Bursitis is an inflammatory disease of the joint capsule, which is manifested by the accumulation of a large amount of fluid in its cavity. The cause of the pathology is often bruise, hypothermia or mechanical impact. Most often, this pathology affects men. In most cases, the elbow joint is affected.
The joint capsule acts as a shock absorber in the human body. Normally, it contains a certain amount of synovial fluid, which reduces friction and protects tissue from rapid wear.
What is bursitis?
Bursitis is an inflammatory disease of the synovial bursa.
The term bursa refers to a sac-like cavity filled with fluid.
Wherever we have bones, tendons, or ligaments, there are sacs called bursa. They are needed so that these places do not rub against each other so much. To prevent friction, the contact points are softened with special bursa bags. These bags are lined with special cells called synovial cells. With the help of bags, the joints work normally and perform the range of movements we need.
There are 160 similar bags with synovial fluid in the human body, and any of them can become inflamed.
The pathology has pronounced symptoms and requires treatment. It occurs due to the fact that the body protects itself in this way, protecting the lining of the bag from further injury and destruction. Sometimes, for the disease to subside and go away, all you need is rest, since in a state of rest the tissues heal, are restored and the inflammation recedes.
When is surgery required?
Surgery is a radical method of treatment. It is performed when there are no positive results after conservative therapy. Surgery should also be considered in chronic cases. Doctors offer two methods of surgical intervention:
- bursoscopy;
- bursectomy.
The first method is an endoscopic procedure that removes the inner layer of the bursa. The second method is more radical. Bursectomy is a standard procedure in which the bursa is removed. Then you need to go through a long recovery process. Bursectomy is performed for frequent relapses of bursitis of the wrist joint, as well as if we are talking about bacterial inflammation of the mucous membrane of the bursa. As a result of complete removal of the bursa, the patient recovers faster. Sometimes, after surgery, dysfunction may occur; this risk is always present.
Causes
In most cases, bursitis is caused by injury, excessive stress on the joints, or infection. As a result of these factors, metabolic crystals begin to form in the bag, which provoke the disease.
Bursitis can also be caused by:
- minor soft tissue injury in the joint area (cuts, abrasions, bruises, sprains);
- inflammation that occurs near the joint capsule;
- chronic infection that occurs anywhere (caries, tonsillitis, genitourinary tract infection, intestinal pathology);
- crystallization in the bursa (for example, such crystals are provoked by uric acid, which occurs with gout);
- The work is monotonous and also hard. physical exercise;
- sports activities for wear and tear;
- obesity;
- unfavorable working conditions;
- chronic pathologies;
Additional causes of joint bursitis include autoimmune diseases, treatment with hormonal drugs, and changes that occur due to age (menopause). Overheating or, conversely, hypothermia of a certain part of the body, allergies, acute intoxication.
People at risk of getting a disease such as bursitis are:
- athletes (sports that involve regular movement, cycling, golf, gymnastics);
- people experiencing high physical stress associated with work;
- people have chronic infections;
- allergy sufferers;
- people with weakened immune systems;
- aged people;
These categories of the population need to carefully monitor their health and, if initial symptoms occur, visit a specialist.
How to prevent the disease?
Patients with joint bursitis need to protect the affected joint. Prevention consists of proper distribution of the load, protecting the diseased joint with a bandage or pressure bandage. It is advisable to take short breaks during sports activities to allow the tissues to recover. Strengthening exercises are also essential to protect and stabilize the joints. Swimming has a positive effect on all joints. At the first signs of bursitis, it is necessary to immediately take all measures to prevent the progression of the disease and the occurrence of complications.
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Symptoms
If bursitis is not associated with injury, then the disease progresses from several days to several weeks.
Symptoms of bursitis are:
- swelling;
- increased temperature in the area of inflammation;
- pain and discomfort in the joint and area around the joint;
- pain on palpation;
- limited movement;
- skin redness;
If a joint is affected by bursitis, this area will be hot to the touch and discomfort will be felt upon palpation. In addition, a person will not be able to normally bend or straighten an arm, leg or other part of the body affected by the disease. In the morning, there may be limited movement and stiffness.
The inflamed bursa can increase significantly in size.
The entire range of symptoms will depend on the root cause that caused the disease, as well as the degree of the disease, the place where the bursa became inflamed.
If the bursa is located close to the skin, then common symptoms will be: swelling, redness and fever. For example, the outside of the heel, the elbow bursa at the very tip of that elbow.
