Elbow bursitis does not go away, what should I do? Elbow bursitis: why the disease occurs, what is the danger and how to treat it

Bursitis is the process of inflammation that develops in the joint capsule. To understand the process, it should be said that around each joint there are several synovial bursae that are filled with liquid contents. They are intended for shock absorption (separation of one articular surface from another) and protection of joints from traumatic damage.

The most common injury is the knee, and the second most common injury is the elbow joint. It contains three bags, each of which contains a certain amount of clear fluid (interosseous, ulnar subcutaneous and interosseous ulnar). The inflammatory process in one of these bags is called bursitis.

What it is?

Bursitis elbow joint – inflammatory lesion of the synovial bursa – bursa. Due to the close location neurovascular bundle and a thin layer of fatty tissue, the elbow joints are vulnerable to various traumatic factors, reacting sharply to even the slightest damage.

Causes

Bursitis of the elbow joint can occur for a number of reasons, among which are the following:

1. In the first place, as a factor leading to the development of bursitis, is arthritis of any nature - psoriatic or gouty. That is, against the background of acute inflammation, fluid begins to accumulate in the cartilage itself or in the synovial bursa, which leads to the formation of bursitis.
2. It can also occur as a result of infection. This happens especially often when the skin tissue directly next to the bursa has been damaged, and a certain microorganism or bacterium has gotten inside. Bursitis can also serve as an infectious cause when the bones and soft tissues of the fingers are exposed to acute inflammation. Also, the infection can enter the synovial bursa not from the outside, but “from the inside,” that is, transmitted through the blood (hematogenous route) and lymph (lymphogenous route).
3. Bursitis can result from microtrauma, but this is somewhat less common. The elbow is injured due to constantly repeating monotonous movements, so this disease is unofficially called the “occupational” disease of all those people whose activities involve resting the elbow on a hard surface. These could be students, engravers, chess players, draftsmen, etc. In such people, the subcutaneous ulnar bursa most often becomes inflamed, and, for example, in tennis players, the interosseous ulnar bursa is inflamed. This difference is associated with the characteristics of the distribution of the load on the elbow, and therefore the location of microtrauma.
4. Sometimes bursitis occurs some time after receiving a mechanical injury to the elbow. In the case when a person hits or falls on this part of the body. Extremely rare, however, occurs idiopathic inflammation synovial bursa, that is, one whose etiological causes remain unclear.

Some other chronic diseases, such as diabetes, are also considered risk factors leading to inflammation in the elbow joint. The cause of suppuration can also be a general weakening of the immune system, metabolic disorders, as well as the use of steroid drugs.

Classification

Bursitis, like any other inflammatory disease, can be acute, subacute or chronic. In addition, the specific type of bursitis depends on which of the bursae is damaged. The quality of the fluid contained in the bursa in this disease is also taken into account.

In this regard, bursitis is distinguished:

• serous;
• hemorrhagic;
• purulent;
• fibrous;
• mixed.

If the disease is based on the introduction of coccal flora, then the process is considered nonspecific. And in cases of disorders associated with tuberculosis, gonorrhea or syphilis, we are talking about specific bursitis.

Symptoms and photos of elbow bursitis

Symptoms of acute serous-hemorrhagic or serous process:

• mild pain, swelling, redness, increased temperature in the area of ​​inflammation.
• movements in the elbow are limited.
• There may be a spherical protrusion visible to the eye, soft to the touch.
• the general condition, as a rule, does not suffer; only some patients experience low temperature body, accompanied by malaise and weakness.
• acute inflammation ends with recovery or becomes chronic.

Symptoms of a purulent type of disease:

• pain with purulent is sharp, bursting or tugging.
• The more acute the inflammation, the more intense the pain syndrome.
• the elbow is hot to the touch, swollen, the skin is congested with blood (hyperemic), sharp pain is noted on palpation.
• movements are severely limited, regional lymph nodes are enlarged.
• symptoms of general intoxication appear: the temperature rises to 38–39 degrees, weakness and weakness are felt, sweating appears, headache, irritability.

Chronic bursitis lasts much longer than acute, manifesting itself with the following symptoms:

• moderate pain when moving,
• discomfort in the elbow area,
• movements in the joint are preserved almost completely,
• the area of ​​inflammation looks like a dense formation.

The photo below shows how elbow bursitis manifests itself in an adult.

First aid

In the case of an acute non-purulent process, it is important to do the following:

• Place a tight seal on the joint pressure bandage, which will not stop arterial circulation, to reduce tissue swelling;
• Form a fixing scarf (orthosis) that will support the arm in a physiological position.

With purulent bursitis, this should not be done: pus under pressure can enter the surrounding tissues and blood vessels.

Diagnostics

The diagnosis is usually easy to make based on an examination by an orthopedic traumatologist. But to clarify the prevalence of the process and exclude complications, there are a number of instrumental diagnostic methods:

• X-ray of the joint: allows you to determine the presence of an inflammatory process in the joint.
• Ultrasound of the joint: helps to clarify the size and location of the inflamed bursa, the amount of exudate in it
• MRI of the joint: allows you to diagnose bursitis of the deep joint capsules.

This disease must be diagnosed as early as possible in order to begin adequate treatment in a timely manner.

Consequences

Complications of elbow bursitis are much more difficult to treat than the disease itself. They arise due to failure to provide timely medical care and the disease progressing to severe forms. A peculiar melting of the walls in the synovial cavity occurs and the pathogenic mass spreads to adjacent areas.

As a result, the following are formed:

Lymphangitis	Inflammation of the lymphoid ducts, which become more pronounced in the form of a mesh or red lines extending from the site of purulent formation.
Lymphadenitis
	It is formed as a result of infection of the lymph nodes, to which lymph flows from the source of inflammation and an abscess is formed.
Suppurative arthritis	The disease typically spreads to the joint that is located next to the victim and limits its movements.

Treatment of elbow bursitis

In the case of acute or chronic bursitis, anti-inflammatory drugs (such as voltaren, ibuprofen, diclofenac) are used at home, as well as antibacterial drugs. The latter are selected taking into account the sensitivity of pathogenic microorganisms.

In mild cases of the disease, various gels and ointments with an anti-inflammatory effect have a good effect, but they only help in conjunction with oral administration of the medications described above. To treat a clearly defined inflammatory process that is difficult to treat, glucocorticoid preparations are used. They are introduced into the cavity of the inflamed joint capsule.

Please note that only a qualified doctor has the right to prescribe all medications; you should not try to do this yourself or even with the help of a pharmacist, as this can be dangerous to your health!

Physiological therapy

After the acute period of bursitis has passed, physiotherapy is added to the complex of treatment procedures. Painful symptoms subside during the first procedures. Physiological procedures are well tolerated by patients, such as:

1. Massage;
2. Laser therapy;
3. Paraffin heating;
4. Mud treatment;
5. Magnetotherapy;
6. Bishofite wraps;
7. Physiotherapy.

It is recommended to treat elbow bursitis at home by following a certain diet. It is recommended to limit the use of table salt in food and reduce the consumption of meat broths, however, boiled meat is beneficial. It is advisable to consume fruits and vegetables according to the dietary menu.

Folk remedies

Some patients, in addition to ointments and gels with anti-inflammatory effects (drugs Voltaren, Indomethacin, Traumeel S, Dimexide, Diclofenac) use folk recipes for bursitis of the elbow joint. Complex treatment at home lasts several weeks and requires regular use of homemade formulations.

• Directions for use: 20 grams of propolis per 1 glass of quality vodka. The resulting liquid must be mixed and allowed to stand for 1 week. Afterwards, the mixture is applied to clean gauze or bandage and applied to the inflamed area for 5-10 minutes. To achieve the effect, you need to apply the compress every day for several weeks.
• Cabbage leaf compress. This method is effective not only for bursitis, but also for arthritis. Wash the leaf, remove the stringy part, cut or beat until the juice appears, apply to the sore spot, bandage it, insulate it with a soft cloth. Cabbage perfectly “draws out” inflammation and reduces pain. As soon as the sheet dries and becomes hot (after about half an hour), replace the compress with a fresh one. Keep the cabbage on your elbow longer: the remedy is harmless.
• Burdock decoction helps relieve joint inflammation, especially with acute bursitis. Directions for use: 2 tbsp required. spoons of crushed burdock root per 1 liter. Boil water for about 5 minutes. Then let the broth brew for 10-15 minutes and apply a compress to the epicenter of inflammation. For complete warming up, it is recommended to insulate the compress with a woolen scarf on top and allow the joint to warm up for 1.5 hours. Course of treatment: once a day for a month.
• Ointment made from honey and aloe. Excellent tool to relieve swelling, heal microcracks and wounds on the elbow. Take 3 des. l. tender pulp, add 1 tbsp. l. liquid honey, 2 drops of ether tea tree. Mix the ingredients thoroughly, put half the mixture on gauze or a bandage, and secure it to the inflamed area. There is no need to wrap up the problem area. Aloe ointment with honey is suitable for the treatment of purulent bursitis of the elbow joint while heating is prohibited. Keep the mixture for 50 minutes, change the compress, wait the same amount. Course – 20 procedures (or less, depending on the result).

Timely diagnosis and correct treatment bursitis will keep your joints healthy. A complex approach to the treatment of the inflammatory process with the use of medications, folk remedies, and physiotherapy will relieve the patient of painful symptoms. Don’t put off treating bursitis “for too long”: the disease often progresses to a chronic stage, and attacks cause significant discomfort.

