With bursitis, the synovial bursa (bursa) becomes inflamed. The disease can affect articular tissue of any location, but most often the inflammatory process affects the elbow. Bursitis is characterized by a gradual onset of symptoms, which makes it difficult to identify the problem at an early stage. Gradually, this can cause loss of performance in the hands, which depends on the characteristics of the joint structure. In accordance with ICD-10, the disease is designated by code M70.3.
A bursa is a connective tissue membrane. It contains cellular tissue that secretes joint exudate, which acts as a lubricant, thereby preventing joint wear. In addition, this secretion provides nutrition to the cartilage tissue in the joint. The elbow joint connects the radius, humerus, and ulna, so this area contains three joints and capsules.
Factors provoking the development of the disease
With elbow bursitis, the inflammatory process involves the joint itself, as well as nearby muscles, tendons and nerve tissue. This leads to the formation of pathological effusion in the bursa. This condition can be provoked by:
Constant excessive overload of the upper limbs. This involves intense physical activity or holding your hands in one position for a long time. Athletes, office workers and draftsmen are considered at risk.
Injury to bone, joint or tendon tissue in the elbow area.
The presence of inflammatory diseases (arthritis, gout). With such pathologies, the ability of the hands to work is reduced, and the bag may rupture with further accumulation of lymph in it.
The presence of pyogenic pathogenic microorganisms in the body. As a result, bursitis develops when the joint becomes infected through blood or lymph.
Autoimmune pathologies.
Specific diseases - syphilis, gonorrhea, tuberculosis.
Presence of intoxication.
Quite often, the disease develops under the influence of several factors at once - for example, with an open elbow injury, infection of the joint capsule can occur. Blood in the synovial cavity is an excellent environment for the life of pathogenic microorganisms, as a result of which pus is formed.
Causes of the disease
The causes of the disease are as follows:
Constant increased load on the joint. Most often this is hard work associated with a load on the upper limbs or prolonged holding of the hands in one position, resting on the elbow (office workers, designers, athletes, chess players);- Injuries and microtraumas of the tendons or bones of the joint, as well as bruises;
- Inflammatory diseases (rheumatoid arthritis, psoriatic arthritis, gout). These reasons have long occupied a leading position in the factors for the development of bursitis, but now that people are more attentive to their health, there are fewer such bursitis;
- Specific and nonspecific infections (gonorrhea, tuberculosis, syphilis);
- Felon - in advanced cases, the infectious agent can be transferred through the blood or lymph into the elbow joint and lead to disease;
- Autoimmune diseases.
The main causes of bursitis are injury, exercise and infection.
Causes predisposing to the disease are some chronic diseases (for example, diabetes) and weakened immunity, which is possible after prolonged or frequent infections or taking hormonal medications.
The causes of bursitis cannot always be determined; in this case, the disease is called idiopathic.
Varieties
Elbow bursitis is classified into several types and forms. Each of them is characterized by different severity of pain, the nature of changes in the appearance of the limb and consequences. According to the nature of the disease, it can be:
Chronic – manifests itself in the form of mild pain that persists for a long period. In addition, there is limited movement in the elbow joint without swelling, although palpation reveals a small dense tubercle.
Acute – manifested by acute pain when moving. It is often accompanied by hyperthermia and intoxication, which causes difficulties in the functioning of both the joint itself and the body as a whole.
Recurrent – develops with a secondary violation of integrity in a previously damaged area or infection. After healing, the walls of the bursa contain a secretion containing pathogenic microorganisms. Symptoms of recurrent bursitis are similar to acute disease.
In addition, elbow bursitis can be:
specific - manifests itself in people who are engaged in heavy or monotonous long-term work, or who have had an injured elbow joint;
nonspecific - develops against the background of treponema, tuberculosis, syphilis and other pathologies.
According to the nature of the joint exudate, the disease is:
Serous - the consistency of joint exudate is similar to serum. Experts consider this type of disease to be harmless and can be easily cured. It is characterized by the appearance of small swelling and pain, hyperthermia in the pathological area with minor changes in the condition.
Hemorrhagic - accompanied by the penetration of blood into the joint secretion.
