Bursitis – causes, signs, symptoms, treatment andcomplications

Bursitis – acute, subacute or chronic inflammation
a synovial sac that is accompanied by an abundant formation and
accumulation of exudate (inflammatory fluid) in its cavity.

In the human body has about 140 burs
(synovial bag). Bursitis can strike any of them, but more often
total inflammation is noted in the elbow, knee and shoulder
joints, at least – in the bursa located between the calcaneus and
Achilles tendon, and in the hip joints.

Что это за заболевание, почему она возникает и как
get rid, let’s look further.

Bursitis: what is it?

Бурсит

Bursitis is an inflammation of the synovial bags (they are called bursa
– small cavities) located in the region
joints, which is accompanied by the accumulation of inflammatory in them
fluid.

As a result, the formation of swelling occurs, the size
which in some cases reaches ten centimeters. To the touch,
the articular bag is dense enough, sometimes touching causes
pain, but it is worth noting that the functionality of the joint itself,
it is not limited.

Bursitis occurs more often in the shoulder, elbow or knee in men younger
35 years old, especially athletes. The thigh may also be affected.
wrist or ankle. This is usually an occupational disease, but
occurs in overweight or abnormal people
matched shoes.

Usually the disease lasts 1-2 weeks and for the life of the patient
no danger. But secondary injury can cause
the development of chronic bursitis, the treatment of which is very
difficult.

In addition to the patient experiencing persistent pain, he
also limited in movement, since the mobility of the joint is disturbed.
The risk group for bursitis includes athletes (skiers, golfers,
tennis players), and people whose profession involves heavy
physical labor (builders, miners, loaders).

What is a synovial bag?

The name of the synovial bag comes from the Latin word bursa
(bursa), which translates as “bag”, “purse.” She is
is a flattened cavity, inside which is
fluid (it is produced by the cells lining the inside of the wall
synovial bags).

The function of the bursa is to mitigate the mechanical effects on
articular elements, due to which there is a better mobility, and
also protection of joints from adverse factors. Bursa
may be articular and periarticular.

Classification

В травматологии и хирургии  существует
several classifications of bursitis:

  • С учетом локализации (локтевого, коленного, плечевого
    сустава и т. д.) и названия пораженной бурсы.
  • Taking into account the clinical course: acute, subacute and chronic
    bursitis.
  • Pathogen-specific: specific (bursitis
    при сифилисе, туберкулезе, бруцеллезе, гонорее)
    и неспецифический bursitis.
  • Given the nature of the exudate: serous (plasma admixture
    a small amount of blood corpuscles), purulent
    (microorganisms, destroyed cells, broken leukocytes),
    hemorrhagic (fluid with a large number of red blood cells) and
    фибринозный (с высоким содержанием фибрина) bursitis.

In addition, in clinical practice often distinguish
асептический (неинфицированный) и инфицированный bursitis.

The reasons

The cause of bursitis is usually an injury, bruise or abrasion, that is,
infection through blood or damage to the affected area.
It is also possible to get pus from erysipelas, it happens
with osteomyelitis, bedsores, boils, carbuncles. Infection
falls through abrasions or severe bruises. Chronic manifestation
this disease occurs due to constant irritation of the hearth
inflammation.

The reasons возникновения бурсита суставов:

  • General weakening of the immune system and reduced protective properties
    due to various infectious diseases
    новообразований, СПИДа, злокачественных новообразований, при
    циррозе печени, алкоголизме и наркомании и т.д.
  • Penetration of various pathogens into open wounds
    surface during injuries and cuts.
  • Excessive occupational stress
    or surge during exercise.
  • The deposition of salts in the synovial bag. Probability of illness
    increases with age.
  • Obesity.

To summarize the above – the main reasons
the occurrence of bursitis: in most cases it is different
damage (chronic microtraumas, bruises, etc.), a little less –
these are metabolic disorders, infections, intoxication,
autoimmune processes and allergic reactions

Symptoms of bursitis + photo

The symptoms of bursitis include the definition of a rounded limited
patient of swelling, elastic consistency, fluctuating, in place
anatomical location of the bag. Such a swelling may be
about eight or ten centimeters in diameter.