Surgery

When complications of the disease develop and in articular capsule pus appears, an operation becomes urgent, which is quite simple, consists of pumping out the fluid, introducing antibacterial and anti-inflammatory drugs into the joint medicines.

Bursitis is usually treated with medications, but if complications occur it requires surgical intervention.

Surgeries are also performed to remove the damaged bursa. They are completely uncomplicated and highly effective. Patients soon return to their normal lives.

Prevention of bursitis

Preventive measures will help avoid the risk of developing pathology:

• strict adherence to work and rest schedules;
• dosing physical activity;
• immediate competent treatment of infectious diseases;
• timely initiation of treatment in order to prevent the transition of the inflammatory process to the purulent phase;
• prevention of traumatic effects on the area where synovial capsules are located;
• use of protective equipment if there is a potential risk of injury;
• abrasions, scratches, cuts, abrasions must be treated with hydrogen peroxide and an antiseptic.

Elbow bursitis is a dangerous disease. The disease should not be left to chance, as complications can be disastrous. The disease cannot be allowed to reach severe forms.

is an aseptic or infectious inflammatory process in the periarticular synovial bursa. It can occur acutely, subacutely or chronically. A soft sensation appears in the area of ​​the elbow joint local compaction. In the acute period, pain and signs of local inflammation occur. Chronic bursitis is characterized by mild to moderate pain and difficulty moving in the absence of inflammation. When suppuration occurs, swelling appears, sharp pains and signs of general intoxication. The diagnosis is made based on clinical signs; if necessary, puncture, MRI and radiography are performed. Treatment of acute bursitis is conservative, chronic and purulent - surgical.

ICD-10

M70.2 M70.3

General information

Elbow bursitis is the most common type of bursitis. It can be aseptic or purulent, acute or chronic. More often it develops as a result of overload and microtrauma of the elbow joint. It is observed in athletes and people with heavy physical labor (miners), as well as in workers who are forced to often lean their elbows on the table. It mainly affects young and middle-aged patients, men are affected more often than women. The treatment of chronic aseptic bursitis is carried out by orthopedic traumatologists, and the treatment of acute aseptic bursitis and purulent bursitis by surgeons.

Causes

The cause of chronic bursitis of the elbow joint is constant microtrauma due to increased load or body position. The localization of inflammation in a particular bag is determined by the characteristics of the load. Thus, in wrestlers, miners and office workers, the subcutaneous ulnar bursa is more often affected, in tennis players - the radioulnar bursa, etc. With rheumatoid arthritis, gout and some other diseases, bursitis develops as a reaction to the deposition of salts in the synovial bursa.

Infection is possible when microbes are introduced through a small wound, abrasion, abscess or boil in the elbow area. For erysipelas, boils, carbuncles, bedsores, osteomyelitis and purulent wounds the infection can enter the bursa through the blood or lymph. Risk factors that increase the likelihood of developing purulent bursitis are general weakening of the body as a result of previous diseases, metabolic disorders, diabetes mellitus, immune disorders and taking steroid drugs.

Pathanatomy

A bursa is a slit-like formation containing a small amount of fluid and located near protruding areas of the bone. Acts as a shock absorber, protecting surrounding tissues from excessive pressure or friction. When overload or repeated microtrauma occurs in the bursa, aseptic inflammation occurs, and the inner lining of the bursa begins to actively produce fluid. As a result, the bag takes on the appearance of a tightly filled pouch and begins to bulge.

Subsequently, the liquid gradually stretches the bag, it increases and can reach significant sizes. Over a long period of time, adhesions with surrounding tissues form, foci of fibrosis and sometimes areas of calcification appear in the capsule. When an infection occurs in the bursa, purulent inflammation develops, which can spread to neighboring organs and tissues.

In the area of ​​the elbow joint there are three bursae: the ulnar saphenous, the interosseous ulnar and the radiobrachial. Most often (in approximately 70-80% of cases), the subcutaneous bursa, which is located along the posterior surface of the joint in the area of ​​the olecranon, is affected.

Classification

Diagnostics

If the subcutaneous bursa is affected, the diagnosis of bursitis of the elbow joint does not cause difficulties. Suspicion of nonspecific and specific infected bursitis is an indication for puncture of the bursa followed by examination of the punctate. In purulent processes, the sensitivity of the isolated infectious agents to antibiotics is determined. For specific inflammation, special serological and bacteriological studies are performed. Involvements of the radioulnar and interosseous bursae are sometimes more difficult to diagnose due to their deep location. In doubtful cases, MRI of the joints is performed. If specific bursitis is suspected, the patient is referred for consultation to a venereologist or phthisiatrician. If gout and rheumatoid arthritis are suspected, a consultation with a rheumatologist is prescribed.

Treatment of elbow bursitis

Treatment of acute bursitis is carried out on an outpatient basis in a surgical office. A tight bandage is applied to the elbow joint, anti-inflammatory drugs are prescribed, it is recommended to keep rest and apply cold to the affected area. In some cases, a puncture of the synovial bursa is performed. For purulent bursitis, treatment is carried out in a clinic or in a surgical hospital, depending on the severity of the process. The patient is prescribed antibiotics, anti-inflammatory and painkillers. A therapeutic puncture of the bursa is performed, followed by lavage and administration of antibiotics. In severe cases, the synovial bursa is opened and drained.

Traumatologists treat chronic aseptic bursitis. Conservative therapy in such cases is ineffective. Punctures also do not bring the desired result, since after removal the fluid accumulates again. The best result is provided by surgical excision of the bursa. The operation is carried out as planned in a trauma department. Local anesthesia is used.

The doctor makes an arcuate incision along the edge of the bursa and injects novocaine into the tissue for better visibility of the border between the bursa and surrounding tissues. Then he bluntly (with a clamp) peels off the bag along its entire length and excises it, making sure that there are no pieces of the capsule left in the wound cavity. Then he sutures the skin and drains the wound with one or two rubber graduates. When excising large bursae, a rubber half-tube can be used. The arm is bent at the elbow joint and bandaged tightly to prevent the formation of a cavity and to ensure skin contact with the underlying tissues. IN postoperative period UHF is prescribed. The sutures are removed on the tenth day, after which the patient is discharged for outpatient follow-up treatment at the emergency room.

Prognosis and prevention

With timely treatment, the prognosis for all types of bursitis of the elbow joint is favorable. With purulent bursitis with the spread of infection to surrounding tissues (especially into the joint cavity), the prognosis worsens. The outcome in such cases can be contractures and joint stiffness. Prevention includes limiting the load on the joint and preventing infection.

When elbow bursitis is diagnosed, symptoms and treatment of the disease depend on its severity and the presence of accompanying pathologies. Many people ignore the body’s first signals of problems. Soreness with movement and slight swelling are often not a cause for concern. However, it is early diagnosis and timely therapy that can quickly cure bursitis. Its chronic form reduces the ability to work and significantly worsens the quality of life.

Description of the disease

Bursitis of the elbow joint is a disease that is characterized by an inflammatory process in the synovial bursa and the accumulation of exudate in it. The Latin name for the synovial bursa - bursa synovialis - gave its name to the disease. Its international code according to ICD 10 is M 70.3. Bursitis refers to soft tissue diseases associated with stress, overload and pressure.

Exudate is the liquid formed during the development of an inflammatory reaction. It is rich in protein and contains shaped elements blood. The synovial bursa is a slightly flattened cavity - a sac. It is attached to the bones that form the joint near the edges of the articular surfaces or at some distance from them. The bursa hermetically covers the joint, protecting it from mechanical stress and infectious lesions. The synovial bursa is separated from the tissues surrounding the joint by a capsule and filled with synovial (articular) fluid.

The inside of the synovial bursa is lined with synovial membrane. The matrix of the synovial membrane is based on collagen fibers and elastic networks. They form a thin fibrous frame. The upper integumentary layer of the synovial membrane is organ-specific to the joint. Its cells (synoviocytes) produce hyaluronic acid. This component of synovial fluid gives it lubricating properties.

The elbow joint is made up of three bones - the humerus, radius and ulna. It is formed from three simple joints:

• humeroulnar;
• brachioradial;
• proximal (located closer to the center of the body) radioulnar.

The elbow joint contains:

• subcutaneous olecranon bursa;
• radiobrachial;
• interosseous ulna.

All three bursae are located in the joint capsule, which is common to all three bones.

Elbow bursitis provokes the deposition of salts on the walls of the joint sac. Synovial fluid contains a significant amount of calcium salts. They help cartilage maintain its elasticity and promote fast healing microtrauma As inflammation develops, calcium salts accumulate and are deposited in the form of dense formations. Calcium deposits cause joint dysfunction.

Infectious and aseptic types of bursitis

Traumatic bursitis is caused by trauma. The inflammatory process occurs immediately after a fracture or. The disease can be caused by ligament rupture.

Post-traumatic inflammation in the synovial sac develops against the background of changes caused by injury. Often the disease is diagnosed during the rehabilitation stage after an injury.

Traumatic and post-traumatic bursitis is classified as aseptic. In the aseptic form, infectious agents are not found in the joint cavity.

Infected bursitis appears after pathogenic microorganisms penetrate the bursa. Most often, gonococci and staphylococci provoke inflammation of the synovial sac. Antibiotics for bursitis of the elbow joint of an infectious nature are a mandatory component of therapy.

Infectious bursitis is divided into specific and nonspecific. Specific diseases include diseases caused by gonorrheal, brucellosis, tuberculosis and syphilitic infections. When elbow bursitis is diagnosed, how to treat it depends on the type of infection.

