Treatment of bursitis with antibiotics

Bursitis is an inflammatory lesion of the synovial bursa (bursa) of the elbow joint, which leads to thickening of its walls and limited mobility of the elbow. Typically, bursitis of the elbow joint is diagnosed mainly in athletes and people whose activities involve performing monotonous mechanical movements. In most cases, the disease proceeds without complications, but when exposed to provoking factors (for example, frequent injuries), it can recur.86

Elbow bursitis: symptoms and causes of inflammation of the elbow bursa

Acute inflammation of the synovial bursa (bursa) is accompanied by pain (especially when moving), swelling of the soft tissues (due to increased capillary permeability, accumulation of protein exudate). In some patients, erythema appears due to inflammation of the bursa. Usually the swelling is greater than the pain because the inflamed joint is in close proximity to soft tissue.39

The chronic form of the disease is characterized by less severe symptoms. But attacks can last up to several weeks, which significantly increases the risk of muscle atrophy due to prolonged restriction of joint mobility.39

The most common cause of olecranon bursitis is trauma. Acute inflammation can develop after an unusual load, with infectious damage to the joint structures. Chronic bursitis occurs against the background of previous attacks of the disease, repeated injuries. In this case, the risk of formation of adhesions and salt deposits increases.39

Drugs for the treatment of bursitis with antibiotics

The best antibacterial agents:

Amoxiclav Quiktab (tablets) - an antibiotic with high bactericidal activity against gram-positive and negative bacteria;
Amoxiclav (powder for solution for injection);
Augmentin suspension (powder for oral administration) is a semi-synthetic antibiotic, used for long-term and step-by-step therapy (mixed infections);
Panclave (coated tablets) - a combination of penicillin and clavulanic acid - penetrates well and is distributed in the synovial fluid and muscle tissue.
Flemoklav Solutab tablets are an antibiotic of the penicillin group.
Arlet (capsules) – resists infections of bone and connective tissue.

In conclusion, it should be recalled that it is unacceptable to prescribe medicine for elbow bursitis on your own on the advice of a friend, focusing on advertising or reviews on forums and websites. Qualified care and complete cure of the disease without relapse can only be guaranteed by an orthopedic surgeon or traumatologist.

How to treat elbow bursitis?

The disease requires complex treatment. Therapy begins with immobilization of the affected joint, which helps reduce stress, pain and swelling. Immobilization can be kerchief or splint (depending on the degree of joint damage). For traumatic inflammation of the joint capsule, a cold compress is usually applied before immobilization.86

The basis of conservative therapy is external topical preparations. Ointments and gels containing non-steroidal anti-inflammatory drugs (NSAIDs) are used for treatment. They have analgesic, anti-edema, anti-inflammatory effects. Due to the ability to suppress mediators of pain and inflammation at their source, NSAIDs reduce pain, swelling, and stop the inflammatory process.39, 86

Ointments and gels with collagen, glucosamine, and chondroitin sulfate are also prescribed for bursitis of the elbow joint to accelerate the regeneration of articular tissues. If the disease has an infectious etiology, additional antibiotics are prescribed.39, 86

For chronic inflammation of the bursa of the elbow joint, physiotherapy is prescribed (microcurrents, UHF, electrophoresis, balneotherapy, etc.). It is aimed at relieving local symptoms of the disease. If elbow bursitis does not improve with conservative treatment within 2 months, surgical treatment may be recommended.86

30g

recommendations for use

Apply a small amount of gel (3-5 cm) 2-3 times a day, followed by rubbing into inflamed or painful areas of the body. The duration of use of the drug should not exceed 14 days without consulting a doctor.

instructions

50g

recommendations for use

instructions

100g

recommendations for use

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BURSITIS IS ALL ABOUT IT...

WHAT'S HAPPENING?