Other symptoms of bursitis:

  • Pain that has aching, shooting, sometimes strong and throbbing
    character, aggravated at night, with irradiation (recoil) in the hand or
    leg, depending on the localization of the pathological process;
  • Swelling due to development accumulation of fluid in
    extracellular space;
  • Redness of the inflamed and swollen place (hyperemia);
  • The limited movement of the inflamed area, the joint that
    occurs after the salt deposits in the inflamed bursa;
  • Elevated or high body temperature, up to 40 ° C;
  • General malaise, feeling of weakness and powerlessness;
  • Enlarged regional lymph nodes located in
    the place of development of bursitis;
  • Nausea.
Features of the flow Acute bursitis Purulent Chronic
Pain Moderate Strong Insignificant
Swelling and swelling Corresponds to the localization of the bag Expressed over the entire joint area. Clearly limited in the form of a tumor.
Skin redness Insignificant Strong Missing
Mobility restriction Moderate Pronounced Missing
Temperature rise Insignificant (до 38 градусов) Strong (до 39 градусов и более) Not typical
Consequences and prognosis Complete recovery or transition to chronic Recovery or the occurrence of purulent complications (phlegmon,
osteomyelitis)
Formation of tumor formation without disturbance
movements

Complications

Complications, которые возникают при несвоевременном лечении:

  • Purulent артрит с вовлечением коленного мениска и связок
    knee joint.
  • Остеомиелит большеберцовой, малоберцовой или бедренной
    bones.
  • Fistula periarticular localization.
  • Adhesive capsulitis. Inflammation of the entire humeral capsule with
    formation of adhesions and scars.
  • Hygroma. During the protracted process may be formed
    isolated cystic cavity filled with fluid.
  • Sepsis. With reduced immunity purulent contents with current
    the blood is carried throughout the body, causing a severe overall reaction.
  • Necrosis. Dying off the fabric of the bag wall occurs in some cases
    and is an absolute indication for surgical
    interventions.

Diagnostics

Simple tests help diagnose bursitis:

  • The doctor asks the patient to try to put a hand behind his head as if
    combing hair.
  • Painной должен немного пройти на корточках.

Если обнаруживается болезненность и ограниченность movements, то
the probability of illness increases. The farther away from the body surface
the inflamed bag is located, the more difficult it is for the specialist to deliver
diagnosis. But no matter how deep the hearth is hidden, when pressed
the patient will definitely feel pain.

Initially, the doctor interviews the patient, palpates the affected
joint. Bursitis can be diagnosed using the following methods.
surveys:

  • radiography;
  • arthrography;
  • bursography;
  • puncturing the joint and taking a biopsy, so you can
    establish the sensitivity of microorganisms to antibacterial
    drugs;
  • ultrasound examination;
  • MRI

Bursitis treatment

Regardless of the localization of pain, the main components of the fight against
disease – rest and stiffness of the joint. how лечить бурсит зависит
on the type of inflammation, but in any case it will be complex
therapy. What is included in it:

  • Drug treatment.
  • Massage.
  • Физиоtherapy.

Recommendations:

  1. The most important criterion in the course of treatment is rest.
    the joint.
  2. Patient must follow bed rest to reduce pain.
    in the joint, while preventing the spread of inflammatory
    process.
  3. The doctor may apply plaster to the affected joint so that the patient does not
    мог вызвать в нем каких-либо movements.
  4. Bursitis can be treated both in the hospital and at home.

how правило, лечение острых бурситов проводится в амбулаторных
conditions. Full recommended for the first five to seven days.
a rest during which a plaster splint is applied and
prescribed treatment with anti-inflammatory drugs. More
ten days of treatment with rest should not last.

Chronic bursitis develops various
complications. The treatment of such forms of the disease is only
operational. In the first case, the operation is performed by a bursectomy.
(surgical removal of the diseased synovial
bags). If there were no infectious contents inside,
postoperative wound heals in 7-10 days. If there is a fistula
carry out its full surgical excision with further treatment
purulent wounds.

Drugs for bursitis

Medications can be used for oral or intake.
injections, and for local therapy (ointments, gels, compresses). how
usually, drugs from the group of analgesics are used and
nonsteroidal anti-inflammatory drugs. They suppress
inflammatory process, contribute to the reduction or complete
the disappearance of the main signs of bursitis (pain, swelling,
temperature).