Classification of the disease according to its form

Bursitis of the elbow joint is classified according to clinical course. They are acute, chronic and recurrent.

1. The acute form of the course is characterized vivid symptoms, increased body temperature and intoxication. Severe inflammatory reactions can cause disruption of internal organs. Acute forms of the disease usually go away on their own within 1-2 weeks. But repeated injuries can make the disease chronic.
2. The chronic process is poorly accompanied severe symptoms. They are observed over a long period.
3. In the recurrent form, the disease occurs with periodic exacerbations. Exacerbations can be triggered by injury, infection or physical stress.

Types of bursitis according to the nature of the exudate

There is an additional classification of bursitis of the elbow joint according to the nature of the exudate.

Inflammations of the synovial sac are: serous, purulent, fibrous and hemorrhagic.

Photo. Subcutaneous swelling in elbow bursitis

1. Serous bursitis of the elbow joint occurs at the initial stage of the disease. During inflammation, a large amount of exudate is released. According to its characteristics, serous exudate resembles synovial fluid. Due to excess internal fluid, the bursa swells and begins to resemble a subcutaneous tumor (as in the photo). Sometimes the diameter of the swollen bursa exceeds 8 cm.
2. Diagnosed when pyogenic microorganisms are found in the exudate. They can penetrate into the synovial cavity through small abrasions on the skin along the lymphatic ducts from a nearby focus of pyogenic infection (furuncle, carbuncle). Sometimes pus can spread beyond the bursa, causing purulent arthritis or cellulitis (melting of adjacent tissues).
3. Fibrous effusion is characterized by the presence of fibrin (a protein that forms a blood clot).
4. Hemorrhagic exudate has a reddish tint because it contains red blood cells. They penetrate into the liquid from destroyed blood vessels. Hemorrhagic bursitis is often the result of injury.

There are also mixed types of bursitis (serous-fibrous or purulent-hemorrhagic).

Why does elbow bursitis develop?

No matter where elbow bursitis occurs, the causes are primarily associated with regular physical activity. The disease is usually found in people who put a lot of stress on the joint during sports training or during professional activities. Regular physical overload is accompanied by minor injuries, which over time trigger a pathological process in the joint.

The disease develops in people who are forced to perform monotonous actions with the elbow joint. It is diagnosed in:

• gardeners;
• draftsmen;
• drivers;
• bakers.

Students and students who are forced to manually rewrite a large number of texts complain about inflammation of the synovial sac. The disease occurs in programmers and pianists.

In this case, the subcutaneous synovial bursa of the olecranon is usually affected. It is located in the place where the skin is most stretched when the elbow is bent. Bursitis of the radiohumeral bursa is less commonly diagnosed. This inflammation is more often found in athletes who perform movements using the elbow joint (tennis players, basketball players, hockey players, javelin throwers, boxers).

The likelihood of developing the disease increases with age. The pathological process is provoked by endocrine, inflammatory and autoimmune diseases, often occurring after 45–50 years:

• gout;
• rheumatoid arthritis;
• systemic lupus erythematosus;
• scleroderma;
• psoriasis;
• Crohn's disease;

Negatively affects the condition of the synovial bursa:

• prolonged hypothermia;
• poisoning;
• overweight;
• allergic reactions.

During an allergic reaction, a large number of antibodies appear. In the acute phase of the immune response, inflammatory mediators are released and the inflammatory process starts.

How does the disease manifest itself?

The main symptom of elbow bursitis is swelling. It occurs very first and worries the patient the most. Sometimes the synovial bursa of a joint, stretched from excess exudate, is the only manifestation of the disease. As the disease progresses, the joint swells and its capsule clearly bulges outward.

The tumor is clearly visible in the elbow area when the arm is extended. Depending on the stage of the disease, the swollen bursa may resemble the shape and size of a small pillow, plum, or apple. The skin in the area of ​​inflammation sometimes turns red. Redness indicates the infectious or autoimmune nature of the disease.

Deformation of the elbow joint forces the sick person to hold his arm in a forced half-bent position. It is not the stretched bursa that bothers him so much as the pain. It can be shooting, aching or pulsating. Often the pain radiates to the arm. They intensify during night rest. The stronger the inflammation, the more intense the pain. It restricts movement, preventing the elbow from straightening. Motor activity is also impaired due to the deposition of calcium salts.

If the inflammatory process has not gone beyond the synovial bursa, an increase in temperature and intoxication, as a rule, is not observed. In severe cases of the disease, the elbow and axillary lymph nodes may enlarge and become painful.

Drug therapy for the disease

If bursitis of the elbow joint is suspected, treatment should begin with immobilization of the arm. The joint is fixed using pressure or kerchief orthopedic bandages. For severe injuries, a plaster splint may be used. Sometimes, after a short period of rest, the pain in the elbow joint subsides on its own; no medications are required.

If the swelling is small, Vishnevsky ointment or blood circulation enhancing agents Finalgon and Fastum are used to reduce it. The medicine is applied to the inflamed joint. At acute form illnesses it cannot be used. It may cause increased swelling.

Non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and reduce inflammation. If a small amount of fluid has accumulated in the synovial sac and there is no severe pain, use external medications in the form of ointments (Ibuprofen, Diclofenac). They are applied to the inflamed joint (if there are no open wounds on the skin).

When symptoms become severe, the patient takes NSAIDs orally. The tablet is taken after meals to reduce Negative influence on the digestive system.

Treatment of bursitis of the elbow joint is carried out using:

• Diclofenac;
• Ibuprofen;
• Ketoprofen;
• Nimesulide.

In the first days of therapy, intramuscular injections may also be prescribed. They are recommended for patients with gastrointestinal pathologies. intestinal tract. Severe pain is eliminated with intra-articular injections of NSAIDs or hormonal drugs. Doing them yourself is prohibited. An intra-articular injection can only be entrusted to an experienced surgeon. Antibiotic treatment is prescribed exclusively for purulent bursitis.

After stopping the acute process, physiotherapy is used:

• dry heating;
• ultraviolet radiation.

UHF procedures are carried out simultaneously with drug treatment. Sometimes used radiation therapy in order to achieve an analgesic and anti-inflammatory effect.

To speed up recovery, the patient is prescribed vitamin complex, calcium supplements and immunostimulating drugs. Calcium deposits are dissolved with magnesium preparations.

Surgical treatment

In case of severe exacerbation, exudate is removed from the bursa using a syringe (aspirated). Aspiration is carried out exclusively under sterile conditions. After removing the exudate, inject into the bursa hormonal drug, which relieves inflammation (Kenalog).

If purulent bursitis is detected, drainage of the synovial cavity is used. During surgery, a small incision is made in the wall of the synovial bursa. Through the hole made, the exudate comes out freely. Sometimes a tube is inserted into the wound so that it does not close and does not interfere with the outflow of fluid.

While drainage is taking place, the patient is in the hospital under observation. Rinsing of the drained cavity may be prescribed. The duration of drainage and the number of rinses are determined by the attending physician depending on the severity of the disease.

In advanced cases, when the pathological process develops over a long period of time, the walls of the synovial bursa change, thicken and form folds. The deformed joint is constantly inflamed and makes it impossible to perform daily activities. Your doctor will tell you how to treat elbow bursitis in such cases. A bursectomy (removal of the bursa) may be recommended. During the operation, the bursa is removed, the surface of the olecranon is smoothed and the skin is sutured. During the rehabilitation process, a new bursa is formed in the elbow joint.

Bursitis is a disease that is not common, but occurs quite often in representatives of some professions. It affects people who perform movements with a load on the same area (tennis players, etc.), or who are constantly in an uncomfortable position.

• Bursitis - what is it?
• Causes of the disease
• Symptoms
• Types of bursitis
• Elbow joint
• Hip joint
• Fingers
• Heel
• Treatment at home
• "Hardening" of joints
• Cocktail
• Compress for elbow bursitis
• Kalanchoe compress
• Cabbage
• Treatment with medications
• Puncture
• Treatment with folk remedies
• Vegetables
• Propolis
• Sugar
• Baths made of pine needles
• Prevention of bursitis

Bursitis - what is it?

In the area of ​​the joints, due to the active movement of ligaments and bones, friction almost always occurs. Synovial fluid, which improves gliding and reduces friction, acts as a lubricant for joints. It is located in the periarticular bags - bursae, which are cavities lined with glands. It is the inflammatory process that begins in them that is called bursitis. There are several types of this disease.

This is interesting! In total, there are about 160 synovial bursae in the body.

1. Purulent. In this case, pus forms in the bag. The disease is bacterial in nature.
2. Serous. This form is considered the mildest, but if left untreated there is a risk of becoming purulent or hemorrhagic.
3. Hemorrhagic. IN in this case hemorrhage occurs in the joint.

In addition, there are acute and chronic forms of the disease.

Bursitis often occurs in the elbow, shoulder, knee, hip joints, heel area and Achilles tendon.

Causes of the disease

The reasons for the development of bursitis are different.

1. Injuries. This can be professional constant stress on the knees or elbows, uncomfortable shoes, frequent running and long, fast walking, long sitting on a hard surface (for example, long cycling).
2. Infections. There is a risk of infection entering the synovial cavity due to injury or decreased immunity (in this case, the virus “travels” through the blood or lymph flow).
3. Chronic diseases that result in salt deposition in the synovial bursa are gout, systemic scleroderma, and rheumatoid arthritis.