The name bursa comes from the Latin word bursa (bursa). It is translated into Russian as “bag”. It consists of a flattened cavity that is filled with synovial fluid. Essentially, this fluid is a joint lubricant that acts as a shock absorber to prevent friction of the articular surfaces and soften the mechanical impact on the articular elements. Thus, synovial fluid protects joint structures from wear and tear. The bursa itself is located between bones, muscles and tendons. In total, there are about 160 such synovial bursae in the human body. And, if a person does not develop bursitis, he does not even think about the existence of some kind of “bags”. But, unfortunately, the occurrence of bursitis is not at all uncommon. Most often it occurs in the shoulder, elbow and knee joints, less often in the hip joints.

WHAT ARE THE MANIFESTATIONS OF BURSITIS?

At the site of bursitis development, synovial fluid accumulates in the synovial bursa, which can be filled with blood. Gradually, the bursa begins to increase excessively in size, and the liquid acquires a yellowish-reddish tint.

If the bursa is closer to the surface of the body, the resulting sac protrudes outward. In this case, a person visually observes puffiness, swelling, sometimes up to 10 cm in diameter. Sometimes such a “bag” of liquid literally hangs down, for example, under the elbow. And it’s simply impossible not to notice it. In any case, with bursitis there is always swelling, which occurs due to the accumulation of fluid in the intercellular space.

Patients often complain of pain at the site of inflammation of the bursa. The pain is aching, shooting, sometimes strong and throbbing, worsening at night. Sometimes the pain radiates to the arm or leg (depending on the location of the pathological process). Redness of the inflamed and swollen area is another symptom of bursitis. And the inflammatory process leads to an enlargement of the lymph nodes located near the site of development of bursitis. A local increase in temperature in the inflamed joint is also possible. Upon palpation, an elastic, fluctuating (consisting of liquid) dense formation is determined. There is often an increase in body temperature. Even up to 38–40°C. Naturally, all this is accompanied by general malaise and a feeling of weakness, and symptoms of general intoxication appear.

WHAT IS THE CAUSE OF THE DISEASE

Most often these are injuries, incl. and those that did not lead to fractures. Bursitis can also be caused by contusions, accompanied by bruises, and sprains. Infection of the body due to an abrasion or a wound through which infection enters. Wearing shoes that rub can also lead to the development of bunions. For many, especially untrained people, excessive stress on the musculoskeletal system during sports, heavy physical work, lifting weights, wearing high heels, flat feet is also the basis for this disease.

Even increased body weight can cause bursitis, because... it increases stress on the joints of the lower body, especially the knees. Diseases such as tonsillitis, pharyngitis, laryngitis, tracheitis, bronchitis, otitis media, sinusitis, influenza, ARVI can also act as provocateurs. Of course, inflammatory diseases of the joints, furunculosis, erysipelas, and osteomyelitis can provoke bursitis.

Disruption of metabolic processes in the body, increased amount of salt in the joint area, and gout are also risk factors for the occurrence of bursitis.

With age, the risk of developing bursitis of various localizations increases. Simply because as the body ages, salts are deposited in the wall of the synovial bursa. The bursa thickens and becomes less elastic. In addition, the older a person gets, the weaker his immune system becomes, and the body’s defenses decrease. This also affects the incidence rate. And the presence of a combination of predisposing factors increases the likelihood of complications.

BURSITIS BURSITIS DIFFERENT

Like many diseases, bursitis can be acute or chronic. The most active manifestation is the so-called acute bursitis , which usually develops rapidly. Literally in 1–2 days. In this case, almost all the symptoms of this pathological process are present.

Chronic bursitis is characterized by mild symptoms, minor pain, lack of motor stiffness of the inflamed joint, but at the same time periodic exacerbations. With chronic bursitis, the swelling also continues to increase. It can be either elastic and tense, or flabby and soft. Sometimes palpation reveals compactions of cartilage density and scar cords. However, with chronic bursitis, neither redness nor fever is observed. Chronic bursitis is a consequence of previously suffered or untreated acute bursitis.

Since the causes of this disease are different, it is divided into infectious (septic) and traumatic (aseptic) bursitis. With bursitis, the infection penetrates either due to a violation of the integrity of the skin, or through the lymphatic tract or blood. The causative agents of infection are gonococci, staphylococci, streptococci, pneumococci. As well as brucellosis, tuberculosis or E. coli.