With a deeply located bursa, swelling and hyperemia of the tissues will no longer be so pronounced; moreover, symptoms may be absent for some time at all. For example, vertebral bursa of the thigh, subacromial bursa of the shoulder.
Swelling may be less noticeable in people who are overweight.
If bursitis is of an acute type, then the pathology may develop unexpectedly, accompanied by acute pain, stabbing pain. At night, a person is tormented by shooting pains. When you feel the joint, you feel a seal, it is not hard, it is filled with liquid. It feels like a balloon filled with water. Movements are limited. There is heat in the area of inflammation, the joint area is hot.
How does bursitis manifest?
- formation of a round swelling in the joint area;
- joint swelling;
- redness of the affected area;
- increased body temperature;
- general weakness;
- painful sensations;
- restriction of movement.
If the pathology is not treated, the above symptoms begin to intensify and the development of phlegmon - damage to soft tissues - is possible. Therefore, the disease should be taken seriously. Competent therapy leads to the complete disappearance of bursitis. But incorrectly selected treatment and indifference can lead to the development of chronic pathology.
Stages of development
Bursitis can be acute or chronic.
Acute occurs abruptly and has pronounced signs of the disease. In the chronic course of the pathology, the symptoms are blurred, and attacks occur from time to time. In this case, the patient sometimes does not have swelling and redness, and there is no increase in temperature.
Classification of bursitis
- Bursitis is divided into affected areas: hip, knee, shoulder, elbow, etc.
- Bursitis is divided into acute, acute, and chronic.
- Considering the causative agent of the pathology: specific or nonspecific.
- Considering the nature of the fluid: serous, purulent bursitis, hemorrhagic, fibrinous.
Bursitis of the knee joint
The knee joint is the most complex joint in the human body. There are a large number of synovial bursae in the knee. Causes of knee bursitis include trauma, sprains, microcrystalline arthropathy, inflammatory arthritis, and infections caused by bacteria.
The symptoms of knee bursitis are as follows:
- swelling in the knee area;
- skin redness;
- increased temperature in the diseased area;
- pain on palpation and movement;
Headache, general fatigue, and nausea may occur if bursitis is accompanied by an infection caused by pathogenic microbes. Bursitis can be superficial or deep.
Risk factors causing bursitis of the knee joint will be: untimely treatment, incomplete therapy, diabetes mellitus, gout, rheumatoid arthritis. Weakened immune system.
Elbow bursitis
Inflammation forms in the joint capsule located near the joint. The nature of the pathology is acute, subacute or chronic.
Symptoms of elbow bursitis are as follows:
- the presence of edema and hyperemia;
- pain when bending and straightening the arm;
- increased temperature in the affected area;
- pain on palpation;
If the disease is not treated, it becomes chronic. Here the symptoms are blurred, the skin acquires a normal shade, and the redness goes away. The pain subsides. However, as the load on the sore arm increases, discomfort begins to bother the person again.
The causes of elbow bursitis are constantly received microtraumas. The disease may appear as a result of infection (wound, cut). Leaning on something for a long time, for example, on a table. This may cause swelling in the elbow. The presence of chronic pathologies in the body.
Bursitis of the shoulder joint
Shoulder bursitis occurs in the bursa of the shoulder joint. Divided into infectious or aseptic. The nature of the disease is acute, sub-acute or chronic.
The symptoms of shoulder bursitis are as follows:
- pain syndrome;
- the presence of swelling and redness in the affected area;
- pain on palpation;
- rarely increased temperature (low-grade fever);
Acute bursitis is either cured or becomes chronic. With a chronic course, the symptoms become less pronounced. The patient may experience pain when moving, limited movement, increased fatigue, and rarely numbness.
Causes of shoulder bursitis: intense physical activity, hard work, injuries, sprains, bruises. If bursitis is of an infectious type, then it occurs as a result of the penetration of pathogenic bacteria into the body, more specifically into the synovial bursa. This happens in the case of: a wound, a cut, an abscess, abrasions.
Bursitis of the hip joint
Hip bursitis occurs more often in the female half of the population, also in older people.
Symptoms of hip bursitis are as follows:
- pain in the hip area that gets worse with movement;
- the presence of swelling on the inner or outer side of the thigh;
- increased body temperature;
These signs more often appear in the acute course of the disease; in a situation with a chronic stage, the signs are dulled and do not have a pronounced character.
However, the person still experiences difficulties when moving; for example, he cannot fully lift his leg.
The causes of hip bursitis are as follows: injuries, excess weight, scoliosis, flat feet, body asymmetry, diseases of bones and joints, old age. Also a sedentary lifestyle, salt deposition in the joints, gout, arthrosis.