In addition, the cause of the development of bursitis can be diathesis, which in itself is not a disease, but facilitates the development of inflammatory processes, which include bursitis. Sometimes the cause of the disease cannot be determined; it occurs unexpectedly on its own.

Important! The older a person is, the higher the risk of bursitis, which is associated with a decrease in the elasticity of the walls of the synovial bursa and an increase in its density.

Symptoms

The first manifestation of bursitis is swelling and swelling in the area of ​​​​inflammation of the synovial bursa. In this case, the patient is bothered by shooting or aching pains and persistent redness of the skin. Limb movements are limited, and pain appears on palpation. Especially, pain and swelling intensify at night.

If bursitis is complicated by an infection, the immune system reacts to it with an increase in temperature, from 38 to 40 degrees. This indicates the development of a purulent form of the disease. In this case, the pain in the limb intensifies, becomes throbbing, and signs of general intoxication of the body appear with nausea, headache, and fever. Nearby lymph nodes may be enlarged.

Important! If left untreated, bursitis can develop into purulent arthritis. In this case, movements of the affected limb, even minimal ones, cause severe pain.

In the chronic course of the disease, the resulting swelling has a soft consistency, and the mobility of the limb is not limited. The skin over the swelling is mobile.

Types of bursitis

Bursitis of the shoulder joint is dangerous because it is difficult to identify until you suddenly notice pain in the arm when making any movement. Even swelling may not be too noticeable. Rotational movements and raising the arms up cause pain.

Attention! Learn about bursitis knee joint in our article.

Elbow joint

Bursitis of the elbow joint is a very common disease and among all types of bursitis it ranks first in terms of frequency of occurrence. Often, like other types of disease, it appears due to permanent, professional injuries, and therefore is diagnosed mainly in athletes, especially tennis players.

Hip joint

Bursitis hip joint It is considered the most difficult because the joint is hidden deep inside, making it difficult to treat. In addition, the disease can cover the entire joint.

Fingers

Bunion of the big toe becomes bent and becomes deformed. The so-called “bone” on the foot, which occurs in many elderly people. There is an opinion that this disease is hereditary, but it is known for certain that taking care of your feet will not allow it to develop. The degree of curvature can be initial, moderate and severe.

Attention! Women who frequently wear high heels are at increased risk of developing bunions.

Heel

Heel bursitis develops on the heel bone due to constant physical stress on the Achilles tendon. The patient is bothered by severe pain in the joint, especially at night, and movements in ankle joint limited.

Treatment at home

First of all, it is recommended to provide relative rest to the sore joint, reducing movement to a minimum. It is best to provide the patient with complete bed rest. However, it should not last more than 10 days - after the acute inflammation has stopped, you need to start doing gymnastics, light at first, complicating the exercises over time.

Remember! The damaged joint needs reliable fixation - to do this, use a tight bandage that will help avoid swelling of the tissue. Compresses are also placed on the joint using Vishnevsky ointment.

"Hardening" of joints

Take ice cubes and apply to sore joints for 10 minutes. When the pain subsides, replace the ice with a warm compress. The warm compress can be based on potatoes or a decoction of herbs (yarrow, burdock, St. John's wort, chamomile).

Cocktail

Take a glass of pre-boiled water, still warm, and stir in a teaspoon of honey and vinegar. It is best to use natural vinegar. Drink the cocktail 2 glasses daily for 2 weeks.

Compress for elbow bursitis

You will need sour milk and eggshells.

1. The shells, having been cleared of the film and dried, need to be crushed into powder.
2. Pour warm sour milk over it to form a homogeneous mass and make a compress from it.
3. It is important to keep the compress warm, so place cellophane on top of the compress and secure it with terry cloth.
4. Apply the compress at night for 5 days, but if the pain does not go away, repeat the course after a 5-day break.

A similar compress is made using honey, vodka and aloe juice (in a ratio of 2:3:1).

Kalanchoe compress

Pick 3 fresh leaves of the plant, wash them and place them in the refrigerator overnight. In the morning, pour boiling water over the leaves so that they release the juice. Make a compress from them on the inflamed joint. Change the compress frequently. Within a few days you will notice tangible results.

Cabbage

Take fresh cabbage leaves and apply them to the joint with the inside, changing the compress every 4 hours.

Treatment with medications

The basis of treatment includes medications, physical therapy, massage, and physiotherapeutic procedures. Treatment is necessary both internally and locally, therefore, when treating with drugs, it is not at all necessary to abandon compresses from ointments or medicinal plants.

Important! The main task during treatment is to relieve inflammation, relieve pain, and restore joint function.

Often indicated for bursitis antibacterial therapy. If bursitis is caused by microbial flora or appears as a result of an infectious injury, antibiotics are prescribed. Moreover, not one, but several drugs at once:

• Lincomycin;
• Ceftriaxone;
• Amoxiclav, etc.

They are administered intravenously and intramuscularly, as well as directly into the area of ​​the inflamed bursa.

Puncture

Reviews about puncture (puncture) of the bursa are very contradictory. Some believe that this procedure can cause irreversible changes in the structure of the joint. And there is a risk of developing sepsis. However, on the other hand, without removing the exudate, the diseased joint will not recover.

Steroid hormones that provide anti-inflammatory drugs - Diprospan, Kenalog - are injected directly into the joint cavity. True, they also have their drawbacks - they inhibit the restoration processes in tissues. But without anti-inflammatory drugs, the inflammatory process cannot be stopped, so their use is necessary.

Non-steroidal anti-inflammatory drugs help, in addition to relieving inflammation, to eliminate pain, swelling and hyperemia. These means include:

• Ibuprofen;
• Diclofenac;
• Voltaren;
• Indomethacin.

They are used both externally (ointments) and internally (injections, tablets).

Important! These drugs have a negative effect on the gastrointestinal tract and blood clotting, so be sure to consult your doctor before using them.

When bursitis is accompanied by fever and intoxication of the body, glucocorticosteroids may be prescribed. They are administered intravenously, into a joint, or taken in tablet form. The course of treatment is up to three months.

Ointments

Ointments are also used for bursitis (Levomikol, Vishnevsky ointment, Collagen Ultra). A compress made from Vishnevsky ointment and alcohol or cologne is very popular.

1. Apply ointment and then vodka to a piece of cotton fabric.
2. Apply the compress at intervals of a couple of days. You need to keep it for a day.
3. It will help reduce the severity of swelling.

At purulent form disease, it is necessary to remove the pus and cleanse the joint of fluid. This fluid is examined to determine the pathogen in order to select the most appropriate antibiotic. Then the bursa is washed antiseptic solution and appropriate antibiotics are administered.

Physiotherapeutic procedures

They are prescribed to improve blood circulation, reduce swelling and improve joint mobility. The procedures are indicated after the acute inflammatory process has stopped.

1. Ultrashort wave therapy (UHF).
2. Ultraviolet irradiation.
3. Phonophoresis (along with analgesics).
4. Magnetotherapy.
5. Laser treatment.
6. Paraffin or mud applications are especially effective for chronic bursitis.
7. Acupuncture.
8. Mineral baths.

When bursitis goes into remission, doctors advise using therapeutic exercises and manual massage.

You can also massage the damaged area yourself, but remember that this must be done carefully - an incorrect massage can only worsen the patient’s condition. Massage the inflamed area at night using plant oils - eucalyptus, petroleum jelly and lavender.

Therapeutic exercises are especially important for bursitis. It helps improve blood flow and, as a result, tissue nutrition, and restore motor function of the joint. Exercises are selected individually, taking into account the patient’s age and type of bursitis. As a rule, the initial exercises are very simple - just swing your arm back and forth.

Treatment with folk remedies

Advice! It is important to coordinate the use of traditional recipes with your doctor - bursitis should not be treated on your own.

Vegetables

It is effective to make compresses from vegetables, alternating them with each other. Vegetables such as potatoes, beets, and cabbage are best suited.

1. For example, on the first day, cut the potatoes into circles and, placing them on a cloth, wrap them around the damaged joint. Don't forget to secure the compress with something warm (scarf or towel).
2. The next day, use beets or finely chopped cabbage as raw materials.

Propolis

Compresses are also made using propolis. To do this, pour propolis (10 g) with vodka (100 g) and leave to infuse in a dark place for 5 days. Apply a compress to the swollen joint until it goes away.

Sugar

Take a glass of sugar and heat it slightly in a frying pan. Be careful not to melt the sugar under the heat. Sugar needs to be poured into a bag from thick fabric and apply to the joint, and then wrap the compress with polyethylene and a towel.

1. Pour a tablespoon of celery seeds into a glass of boiling water and leave for 1.5 hours. Then strain and drink for 2 weeks, 2 times a day.
2. Grapefruit juice. Drink ½ citrus juice 3 times a day.
3. Pick lilac leaves and squeeze them. Use as a compress.
4. Mix aloe juice, honey and alcohol (take parts in a ratio of 1:2:3) and apply as compresses.

Compress for chronic bursitis

Melt teaspoons of honey and soap shavings in a water bath. Spread the mixture on clean gauze and sprinkle it with finely chopped onions. The compress should be insulated and left overnight. This ancient method is proven and effective.

Remember! Chronic bursitis can lead to adhesions in the joint, which impair its function. In the chronic stage, this disease is effectively treated with folk recipes.

Baths made of pine needles

Collect needles, cones and pine branches, pour cold water and boil for 30 minutes. After this, leave to infuse for 12 hours in a closed container. You need to use about 1.5 kg of raw materials per bath. Take a bath for 20 minutes. If bursitis affects an arm or leg, limit yourself to a bath. In this case, only 300-500 g of pine needles will be needed.

