveals the stage of exacerbation of the inflammatory process.

Diagnosis and treatment of bursitis

If symptoms of bursitis appear, specialist help is recommended. The doctor makes the diagnosis based on the clinical manifestations of the disease and examination results. A differential diagnosis of arthritis is carried out, which occurs with severe motor limitations. With bursitis, the range of motion is only slightly reduced, and sometimes completely preserved.

Experts prescribe the following types of diagnostics:

• determination of sensitivity to antibiotics (if bursitis is infectious);
• serological and bacteriological studies (used to identify specific infections, in particular syphilis and gonorrhea);
• magnetic resonance imaging of the affected joint;
• radiography.

In the acute form of bursitis, treatment consists of resting the affected joint and carrying out symptomatic therapy. Antibacterial agents are used for purulent complications. Antibiotics are selected taking into account sensitivity, which allows you to quickly suppress the infectious process and avoid serious complications. Sometimes specialists resort to joint puncture to administer corticosteroids and remove accumulated fluid, and perform drainage with rinsing with antiseptics and antibacterial drugs, which requires longer recovery and pain relief over several weeks.

Chronic bursitis is treated with anti-inflammatory and painkillers. But more often surgical excision of the synovial bursa is indicated. The operation is performed for advanced bursitis or when puncture of the synovial bursa does not give the expected effect.

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Main methods of treatment

Bursitis is treated using conservative and surgical methods. Surgical intervention is indicated for the patient if purulent pathology or a significant increase in pain during movement is detected. The disease is treated by highly specialized doctors: orthopedist, rheumatologist, traumatologist, surgeon. What is the conservative treatment of bunion of the big toe:

• joint fixation. In case of a complicated course of the disease, plaster bandages are used to completely immobilize the affected finger. Recently, they have been successfully replaced by special clamps and comfortable orthoses. They are easy to remove and clean, and allow air to pass through well. If a patient has a hallux valgus deformity, he is advised to constantly wear orthopedic devices;

• cold compresses. In the first 2-3 days of treatment, apply a bag of ice cubes to the area of ​​pain and inflammation for 10-15 minutes. To avoid frostbite, it is wrapped in dense material: a scarf, a towel. The procedure helps eliminate swelling and pain;

• NSAIDs. Non-steroidal anti-inflammatory drugs are taken one tablet 1-3 times a day after meals. In the treatment of bursitis, Nimesulide, Ketorolac, Diclofenac, Meloxicam, and Ibuprofen are usually used. They have a multifaceted clinical effect: they relieve swelling, inflammation, and reduce the intensity of pain. NSAIDs are not prescribed to patients with gastritis, ulcerative lesions of the stomach and duodenum.

Antibiotic therapy is used to destroy pathogenic bacteria. When choosing drugs, the results of laboratory tests are taken into account. Macrolides, cephalosporins, and semisynthetic penicillins with clavulanic acid have proven themselves to be effective in the treatment of bursitis.

In the treatment of thumb bursitis, anti-inflammatory external agents are used: ointments Indomethacin, Ibuprofen, gels Voltaren, Fastum. After stopping the inflammation, orthopedists prescribe warming creams and balms, for example, Viprosal or Capsicum, to patients. They improve blood circulation and accelerate the healing of damaged tissues.

In the process of surgical treatment of bursitis of other localization, the articular cavity is opened and the synovial bursa is excised. But when the thumb joint is affected, this is not enough, since the cause of the disease remains unresolved. It is necessary to restore the correct position of the phalanx and remove the bone growth.

The operation is performed with local anesthesia. After dissecting the joint capsule in the area of ​​the thumb, the surgeon removes part of the bone tissue and places the phalanx in its anatomical position. If necessary, steel surgical pins are used for fastening. After stitching the edges of the wound, a fixing bandage is applied to the thumb. The rehabilitation period lasts from one to two months.

The prognosis for complete recovery from bursitis of the big toe is favorable, but only if it is detected in the early stages. Chronicity of the disease causes the development of serious complications. In the absence of timely diagnosis and treatment, the patient’s neighboring joints become deformed after some time. Therefore, the occurrence of even mild aching pain should be a signal to consult a doctor.

Symptoms of bursitis

With bursitis of the thumb, severe pain and swelling of the joint are noted. The skin in the affected area swells greatly, a mobile soft neoplasm appears, pressure on which causes severe pain. This formation is caused by the accumulation of synovial fluid in the joint capsule and is nothing more than swelling.

With bursitis of the finger, the articulation of the joint is very painful during movements and loads, but even at rest the aching pain remains.

If bursitis of the phalanx of the finger is caused by infection, the following symptoms are observed:

• severe swelling and redness of the finger;
• severe throbbing pain;
• nausea;
• increased body temperature;
• severe general malaise.

A bacterial infection causes suppuration, as a result of which the cavity of the joint capsule is filled with purulent exudate. This causes symptoms of intoxication in the body. Purulent inflammation is the most dangerous and requires urgent treatment.

With bursitis, the joint of the finger becomes swollen and red.