Purulent - indicates the development of the inflammatory process and the penetration of pathogens. In this case, the patient complains of bursting pain, hyperemia and swelling of the tissues in the elbow area. For purulent bursitis, antibiotic therapy is urgently performed.
Olecranon bursitis
This disease is an inflammation of the synovial bursa of the elbow. The pathology covers the bursa - a sac that is located under the skin above the olecranon.
The function of the bursa is to ensure normal sliding of the bones and tendons of the shoulder muscles. With inflammation, friction between these areas increases, so inflammation develops.
Types and causes of occurrence
The underlying causes of this disease are regular injury to the elbow or periodic pressure on the bursa. This is facilitated by:
- fractured elbow, severe bruise in this area;
- constant repetitive movements that lead to injury to the olecranon. This group most often includes people who constantly bend the elbow joint in their activities (schoolchildren and students, accountants, gardeners, office workers who are engaged in written work and their elbow joint is constantly bent)
- professional physical activity. This group includes throwers, weightlifters, gymnasts, baseball players who constantly have a bent elbow, and football players who regularly fall on their elbow.
Depending on the composition of the pathological fluid, olecranon bursitis can be:
- purulent,
- serous,
- nonspecific. Formed as a result of brucellosis, syphilis, etc.
Symptoms of olecranon bursitis:
At the initial stage of the disease, redness of the elbow joint is observed, which in turn is the first sign of the onset of inflammation. After a few hours, the person begins to feel painful sensations. The pain is quite strong and constant, which is due to the fact that there is a nerve bundle next to the bursa.
Signs of olecranon bursitis are:
- Severe and throbbing pain in the elbow, which may intensify when moving the elbow and subsides when standing still.
- Inability to fully straighten and bend the elbow.
- When you touch the elbow, you feel hot and when compared with the other limb, the affected elbow is too hot.
- the elbow swells, turns red,
- a spherical protrusion is formed, which is soft to the touch. Compaction indicates the presence of effusion in the cavity of the synovial bursa.
The most common diagnosis is acute olecranon bursitis. Chronic bursitis implies a mild clinical picture with periodic exacerbations and remissions. In this case, patients note redness and swelling of the elbow joint with minor pain.
Treatment of olecranon bursitis:
The initial stage of therapy is to stop the inflammatory process. To do this, the doctor prescribes non-steroidal anti-inflammatory drugs to the patient, as well as: applying a cold compress, using an anti-inflammatory ointment with an analgesic effect on the site of inflammation. Local medications reduce swelling and activate tissue metabolism.
If acute intense inflammation or a chronic form of bursitis has been diagnosed, the doctor injects corticosteroids into the bursa. A powerful anti-inflammatory effect occurs within a few hours and lasts up to two to three days. Treatment with hormones is not always carried out, since steroids weaken the elasticity of connective tissue.
Next, antibiotics are added to treatment. Antimicrobial agents inhibit bacterial growth and reduce inflammation. Depending on the severity of symptoms, antibiotics are prescribed in the form of tablets or injections.
Immobilization becomes a mandatory point. The limb is immobilized by applying a tight bandage and hanging it from the neck throughout the entire treatment period.
According to indications, surgery is performed. The bursa is opened, cleaned, washed, an antibiotic is administered, and then the cavity is drained. It is extremely rare that the synovial bursa is excised and successfully removed. After the procedure, the limb is immobilized for up to 10-14 days.
The treatment prognosis is favorable. After just a few weeks, the disease goes away completely and no complications are observed.
Diagnostic measures
When visiting a medical facility, an orthopedist diagnoses elbow bursitis by performing:
Visual and palpation examination, as well as questioning the patient.
X-ray examination. Such diagnostics are needed to assess the condition of the olecranon process - in some cases, the formation of osteophytes is found in this place. Using this method, you can choose a treatment method (conservative or surgical).
Puncture of the synovial cavity. It is performed when it is necessary to accurately determine the origin of the disease (infectious or inflammatory etiology). The exudate obtained as a result of the puncture is sent for laboratory testing to identify sensitivity to antibacterial and other drugs and determine the nature of the disease, after which the doctor will decide on a treatment plan.