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What it is?

In order to understand what this Latin term means, let's briefly look at the anatomy of the elbow joint.

So, the elbow joint has the following structure:

It is formed by one large bone - the humerus - from above, and from below it involves two smaller bones - the radius and the ulna (they also form a joint among themselves);

Between radius and shoulder, between the radius and the elbow, as well as between the elbow and the skin, there are synovial bursae (“bursae” in Latin), which are filled with a small amount of a special “lubricant” (synovial) fluid.

They are “invented” in order to minimize friction during movements in the joint and to reduce trauma to surrounding tissues when performing joint function.

Inflammation of one of the joint capsules, accompanied by the accumulation of an increased amount of pathological fluid in it, is called bursitis.

Symptoms of the disease

A swelling appears in the area of ​​one of the synovial bursae, which looks like a compaction, quite soft when palpated, measuring about 70-100 mm.

At the same time you feel:

• fluctuation of fluid inside the joint;
• pain in the area of ​​the affected joint;
• pain when moving the elbow.

A distinctive feature of bursitis specifically - movements in the elbow are painful, but possible - this differentiates this disease from arthritis.

If the effusion into the bursa becomes infected and becomes purulent, this pus can begin to melt the surrounding soft tissue (cellulitis).

In this case, the following symptoms appear:

• body temperature rises;
• weakness, fatigue;
• nausea and/or vomiting;
• the joint area is red, very painful, tense;
• There may even be confusion and delirium if there is a sufficient amount of effusion caused by an aggressive pathogen.

Kinds

According to the nature of the disease, it is divided into several main types.

Spicy

This is the first time a disease has developed, usually arising as a result of a joint injury, which is often subsequently joined by an infecting microorganism (this will be called acute purulent bursitis).

In this case, the synovial bursa sharply increases in size and becomes hemispherical in shape.

Initially, with acute bursitis, serous (transparent and sterile) fluid accumulates in the bursa, but with sufficient force of injury, blood or blood plasma also enters there (hemorrhagic bursitis).

Blood stimulates fibrin deposits in the cavity of the synovial bursa, then fibrin is organized and blocks the vessels of the synovial membrane.

As a result of this process, the wall of the bursa thickens, the surface of its inner shell is covered with connective tissue, which, growing, begins to divide the cavity of the bursa into additional pockets (acute proliferative bursitis).

Purulent

It develops when bacterial microorganisms enter the cavity of the synovial bursa.

These microbes can get there:

• via the lymphatic tract from the lesions purulent inflammation(boils, carbuncles, erysipelas, bedsores);
• through the bloodstream (for sore throat, influenza, brucellosis);
• contact - when the bursa is directly wounded by an infected object or during a purulent process in the joint, when the membrane of the synovial bursa is in direct contact with pus.

Depending on the nature of the microbe that caused the process, bursitis can be:

• specific: gonorrheal, brucellosis, syphilitic, tuberculosis;
• nonspecific: such bursitis is caused by “ordinary” coccal flora.

Chronic

Occurs due to frequent (constant) mechanical irritation of the bag.

This happens especially often in people of such professions who, due to the nature of their work, often make movements in the elbow (“tennis elbow”) or rub their elbow on the surface of the table (“watchmaker’s elbow”, “jeweler’s elbow”).

Recurrent

It occurs in cases where, after the inflammatory process has subsided, areas of dead tissue or inflammatory fluid remain in the elbow joint bursa.

Because of this, at the slightest mechanical injury to the bursa or unfavorable conditions for the joint, the disease flares up again.

Causes of the disease

Factors that provoke the development of bursitis include:

• entry of the microbe into the cavity of the synovial bursa: through lymph, blood flow, contact;
• bruise, wounds, abrasions of the elbow joint;
• permanent joint injuries in representatives of certain professions;
• long-term static position with support on the elbows (when performing certain work, in a state of alcohol or drug intoxication);
• due to some systemic diseases: rheumatoid arthritis, scleroderma, gout.

Diagnostic methods

The diagnosis is usually easy to make based on an examination by an orthopedic traumatologist.

But to clarify the prevalence of the process and exclude complications, there are a number of instrumental diagnostic methods:

• X-ray of the joint: allows you to determine the presence of an inflammatory process in the joint.
• Ultrasound of the joint: helps to clarify the size and location of the inflamed bursa, the amount of exudate in it
• MRI of the joint: allows you to diagnose bursitis of deep joint capsules.

How to treat?

This disease must be diagnosed as early as possible in order to begin adequate treatment in a timely manner.

Therapy for acute and chronic forms differs.

Treatment of acute and purulent bursitis of the elbow joint

First aid

In the case of an acute non-purulent process, it is important to do the following:

• apply a tight pressure bandage to the joint, which will not stop arterial circulation, to reduce tissue swelling;
• form a fixing scarf (orthosis) that will support the arm in a physiological position.

Medicines

Various types of drugs are used to treat bursitis.

The choice depends on the type of acute pathological process occurring in the bursa - whether it is serous, hemorrhagic or purulent.

Treatment with antibiotics

If bursitis occurs, the bursa is punctured.

Based on the results of the punctate analysis, antibacterial treatment is prescribed:

• with purulent bursitis The contents of the inflamed bursa are inoculated onto nutrient media to determine the type of microbe and its sensitivity to antibiotics. Until culture results are obtained, treatment with broad-spectrum antibiotics in the form of injections is prescribed. After receiving the results, the drug can be changed taking into account antibiotic sensitivity;
• with serous or hemorrhagic bursitis Antibiotics are prescribed to prevent suppuration. Drugs in tablets can be used.

Video: technique for puncture of elbow bursitis

Dimexide therapy

Compresses are used with this drug, which itself, diluted 1:4 with boiled water, is an excellent antiseptic.

Dimexide draws out pus and prevents its appearance in the joint capsule.

If such a diluted drug is sprinkled on top with a dry antibiotic (for example, Ceftriaxone), then it will not act on its own, but will carry the antibiotic through the skin, delivering it to the joint.

Injections

In the treatment of bursitis, both intramuscular or intravenous injections (antibiotics, anti-inflammatory, painkillers and absorbable drugs) and the introduction of drugs into the elbow joint bursa are used.

In this case, the following is injected into the joint:

• antibiotics;
• anti-inflammatory hormones (Hydrocortisone, Kenalog);
• antiseptics.

Iodine

This antiseptic is used to treat superficial wounds and abrasions in the area of ​​the inflamed joint capsule - only in the absence of an allergy to this drug.

There is also a recipe for the “folk” treatment of bursitis with iodine (should be used in combination with therapy prescribed by a doctor), for which you take:

• 1 small bottle of iodine;
• 1 bottle of triple cologne;
• 1 bottle of valerian extract;
• 6 Analgin tablets, crushed into powder.

All components are mixed, left in a dry, dark place for 5 days, then used as a rub on the joint.

Ointments

The following ointments can be used to treat bursitis:

• Traumeel S (homeopathic anti-inflammatory agent);
• dimexide (it is already available in the form of a gel for external use only);
• anti-inflammatory ointments: Voltaren, Diclofenac, Indomethacin and others.

Pills

In tablet form the following can be used:

• anti-inflammatory drugs: Nimesil, Diclofenac, Analgin;
• “prednisolone” tablets (only for serous inflammations, in exceptional cases);
• antibacterial drugs - as prescribed by a doctor.

Other conservative treatment

In the treatment of bursitis, “all means are good”, so methods traditional medicine must be combined with additional therapy.

Treatment with leeches

In this case, when placing leeches in the area just above or below the elbow joint, the following occurs:

• improvement of microcirculation in the “sick” bag;
• decreases venous stasis(therefore, the cavity of the bag is cleaned faster);
• tissue ischemia is eliminated;
• tissue trophism improves.

The leech acts on the diseased joint with several enzymes at once, the main one of which is destabilase - an enzyme that “cuts” blood clots and clots in the cavity of the bag.

Folk remedies

• Tear off several leaves of Kalanchoe and beat them off. Place them on the area of ​​the sore joint and wrap them well with a woolen scarf.
• Soak gauze with a decoction of burdock root, apply it to the joint, cover it with polyethylene, and wrap it with a woolen scarf.
• Cut raw potatoes into thin slices, place them on a cotton cloth, and wrap the joint. Cellophane is placed on top, then wrapped with a woolen scarf or scarf.

You can also use the following methods at home:

• Baths for a sore joint (if the process is not purulent) from a decoction of branches and pine cones. To do this, add 5 liters of cold water to the branches and cones, bring the mixture to a boil, cook for about half an hour, and leave for 12 hours.
• Three times a day, half an hour before meals, take half a glass of freshly prepared grapefruit juice.
• Mix 30 grams of propolis with 20 grams of soft butter. An hour before meals, three times a day, take a teaspoon of this mixture.

Physiotherapy

The following methods are used:

• ultrasound;
• diathermy;
• ultraviolet irradiation;
• when inflammation subsides - paraffin applications, balneotherapy.

Surgical treatment

In case of acute purulent bursitis, the inflamed bursa is opened, its walls are excised, and treated with antiseptics. Next, the wound is treated openly.

In case of a recurrent purulent process, the inflamed bursa is excised completely, the wound is washed with antiseptic solutions, then the person receives antibiotics in the form of injections, painkillers, and UV irradiation of the wound.

Treatment of chronic and recurrent forms of the disease

After the first course of treatment for an acute process, it is important to undergo physiotherapeutic procedures.