WE MAKE A DIAGNOSIS

At the first signs of bursitis, especially if there are reasons for its occurrence, you need to contact a surgeon, traumatologist, rheumatologist or orthopedist. Since the surgeon, along with the therapist, is a primary care doctor, this doctor consults any patients during his visiting hours under the compulsory medical insurance system at the district clinic. With traumatologists, everything is also simple. In order to get an appointment with them, it is enough to go to the trauma center. But rheumatologists and orthopedists in our clinics, firstly, are in short supply, and secondly, they belong to the category of secondary level doctors and without a referral from a surgeon or traumatologist, or without an appointment, you cannot get to them. However, there is no need to be upset. A surgeon or traumatologist will fully cope with the problem of diagnosis and treatment.

The first and sometimes sufficient stage of diagnosis is a visual examination by a doctor. He palpates the inflamed area and asks about the presence of the reasons that could provoke the occurrence of bursitis. Often, to clarify the diagnosis, the doctor prescribes radiography (X-ray) and a general blood test to the patient. It happens when a surgeon or traumatologist gives the patient a referral for bursography (radiography with the introduction of a contrast agent), arthrography (endoscopy of the knee), angiography of blood vessels (this method of contrast X-ray examination allows one to characterize the condition of the blood vessels of the body) and (or) ultrasound. In some cases, if it is necessary to clarify the diagnosis, the doctor may refer you to a computed tomography (CT) or magnetic resonance imaging (MRI).

WE CURE!

The treatment strategy for bursitis depends on the type of inflammation. However, in any case, it will be complex therapy. It includes:

Providing the diseased limb with functional rest . Thus, the joint in the area in which the inflammation of the bursa has occurred must be fixed in a stable position to prevent movements and stress on the altered tissues. For this purpose, a pressure bandage made of an elastic bandage, a hard or soft-elastic orthosis (elbow pad, knee pad), a scarf bandage, a plaster cast or a splint made of adhesive tape (a special orthopedic material) are used.
Drug therapy . The basic means used to treat bursitis are non-steroidal anti-inflammatory drugs. They must be prescribed to all patients, but taking into account the existing concomitant pathology (used with caution in persons with diseases of the stomach and duodenum).

To relieve pain, non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics are used - Indomethacin, Naproxen, Chlotazol. If the pain due to bursitis does not go away, despite the use of drugs from the NSAID group, hormonal drugs are prescribed - glucocorticoids, of which Prednisolone and Hydrocortisone can be distinguished.

To relieve muscle spasms, which can occur with severe joint pain, muscle relaxants (Baclofen, Sirdalud, Mydocalm) are used. To relieve body temperature, you can use Ibuprofen, Nurofen, Paracetamol, and anti-gout drugs are used to remove salts deposited in the bursa. For example, “Allopurinol”, “Allomaron”, “Milurit”. The most widely used are injection and tablet forms containing diclofenac, meloxicam, nimesulide, ibuprofen, paracetamol. Antibiotics are prescribed if there are signs of purulent bursitis or if there is no positive effect of anti-inflammatory treatment. In this case, for example, drugs such as amoxil, augmentin, levofloxacin, cefuroxime, ceftriaxone are used. Auxiliary agents for anti-inflammatory therapy of bursitis are glucocorticoids (hydrocortisone, methylprednisolone, dexamethasone) in a short course (2-3 times). And only in cases of severe acute bursitis - to provide a powerful anti-inflammatory effect. Anti-inflammatory therapy can be supplemented with topical medications. These are ointments or gels: nimide, remisid, dolobene, diklak, indovazin, fastum, etc.

To reduce swelling and inflammation of the periarticular bursa, you can apply warm alcohol-based compresses to it (diluted 1:1 with furatsilin, saline or novocaine). Compresses with dimexide, which must be diluted 1:3, are also effective.