Bursitis of the heel or foot
Occurs as a result of inflammation in the synovial bursa of the foot. It can be acute or chronic.
Symptoms of heel or foot bursitis:
- tissue hyperemia;
- edema;
- increased temperature in the area of inflammation;
- pain when palpating and stepping on the leg;
In the chronic course of the pathology, the above symptoms are blurred.
Heel bursitis is caused by the following factors: injuries, bruises, standing work, uncomfortable shoes, physical activity in athletes, heavy physical work associated with lifting and moving heavy objects. Abnormal development of the feet at birth or already acquired.
Complications
Any form of bursitis leads to severe complications. Untreated acute bursitis can provoke the development of an acute purulent process when the surrounding tissues are affected by pathogenic bacteria. Arthritis develops, which limits a person’s movements and does not allow him to fully engage in sports. When the acute phase becomes chronic, further discomfort and constant pain force a person to leave sports and stop engaging in his favorite profession.
If you start self-medicating and do not consult a doctor in time, you can bring the process to a sad state.
Diagnostics
The diagnosis is made by a surgeon, traumatologist, or orthopedist. Additional consultation with an infectious disease specialist may be necessary.
At your appointment, your doctor will easily identify bursitis. Initially, the specialist will conduct a visual examination and collect the patient’s complaints.
The diagnosis is made based on the collection of all signs of pathology and diagnosis.
The following diagnostic methods are needed to exclude other diseases:
- X-ray;
- mri;
- puncture and analysis of synovial fluid;
- blood analysis;
X-rays are performed to see the condition of the patient’s joints, whether there are osteophytes or arthritis.
Magnetic resonance imaging is necessary to visually see the overall picture of the disease.
Fluid puncture is done to exclude infection. With knee or elbow bursitis, the synovial fluid is most often infected.
A clinical blood test is needed to see whether the patient has diabetes or rheumatoid arthritis.
Only a comprehensive examination allows you to accurately diagnose and select effective treatment for bursitis.
Treatment
Treatment of joint bursitis is aimed at quickly relieving pain and further eliminating the disease. Therapy lasts 14 days or 1.5 months. Surgical intervention is necessary in advanced cases.
Treatment for bursitis includes:
- taking medications;
- physiotherapy;
- aspiration;
It is important to provide rest to the diseased part of the body and avoid further traumatization. If you endure pain, move or work through discomfort, then bursitis will develop into a chronic stage.
The doctor prescribes compresses and ointments to treat bursitis. Cold compresses can be applied to the sore spot for no more than 15 minutes; if kept longer, there is a risk of frostbite.
Non-steroidal medications are prescribed. These include: Ibuprofen, Dexalgin. Antibiotics if infection is present.
If liquid has accumulated, it is removed. This is done after the inflammation in the bursa has decreased, but the fluid remains. Using a syringe, the specialist pumps out 5 to 20 milliliters of liquid, then injects cortisone. Apply a pressure bandage to prevent fluid from accumulating. It is important to carry out such manipulations only in sterile conditions, minimizing the risk of infection and infection.
Injections into the sore joint help a lot. Injections for bursitis are prescribed with Diprospan. Glucocortisone, Prednisolone, Methylprednisolone, Dexamethasone, Triamcinolone are also prescribed.
Physiotherapeutic methods are used such as: ultrasound or diathermy. Physiotherapy helps relieve inflammation, relieve pain, and increase the effect of medications. At the same time, physiotherapy often has no contraindications. Perfectly complements the complex treatment of bursitis.
Other physiotherapy methods:
- balneotherapy;
- magnet therapy;
- electrophoresis;
- shock wave therapy;
A massage may be prescribed, but only during the period when the illness subsides.
Surgery is needed when there is a very large lump, and the treatment will be long and lengthy. Then the specialist can perform a puncture or drainage of fluid in the bursa.
Surgery for bursitis is performed in case of accumulation of purulent contents in the bursa. Sometimes a specialist performs tissue excision or bursectomy. This is done when the previous treatment did not have the desired effect.
Treatment of bursitis
- Providing motor rest.
- Taking medications to relieve pain.
- Taking anti-inflammatory drugs.
- Perform surgery if necessary.
Often, to determine the pathogen and select drug therapy, it is necessary to puncture the bursa.
The most reliable way to get rid of bursitis and reduce the frequency of relapses is to perform excision of the joint capsule. With this method of treatment, the disease reoccurs in only 2% of patients.