If the process has developed as a result of professional activity, the patient is recommended to change his type of work.

Periodic thermal procedures, compresses with dimexide, applying anti-inflammatory ointments to the joint area.

If the purulent process recurs, the main type of treatment is surgical, when the synovial bursa is completely excised.

After this, the person receives antibacterial and anti-inflammatory therapy for about 7 days.

Prevention measures

It consists of eliminating stress on the joint.

Sometimes, during a chronic course of the process, it is recommended to wear special orthoses.

The concept of “prevention of bursitis” also includes:

• timely treatment of wounds and joint injuries;
• treatment of general inflammatory diseases;
• wearing protective bandages on the area of ​​the subcutaneous bursa if your work involves constant external trauma to the joint tissues.

Thus, treatment of elbow bursitis should be comprehensive, including both local and general therapy, the use of folk and physiotherapeutic remedies.

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Distinctive features of the treatment of acute bursitis

The acute form of this disease can be treated on an outpatient basis. It is necessary to fix the diseased joint. This is best done with an elastic bandage. In particularly acute cases, the doctor can fix the joint using a plaster splint.

To relieve intense inflammation, ointments based on non-steroidal anti-inflammatory drugs are usually used. Drugs such as Diclofenac and Nicoflex have proven themselves well in treatment. With pronounced pain syndrome glucocorticosteroid drugs are used. Most often, the doctor prescribes hydrocortisone ointment to patients. In the same cases, the administration of Novocaine is indicated.

Joint punctures are prescribed if treatment with ointments does not bring significant results within a week. Antibacterial agents are indicated only if an infection is associated with the inflammatory process.

After conservative treatment of bursitis with ointments, if the main symptoms subside, physiotherapy is indicated. Irradiation with ultraviolet rays, phonophoresis, and electrophoresis are prescribed. Alcohol compresses and bandages are indicated.

Use of antibiotics

Local antibiotics for bursitis are prescribed only by a doctor. Self-prescription of such medications for joint pain and inflammation is strictly prohibited. Typically, Levomycetin or another antibiotic-based ointment is used, prescribed after a thorough diagnosis of the inflammatory process in the joint capsule.

For treatment, ointments with non-steroidal anti-inflammatory drugs can be used in parallel. This is Ibuprofen or Diclofenac. However, when treating NSAIDs, the use of an antibiotic is mandatory: in this way it is possible to significantly reduce the severity of the inflammatory process in the elbow.

Along with creams, antibiotic injections may also be prescribed. This type of treatment is required for purulent complicated bursitis.

Use of Diclofenac

Diclofenac ointment or cream is widely used to treat inflammation of the joint capsule. Among the advantages of such a medicine are not only its excellent analgesic effect, but also its affordable price. This drug is not suitable for self-medication: the patient should in any case consult a doctor before starting therapy.

The ointment has the following contraindications:

• diseases digestive organs at the acute stage;
• aspirin triad;
• disorders of hematopoietic processes, especially of unknown origin;
• sensitivity to Diclofenac or to any other drugs of a similar group.

During treatment, the dosage prescribed by the doctor must be followed. The patient cannot determine it independently. Sometimes a higher dose is prescribed by a doctor for severe pain.

When treating with Diclofenac, caution must be exercised, as the drug can cause the following side effects:

• nausea, vomiting and other disorders of the digestive tract;
• liver dysfunction (very rare);
• headaches, dizziness and increased nervous excitability;
• increased fatigue;
• sleep disorders;
• feeling of double vision;
• depressive states;
• blood disorders: drop in the number of red blood cells, leukemia, thrombocytopenia;
• skin disorders: rash, itching, hair loss;
• burning and redness at the site of external use.

It must be remembered that joint treatment with Acetylsalicylic acid significantly reduces the effectiveness of the ointment for bursitis of the knee joint.

Products with Ibuprofen

Ibuprofen ointment does not have a pronounced systemic effect on the body. Its components are selected in such a way that it is active only in areas of inflammation. The drug is effective not only for diseases of the elbow joint, but also in cases where a person, for example, has knee pain.

The peculiarity of the ointment is that its active component slowly penetrates the diseased tissue. This achieves the effect of prolonged action of the drug. It is in the affected tissues that it is possible to achieve increased concentrations of Ibuprofen. As a result, relief from pain and inflammation occurs quite quickly.

The ointment can be used in the following cases:

• joint pain;
• phenomena of inflammation in the elbow;
• restriction of active movements in it;
• swelling and degenerative lesions of the periarticular bursa;
• Elbow bruises (without breaking the integrity).

The ointment or cream should be applied in a strip to the affected area of ​​the body and rubbed until completely absorbed. Usually the doctor indicates to the patient in detail the duration of treatment. The duration of therapy cannot be determined based on instructions or other information.

As a rule, if the rules of therapy and all the doctor’s instructions are followed, side effects develop very rarely. In exceptional cases, allergic reactions may occur. This happens with increased sensitivity to the active components of the ointment.

It should not be used during pregnancy, skin disorders, or children (under 14 years of age). It is also unacceptable to treat bursitis of the knee joint while breastfeeding, since it active ingredients pass into milk and have an adverse effect on the baby. This ointment is used especially carefully for bronchial asthma and hay fever.

When to use Dolobene and its analogues

This combination drug, it contains Dimethyl sulfoxide, Heparin and Dexpanthenol. It promotes the restoration of affected tissues and activates metabolic processes in them.

Dolobene can be used in the following cases:

• injuries of the elbow joint, including sports ones;
• muscle damage;
• inflammation of the joint capsule of the elbow;
• sprain;
• acute pain in the elbow;
• other degenerative joint disorders leading to severe mobility impairment.

Dolobene gel should be applied to the affected area and then evenly distributed over the affected surface, rubbing into the skin. This must be done very carefully so as not to cause additional pain. You can additionally apply a bandage.

You need to be careful, as Dolobene can cause the following side effects:

• local allergic reactions;
• itching and burning sensation
• appearance bad taste in the mouth (this sensation passes quickly);
• sometimes there may be some change in the sensation of taste);
• Quincke's edema can very rarely occur.

It is forbidden to use Dolobene gel in case of severe disturbances in the functioning of the liver and kidneys, in addition, in case of vegetative vascular dystonia. The drug is not prescribed during pregnancy and lactation. Children under the age of five are not prescribed this medicine due to the lack of treatment practice. It must be remembered that this is still a non-steroidal anti-inflammatory drug, and it is taken with extreme caution.

Use of Vishnevsky ointment for bursitis

This ointment contains tar, castor oil and xeroform. Refers to antiseptic agents. However, Vishnevsky ointment is an excellent mixture for the treatment of inflammatory processes, as it absorbs exudate well.

The action of the ointment is based on the properties of its components:

• xeroform has a strong anti-inflammatory effect and is good at relieving purulent inflammation of the joint capsule;
• birch tar intensifies blood flow to diseased tissues;
• Castor oil softens the skin and helps other ointments to be absorbed into the skin faster.

This ointment for bursitis is well absorbed into the skin due to its structure. It is very easy to apply and then quickly absorbs into the affected tissue.

Ointment for bursitis of the knee joint is recommended to be used only as directed by a doctor. With bursitis, it is extremely undesirable to self-medicate, since the disease can become chronic. A contraindication to the use of the product is a pronounced tendency to allergic reactions.

Warming ointments for bursitis

They contain specific components that increase capillary permeability: snake or bee venom, pepper extract, essential oils. They locally cause tissue hyperemia and increase blood flow. The only caveat regarding the use of such compositions is that they cannot be prescribed in acute period or immediately after injury, since in this case, on the contrary, tissue cooling is necessary.

Typically, such ointments include:

• Methyl salicylate;
• Ketoprofen;
• Ibuprofen;
• Diclofenac.

The action of all ointments in this group is aimed at getting rid of unpleasant symptoms and quickly restoring active movements in the joints.

The modern market offers a huge number of warming ointments that are successfully used against bursitis. They cope excellently with the symptoms of inflammation of the joint capsule. All such medications, despite the fact that they can be used at home, are prescribed only by a doctor. Self-medication of bursitis is prohibited, since it is impossible to get rid of it in such conditions, and the risk of developing dangerous complications at the same time increases significantly. The vast majority of these drugs are sold in pharmacies without a doctor's prescription.

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Types of bursitis

Bursitis is classified according to duration:

• spicy: it is manifested by sudden pain when moving the limb and rapid accumulation of exudate. There may be an increase in temperature, the appearance of general intoxication and dysfunction of the main organs;
• chronic: appears for a long time aching pain in the elbow without affecting the mobility of the arm. The pathology is characterized by a dense small formation, but there will be no large tumor;
• recurrent: manifested by exacerbation chronic pathology with the presence of some part of the inflammatory exudate due to repeated trauma and disruption of the tissue structure by infection.

Depending on what inflammatory and pathological processes develop in the synovial bursa of the elbow; bursitis is classified according to the type:

• purulent: when the bursa is filled with purulent exudate caused by infectious and pyogenic bacteria;
• serous: when filling a bag with a clear liquid that is not associated with infectious agents;
• hemorrhagic or post-traumatic with accumulation of blood. Manifests itself after injuries and due to specific infections;
• fibrinous with fibrin deposition in the cavity of the bursa. This indicates a tuberculous process in the body;
• calcareous with accumulation of calcium salts in the bursa capsule. At the same time, it loses its elasticity and cannot provide shock-absorbing protection to the joint.