Symptoms
The symptoms of bursitis are quite striking, so they will not go unnoticed.
Unfortunately, not all people, having discovered certain symptoms, rush to see a doctor, thereby delaying the pathological process.
The main symptoms of elbow bursitis:
Swelling in the elbow area that occurs for no apparent reason. Swelling does not always cause pain and may not in any way affect the range of motion, so many people do not see a reason for concern with such a symptom. You can see what swelling looks like in a photo on the Internet;- Increased swelling in the joint area. This indicates the progression of the disease!
- Discomfort and pain in the joint. Painful symptoms increase with load on the joint, especially when leaning on the elbow;
- Sharp redness of the skin in the area of the elbow joint. If you look at a photo of redness on the Internet, you can see that it has fairly clear boundaries;
- Stiffness in the joint and limited range of motion. Subsequently, the symptoms progress and make it impossible to bend the arm;
- Purulent degeneration of effusion, which also indicates a complication of the disease. If you do not begin to treat bursitis at this stage, fistulas will form through which pus will come out;
- Hyperthermia up to a feverish state;
- General malaise, loss of appetite, sweating;
- Enlarged lymph nodes.
Chronic bursitis of the elbow joint in most cases is the result of delayed treatment or lack thereof. The chronic form of the disease occurs with relapses, each time with more severe symptoms. Therefore, if the signs described above, or even one symptom, are detected, you cannot delay visiting a doctor!
Therapeutic measures
Initially, with elbow bursitis, you need to begin to eliminate problems with the motor activity of the joint. To do this, an immobilization (scarf, pressure, or in some cases plaster) bandage is applied. If the wound is open, surgical treatment is performed followed by application of an antiseptic bandage. The patient is prescribed treatment with broad-spectrum antibacterial agents.
If fluid has accumulated in the ulnar bursa, it must be removed using a syringe in a sterile room. To eliminate signs of the inflammatory process, the following methods are used:
injection of a steroid hormonal drug (for example, Kenalog) into the joint cavity;
combined use of non-steroidal drugs;
use of ointments (Voltaren, Ibuprofen).
Therapy for elbow bursitis involves taking vitamin complexes in combination with immunostimulants. At the end of therapy, the patient is prescribed physiotherapeutic procedures.
When conservative therapy is ineffective, surgical intervention is recommended in the form of:
drainage of the bursa - pumping is carried out through a small incision;
excision of the joint capsule - during the recovery period, a new bursa is formed.
Diagnostics
Elbow bursitis requires complex treatment, which is prescribed by a surgeon or rheumatologist. Before visiting a doctor, at the first signs of illness, you can apply an immobilizing bandage to your elbow, which will provide rest.
To establish a diagnosis, the doctor examines the patient and necessarily prescribes an x-ray. If purulent bursitis of the elbow joint is suspected, a puncture of the joint capsule is performed - it must be treated with the mandatory prescription of antibiotics. This makes it possible to determine the nature of the disease (infectious or inflammatory), and also to select antibiotics taking into account the sensitivity of the microflora in order to prescribe adequate and effective treatment.
The use of alternative medicine
It is worth noting that the unauthorized use of folk remedies instead of traditional antibacterial drugs for bursitis is prohibited. First you need to consult with a specialist about the use of alternative medicine. Such drugs can only be used as an auxiliary treatment, and only with the permission of a doctor.
For bursitis, you can resort to help:
Compresses with alcohol tincture of propolis. To prepare the product you will need vodka and a few grams of the substance. It must be infused for 7 days in a sealed container. You can purchase a ready-made product at a pharmacy.
Ointment with aloe juice and honey. One part of aloe and 2-3 parts of honey and vodka need to be mixed. The resulting product should be applied to the affected joint.
Lotion with lilac inflorescences. The flowers need to be lightly squeezed and tied to the bend of the elbow using a bandage. This helps cope with inflammatory manifestations.
Sugar, heated in a frying pan, is poured into a fabric bag and applied to the joint. This way you can eliminate swelling.
In addition to the use of medications and folk remedies, it is recommended to observe preventive measures in the form of proper distribution of things at the place of work, proper rest, and reduction of physical stress on the affected area. It is also recommended to avoid hypothermia.