Кроме препаратов общего действия, врачи-ортопеды
surely dispense to patients with bursitis local remedies such
as an ointment, a warming compress, and the like.

The means of local therapy of bursitis include:

  • �Solcoseryl;
  • �”Levomekol” (has a resolving effect and contributes to
    rapid subsidence of residual inflammation);
  • �”Dimexide” for the treatment of bursitis (used as
    compresses);
  • chondroitin sulfate-based ointment (Teraflex ointment, as
    showed clinical studies, has a positive effect
    after the first month of use of the product);
  • nonsteroidal anti-inflammatory ointments;
  • homeopathic and vegetable ointment.

Physiotherapy

Bursitis treatment may also include the following
physiotherapeutic procedures:

  • UV irradiation;
  • UHT – treatment with acoustic waves;
  • Induction (magnetic field use);
  • Electrophoresis (administration of the drug using current);
  • Paraffin-ozocerite applications.

All these actions are aimed at enhancing metabolic processes.
organism. Assign them strictly individually, in accordance with
symptoms of the disease.

Massage and physiotherapy

When bursitis goes into remission, doctors advise
apply therapeutic exercises and manual massage. You can also
massage the damaged area yourself, but remember that
this should be done carefully – the wrong massage can
only worsen the patient’s condition. Massage the inflamed area on
night using plant oils – eucalyptus, vaseline and
lavender.

Therapeutic gymnastics is especially important in bursitis. She helps
improve blood flow and, as a result, tissue nutrition, restore
motor function of the joint. Exercise is chosen and
individual consideration of the patient’s age and type of bursitis. how
As a rule, the initial exercises are very simple – just do it.
wiggle your hand back and forth.

The whole period of treatment for bursitis takes on average from 1-2 to 4-5
weeks. The forecast is almost always favorable. Relapses
diseases with timely and complete treatment (including
surgical) happen in 2-3% of cases.

Folk remedies for bursitis

All traditional methods of treatment of bursitis should be applied after
permission of your attending physician.

  1. Kalanchoe. Take 3 large sheets of Kalanchoe, wash them and
    put in the refrigerator overnight. In the morning make a mush and
    tie it up as a compress to the inflamed area.
  2. Apple vinegar. Drink based on water (200 ml), 15 ml
    natural vinegar and a tablespoon of honey take
    twice a day on an empty stomach. Курс — 2 недели.
  3. Celery from bursitis. Celery Seed Tea Promotes
    body resistance and helps fight inflammatory
    processes in any tissues, including articular. Table spoon
    dry celery seeds pour ¼ l boiling water, cover, insist 2
    hours, filtered and drink 100 ml twice a day. The course of treatment 15
    days.
  4. Excellent anti-inflammatory and analgesic effect.
    have cabbage leaves, or rather, compresses of them. Cook
    This application is very simple: you need to take a clean cabbage leaf,
    remove from the knife all the rough streaks and slightly beat off the wooden
    gaiter until juice appears.
  5. When bursitis make compresses and on the basis of propolis. For this
    pour vodka (100 g) propolis (10 g) and leave to infuse
    dark place for 5 days. Apply to the swollen joint compress
    until it passes.
  6. The main component of the next compress is castor
    oil that is recommended to be processed directly
    affected place. White cotton should be wetted
    castor oil, squeeze out the excess. Wrap the sore area,
    cover with a thick cloth, such as a towel, to avoid spillage
    drops of oil, the entire compress wrap cellophane.

Prevention

Prevention бурсита включает в себя соблюдение следующих
recommendations:

  • People predisposed to the occurrence of bursitis (athletes,
    some workers, etc.) must take precautions
    timely rest the joints, wear special protective
    bandages.
  • It is necessary to timely treat wounds in the joints,
    prevent them from becoming infected.
  • Timely treatment of any infectious diseases,
    pustular skin lesions.
  • For sports you need to choose comfortable shoes
    size.
  • Before intensive loads on the joints need to perform
    �”Warm-ups”.
  • Under no circumstances can athletes train beyond measure,
    violate the requirements of a sports doctor and coach.

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