The video in this article shows an operation for purulent bursitis of the elbow:

Inflammatory pathology is also distinguished according to two more classifications:

• specific bursitis: manifests itself against the background of syphilis, gonorrhea, brucellosis. Its treatment begins after complex therapy that eliminates the underlying disease;
• nonspecific infectious bursitis due to injury: a cut or an open fracture. The pathogen penetrates through the wound, pus and blood accumulate in the bursa. The condition of the pain area is dangerous due to possible necrosis or blood poisoning.

Causes

The main reasons for the development of pathology are as follows:

• injuries: blows, falls on the elbow, microtrauma due to forced repetition of the same movements at work;
• overload of the elbow joint sports competitions and training while performing heavy work, for example, in a mine, in factories or in auto mechanic shops;
• penetration of infectious microorganisms into the blood and lymph: Staphylococcus aureus, streptococci, as well as specific bacteria: tubercle bacilli, Treponema pallidum, Brucella, gonococcus;
• joint diseases: rheumatoid or gouty arthritis, systemic scleroderma, lupus erythematosus;
• allergies: the body can respond to allergens and their effects by developing inflammation in the bursa in children under 7 years of age and school age;
• unknown cause of the inflammatory process. Then this form of pathology is called cryptogenic.

Symptoms of bursitis

Bursitis can develop against the background of psoriatic, rheumatoid or gouty arthritis, due to microtrauma resulting from constant support of the elbow on a hard surface during work. An old mechanical injury or a fall on the elbow can also cause inflammation of the elbow joint. If the skin is damaged and infection (bacteria) penetrates into the bursa, purulent inflammation develops.

The infection can spread through the bloodstream and lymph within the body from another infected organ. Weakened immunity, metabolic disorders, diabetes mellitus, and even treatment with steroid drugs can lead to inflammation in the elbow; for an unknown reason, symptoms of idiopathic bursitis may occur.

If local inflammation develops, then it will manifest itself with the following symptoms:

• redness of the skin;
• swelling and swelling;
• an increase in local temperature;
• painful attacks upon palpation and movement of the hand;
• dysfunction of the joint: decreased range of motion and performance.

A slight swelling gradually turns into a hemispherical or rounded dense and elastic formation, the size of which can reach 10 cm or more. Pain and symptoms of intoxication of the body appear: body temperature rises, weakness and malaise, nausea and vomiting bother. Before treating bursitis of the elbow joint, you need to undergo diagnostics, including a differential check, to identify the nature of the causative agent of the pathology.

To confirm bursitis and/or concomitant disease(for example, arthritis), the doctor prescribes an x-ray and puncture. Accurate confirmation of the etiology of the disease is confirmed by a general and biochemical blood test.

The size and localization of inflammation in the bags and the amount of exudate in them can be learned from an ultrasound examination of the joint. Deep inflammation can be diagnosed using MRI results.

Treatment

Before treating chronic elbow bursitis, it is necessary to perform a puncture to remove exudate. If inflammation due to injury occurs, antibiotics and hormonal agents, such as Hydrocortisone, should be injected into the bursa.

Treatment of bursitis of the elbow joint should be comprehensive and include surgical, medicinal, physiotherapeutic, alternative and folk methods.

Important! In order not to further aggravate the inflammation, it is necessary to unload the joint as much as possible and reduce its work with a tight bandage without interfering with blood circulation, put on a bandage or orthosis, and support the arm with a scarf or special belts.

The price for elbow bandages is from 200-150 rubles, for orthoses - from 500-900 rubles. If bursitis is associated with an extensive closed injury, then immobilization of the limb is carried out plaster cast or splint.

Surgical operations

If chronic, acute and purulent bursitis of the elbow joint is detected, treatment involves opening the inflamed area. Bursectomy is used: excision of the ulnar bursa and then drainage. A special tube is inserted to remove all purulent exudate, rinse and administer antibacterial drugs and corticosteroids for inflammation.

Constant relapses lead to thickening of the walls of the bursa, the formation of folds and an increase in its volume. Conservative treatment does not always give the expected effect, so the bag is cut and excised using general or local anesthesia.

To ensure rest and speedy healing of the wound, a splint is applied for 5-7 days or more. During this time it grows connective tissue, forming a new articular capsule. Next, orthoses or bandages are used.

If it is possible not to operate, then the purulent contents are removed and the cavity of the bursa is washed during the puncture.

Medicines

After a course of non-steroidal drugs for inflammation (Ibuprofen, Ketorolac), pain and temperature in the inflammatory epicenter decrease.

It is important to know. To reduce negative impact non-steroidal drugs on the gastrointestinal mucosa, drugs of the proton inhibitor group should be taken at the same time: Nexium, Esomeprazole, Omez and others.

If there is a purulent-infectious process in the bursa, broad-spectrum antibiotics are taken. The doctor prescribes an antibiogram, based on the results of which he individually selects necessary medicine. In advanced cases, corticosteroids are injected into the joint. After removing the purulent exudate, Kenalog, the most popular steroid hormone for relieving inflammation, is injected into the bursa.

Attention! You cannot prescribe antibiotic prophylaxis for non-infectious bursitis on your own! It will not bring any benefit, but will only develop the bacteria’s addiction to the drug.

If there are no wounds or scratches on the elbow joint and it is free from plaster or bandages, then the problem area is lubricated with anti-inflammatory gels and ointments such as Nise, Diclofenac, Voltaren or Ibuprofen. Strengthen the body with vitamins, calcium preparations, and immunostimulants.

Physiotherapy

In the post-acute period, in order to eliminate inflammation and improve metabolic processes in the elbow joint, physiotherapy is prescribed:

• UHF or ultrasound;
• magnetic therapy;
• phonophoresis using hydrocortisone;
• paraffin wraps;
• ozokerite applications;
• acupuncture;
• acupressure.

Physiotherapy procedures include treatment of elbow bursitis with folk remedies and/or natural remedies at home, such as bischofite or stone oil.

Rock oil consists of aluminum alum with magnesium sulfate and water-soluble salts. It is collected from the surface of rocks. But it should not be confused with mumiyo, since oil is a mineral product, and mumiyo is an organomineral product.

These two rock substances have different composition. Stone oil boosts immunity and kills bacteria. It is sold in its pure form or mixed with cedar or fir resin, sea buckthorn extracts, medicinal herbs: nettle, sea buckthorn, mint, St. John's wort, as well as chaga, beaver stream and other medicinal substances.

Bischofite in the form of natural brine is extracted by drilling wells. It is saturated with bromine, iodine, chloride-magnesium-sodium complex, iron and other elements beneficial to health. Bishofite warms and has a moderate anti-inflammatory and analgesic effect, restores elbow mobility.

Therapy with bischofite and stone oil

After removing excess exudate from the synovial bursa and in the absence of concomitant arthritis, treatment of elbow bursitis at home can be supplemented with bischofite and stone oil.

Instructions for treatment procedures are given in the table:

Physiotherapy

In the recovery (post-acute) period after surgery or a course of medications, they begin to develop the elbow through physical therapy. At first, minimal loads are applied: they are retracted in different directions and the forearm is adducted.

In physiotherapy and departments physical therapy medical centers carry out passive development of the elbow joints on the FISIOTEK HP robotic simulator.

Kinesitherapy and ground gymnastics by Bubnovsky is an alternative to traditional medicinal methods treatment and classical exercise therapy for elbow injury, ligament damage and bursitis. The elbow joint is developed using universal simulators in the post-acute and/or rehabilitation period after surgery.

Traditional treatment

When diagnosed with “bursitis of the elbow joint,” treatment with folk remedies becomes an important part of therapy, both when prescribing surgery, and when performing a puncture and using medications. Herbal treatment is recognized official medicine and can relieve surgery and pain if you start using ointments and compresses, baths and applications in time.

Application from Kalanchoe

Large leaves are washed thoroughly and placed in the refrigerator overnight. In the morning, scald with boiling water or press much with a spoon until juice appears or crushed. Apply to the inflamed elbow and secure with cellophane and a scarf. Change the application 3-4 times a day, more often for purulent bursitis.

Applications from lilac flowers

Pure flowers are crushed until the juice appears and applied on linen cloth to the elbow for 2 hours, then replaced with a “fresh” bandage.

Aloe compress with honey

For acute bursitis: mix aloe juice (1 tbsp) and honey (2 tbsp). Distribute the composition over gauze (bandage) folded in several layers. Apply to the elbow and secure with cellophane and woolen cloth. Leave for 2 hours.

For purulent bursitis: mix alcohol (2 tbsp.) with pharmaceutical ox bile (1 bottle), ground horse chestnut fruits (2 tbsp.), crushed aloe leaves (3 pcs.). Leave for 10-12 days. Then the linen cloth is moistened and applied to the problem area, covered with film and secured with a woolen scarf. Course – 10 procedures overnight, break – 10 days.

Lotions from tincture with propolis

Infuse propolis (15 g) in vodka or alcohol (100 ml) for 7 days. Apply lotions until the expected effect is obtained.

Baths with pine extract

Cones and branches of pine needles (1.5 kg) are placed in a bucket of water, boiled for half an hour and left for 1.5 hours. Separate the water from the grounds and add 1-2 liters to the bath, 0.5-1 liters to the elbow bath.

Conclusion. Traditional medicine in comprehensive program used to strengthen the immune system, reduce swelling and inflammation, eliminate pain, and prevent complications. In this case, hypothermia of the elbow joint should not be allowed, and the load should be increased gradually.

rophylaxis

After surgery and in order to prevent bursitis, wearing orthoses or bandages on the elbow joint of various designs and types is prescribed.