Physiotherapy . This includes a whole range of procedures: electrophoresis of drugs, UHF, magnetic therapy, phonophoresis, paraffin applications. Ultraviolet irradiation, UVT (acoustic wave treatment) and paraffin-ozokerite applications can also be prescribed. But such procedures can be carried out only after the inflammatory manifestations have reduced and there is no suppurative process. Patients with bursitis are prescribed physical therapy (PT). Classes are aimed at developing the joint, its faster healing and rehabilitation. But exercises should be done only under the guidance of a doctor or exercise therapy instructor.

Surgical treatment . It is prescribed in two cases.

The first is suppuration of the periarticular bursa or surrounding tissues. In this situation, the surgeon makes an incision into the purulent cavity, removes the purulent liquid contents and excises non-viable tissue. During surgical treatment, the doctor must leave a drainage. It allows the wound to fully cleanse itself and then close in a timely manner. The second indication for surgical intervention may be the formation of chronic bursitis. For such patients, the problematic bursa is completely removed. Sutures are usually removed 10 days after surgery. Surgical treatment is carried out in a hospital setting.

In any case, a patient with bursitis is recommended to drink plenty of fluids (2–3 liters of fluid per day). To strengthen the immune system, doctors advise taking immunomodulators and pharmacy vitamin complexes, vitamin C (ascorbic acid). By the way, large amounts of this vitamin are found in foods such as rose hips, viburnum, raspberries, currants, cranberries, citrus fruits, etc.

You also need to follow a diet. In particular, you need to limit yourself in the use of table salt. It is not recommended to consume spicy, fatty and smoked foods, fast foods, margarine, legumes, mushrooms, spices, chocolate, alcoholic beverages, cocoa, strong coffee and tea. Preference should be given to cereals, lean meats and fish, low-fat dairy products, vegetables, fruits, citrus fruits, nuts, seeds, honey, marmalade, mineral water, green tea.

PREVENTION IS PREVENTION FOR BURSITIS

People predisposed to bursitis should promptly rest their joints and wear special protective bandages. This applies even to those who regularly exercise.

Everyone should always treat emerging wounds in the joint area and prevent them from becoming infected.

Timely treatment of any infectious diseases and pustular skin lesions is necessary.

Shoes must be chosen that are comfortable and appropriate in size. And walking in high heels should be alternated with shoes with comfortable wedges 3–5 cm.

How to reduce pain due to inflammation of the elbow bursa at home?

One of the modern means for relieving pain from bursitis of various localizations is the drug Bystrumgel. It contains one of the effective inhibitors of pain and inflammation mediators - ketoprofen, which helps relieve pain and reduce the inflammatory process.11

Bystrumgel has anti-edematous, anti-inflammatory, analgesic effects. It can be used for the symptomatic treatment of pain due to reactive arthritis, osteoarthritis, tendinitis, myalgia, and radiculitis. The drug is also suitable for reducing swelling, pain, and inflammation in injuries of the musculoskeletal system.11

General characteristics of antibiotic treatment

Olecranon (elbow) bursitis is very common. When the joint capsule becomes inflamed, synovial fluid accumulates, swelling and redness appear. Most often, symptoms disappear within 1 to 2 weeks.

But if the disease is advanced, the inflammatory process quickly progresses and develops into a purulent or serous-purulent form. Microbial flora (staphylococci, streptococci, etc.) enters the affected area. Pathogenic microorganisms can enter through damaged skin during joint injury, as well as through the blood (hematogenously). The infection can only be eliminated with antibacterial drugs.

At the first manifestations of the disease (pain, swelling, inflammation), consultation with a surgeon, traumatologist or orthopedic doctor is important.

The diagnosis, stage and nature of the pathology are determined by the doctor based on the diagnostic results:

initial examination, medical history (presence of concomitant diseases);
general and biochemical blood test (folate level, vitamin B12 levels, presence of anemia);
thyroid condition (lack of hormones);
X-ray examination determines the general condition of the elbow joint (the presence of complications, for example, osteophytes that injure the synovial bursa);
a fluid puncture is taken (a laboratory test to determine the type of infectious agent, the sensitivity of the pathogenic microflora to antibiotics is determined);
To clarify the diagnosis, an ultrasound, CT or MRI of the damaged elbow joint is prescribed.