Prevention of elbow bursitis also includes:

• dosed loads on the joint;
• correct mode of work and rest.

The threat of injury should be eliminated and traumatic effects on the elbow at work and during sports training should be prevented.

Consequences

The consequences of elbow bursitis take longer and are more difficult to treat.

Bursitis provokes:

• phlegmon: the purulent cellular space under the skin melts down to the muscles. Inflammation and swelling extends to healthy tissue, surrounding the bursa;
• lymphangitis: lymphoid ducts become inflamed, which take on the appearance of red lines or a mesh coming from the purulent area;
• lymphadenitis: lymph nodes become infected through the flow of lymph into them from the inflammatory focus. In this case, an abscess forms;
• purulent arthritis: when inflammation moves to the joint next to the purulent bursa.

Bursitis or inflammation of the synovial bursa of the elbow joint should be treated with conservative and traditional medicine methods. early stages and surgical intervention on late stages advanced pathology.

ICD-10 code: M70.2 (olecranon bursitis), M70.3 (other bursitis of the elbow joint)

Bursitis of the elbow joint is a fairly common disease characterized by an inflammatory process in the joint capsule of the elbow.

The elbow joint is a complex anatomical joint in which there are three synovial bursae: radiobrachial, ulnar subcutaneous, and ulnar interosseous.

The joint capsule or bursa is filled from the inside with synovium, that is, cells that secrete joint (synovial) fluid. It acts as a lubricant, preventing wear of the articular surfaces. Sometimes inflammation develops in the bursa, pain and other symptoms appear.

Why does elbow bursitis develop?

Elbow bursitis or olecranon bursitis is also called student's elbow, since the disease most often develops in people whose professional activity closely related to the emphasis on the elbows.

• Stretching of joints, their periodic overload.
• Injuries to the elbow, nearby tendons and periarticular bursa.
• Arthritis and gout, which cause inflammation and affect the periarticular capsules.
• Mechanical damage to the skin in the elbow area.
• Penetration of microbes into the synovial bursa of the elbow through lymph or blood flow.
• Constantly keeping the elbow in the same position.
• Disturbance of metabolic processes in the body.
• Autoimmune diseases.

Types of elbow bursitis

There are several types of elbow bursitis.

Purulent

Infectious, or purulent bursitis of the elbow joint, occurs due to the penetration of pyogenic microbes from purulent foci into the synovial bursa. lymph nodes or through blood.

With constant irritation of the synovial bursa in the elbow area, mucous-serous exudate begins to accumulate in it, and the penetration of infection leads to the transformation of serous exudate into purulent. The patient observes redness of the skin in the elbow area, increased temperature, and limited mobility of the limb.

Acute bursitis

Manifests severe pain, intensifying with movements. A painful point is felt in the inflamed area, touching which leads to pain spreading to the entire surface of the arm.

In acute inflammation, the elbow becomes very swollen and painful. When palpating the joint, fluctuation is determined, that is, fluctuation of the fluid when pressing on the skin of the elbow.

Recurrent

Chronic (recurrent) bursitis is manifested by mild pain in the joint, which lasts for a long time. The joint is not limited in movement, the tumor is not visible or felt, but when palpated, some dense formation can be detected.

Recurrent bursitis occurs due to reinfection of damaged areas. Any damage provokes an exacerbation of the pathology.

Post-traumatic bursitis

The disease develops with occupational stress on the elbow joint. After injury, the bursa usually becomes infected with streptococcus, staphylococcus and other pathogenic organisms.

If you ignore post-traumatic bursitis, it will turn into purulent, then into the acute stage and cause acute bursitis of the elbow joint.

Based on the nature of the fluid accumulating in the bursa, they are distinguished:

1. Serous bursitis, which is considered quite mild and harmless. The liquid has a whey consistency.
2. Hemorrhagic, when fluid along with blood accumulates in the cavity of the synovial bursa.
3. Purulent, in which, as a result of the neglect of the case, pus forms in the bursa. This species is considered dangerous as it can lead to sepsis and limb amputation.

Symptoms of the disease

Elbow swelling

It appears suddenly. At first, the swelling does not interfere with normal life and mobility of the limb. But if you ignore this symptom, the swelling will gradually progress and the disease will enter the acute stage.

Temperature increase

If the temperature rises simultaneously with swelling of the elbow, this indicates an inflammatory process; you should urgently consult a doctor.

Pain in the joint area and changes in its shape

You should pay attention to the symptoms of pain in the elbow joint if it appears suddenly, for no apparent reason. Also, based on an additional symptom, such as a feeling of fluid transfusion inside the joint when bending and straightening the elbow, one can understand that inflammation of the bursa is developing.

Diagnostics

Before treating bursitis of the elbow joint, an orthopedic traumatologist is examined, who can easily determine the disease and its causes. But if there is no exact certainty, then the following studies are carried out:

• X-ray. To determine the inflammatory fluid in the elbow bursa;
• Ultrasound. Helps determine how much fluid has accumulated in the elbow joint, allows you to diagnose accurate diagnosis and decide on the need for surgery;
• MRI. It is rarely used, if you need to find out the degree of neglect of the disease.

Treatment

It depends on the stage of development of the disease.

Elbow immobilization

At the initial stage of elbow bursitis, it is necessary to provide complete rest to the hand. Apply a fixing bandage directly to the elbow, but not too tight so that blood circulation is not disrupted. This can be done at home. It is necessary that the hand is in one position as if it were fractured.

Medicines (tablets, ointments, injections)

Elbow bursitis is treated with painkillers and anti-inflammatory drugs. Gels and ointments are used, for example Diclofenac, Voltaren, Dimexide, Indomethacin.

In the acute phase or in the chronic form of bursitis, antibiotics and anti-inflammatory drugs are prescribed to reduce pain symptoms, relieving inflammation. Ibuprofen, Movalis, Dikloberl, Diclofenac are prescribed orally in the form of tablets.

Injections of drugs that have an analgesic, absorbable, and anti-inflammatory effect are used. Treatment with corticosteroids is prescribed. This helps remove inflammation and reduce the amount of fluid in the synovial bursa.

If hemorrhagic or purulent bursitis of the elbow joint is diagnosed, antibacterial treatment is prescribed. Broad-spectrum antibiotics from the group of macrolites, penicillins, and cephalosporins are prescribed. These are Ampicillin, Cefix, Fromilid, Cefazolin. Antibiotics are used both in tablet form and as injections.

Most often as primary remedy Dimexide is used. He is being bred into boiled water in a ratio of 1 to 4. A cotton cloth is moistened in the resulting solution and applied to the elbow. Insulated with polyethylene and woolen fabric.

Dimexide is used as a compress, diluted in a ratio of 1 to 1. But the medicine has many contraindications and can cause harm to the body. You can dilute Dimexide with novocaine in a ratio of 1 to 3.

The compress should not be kept for more than 40 minutes. If a burning sensation is observed, it must be removed. The course is no more than 10 days. Sometimes Dimexide is used as a conductor for antibiotics. Then dry antibiotics are added to its aqueous solution and applied to the skin.

Dimexide has the ability to draw pus from the wound surface and is perfect for the initial treatment of bursitis at home. It easily penetrates tissue and blood through intact skin.

Dimexide is a universal solvent, enhances the passage of many drugs, and has anti-inflammatory and antimicrobial effects. Dimexide activates antibiotics and accelerates the healing process.

Physiotherapy

During the period of remission, physiotherapy is prescribed. It includes: ultrasound, acupressure, acupuncture, balneotherapy, UHF, magnetic therapy, paraffin, ozokerite, phonophoresis with hydrocortisone. Physiotherapy helps eliminate inflammation and improves metabolic processes in Bursa.

Surgical treatment

If bursitis is acute, purulent, chronic, then it is required surgery. There are several types of operations.

Puncture

During the operation, the synovial bursa is cut, cleaned of pus, and washed with saline. Then processed antiseptics, antibacterial injections are injected under the skin and the wound is sutured.

Drainage

Used for complex bursitis. The bursa cavity is opened and drained using a tube. The drainage is left until the inflammation of the joint subsides.

Bursectomy

The operation consists of excision of the ulnar bursa followed by application of a splint to ensure the joint rests.
Surgery can most effectively cure elbow bursitis. Conservative treatment is effective for non-infectious bursitis.

Therapy with folk remedies

As additional treatment Treatment with folk remedies at home is well suited. It is impossible to cure olecranon bursitis with folk remedies, but they are good at eliminating some of the causes and symptoms of the disease.

Cabbage leaf

Cut the veins from a cabbage leaf and beat the leaf until the juice appears. After this, the sheet is applied to the elbow and insulated. Every 4 hours you need to replace the sheet with a fresh one.

Compress with lard

At home, the affected limb is steamed and a piece of unsalted lard is wrapped around it. Leave the compress overnight. Salo helps soothe pain and relieve inflammation due to its ability to draw out toxins. The compress can be used for 2 weeks.

Bee products

You can remove the symptoms of the disease at home using an alcohol tincture of propolis or an ointment based on it. It is necessary to moisten a clean cotton cloth in it, apply it to the sore elbow and wrap it with a warm woolen cloth.

With timely treatment, elbow pain decreases within 3, maximum 6 weeks. If surgery has been performed, the functionality of the joint is restored a couple of weeks after the operation. Scar tissue after surgery can take up to a year to form.

Therefore, promptly identifying the causes and symptoms of the disease and contacting a specialist is the key to a quick recovery.