Which antibiotics are being overused

Inflammation of the elbow bursa

Elbow bursitis (Bursitis olecrani, student elbow): Inflammation of the bursa at the tip of the elbow formed by the elbow, which is mainly noticeable with severe pain and swelling up to the size of an egg In most cases, an overload of the elbow is the cause (e.g. due to prolonged desk work), sometimes diseases such as gout or arthritis are the cause. In rare cases, open injuries or operations on the elbow lead to bacterial (septic) inflammation of the bursa there. Treatment includes immobilization and anti-inflammatory drugs, or antibiotics for bacterial inflammation. In stubborn cases, the bursa is surgically removed. No lasting consequences are to be expected with appropriate therapy.

Leading complaints

  • Swelling up to the size of a hen's egg, often also reddening of the skin and overheating over the tip of the elbow
  • Severe tenderness to pressure, v. a. leaning on the elbow is painful
  • Sense of tension and pain in the elbow joint when the arm is bent too much
  • In acute cases, pus focus sometimes visible within the reddened area, which can break through to the outside and leave a hole in the skin
  • After an injury, persistent watery discharge from a tear or laceration at the tip of the elbow.

When to the doctor

Within the next few days if

  • the symptoms persist despite rest and cooling.

The same day if

  • a pus has broken through or there is a tear or laceration at the tip of the elbow.

Immediately at

  • Fever and chills.

The illness

Disease emergence

Lie in different parts of the body Bursa (Bursae) lie between the protruding bones and the skin, where they act as shock absorbers. One of these bursa is right at the tip of the elbow. If he z. If, for example, it is overstrained when constantly leaning on the elbow (student elbow), injured in a fall or irritated by uric acid crystals in gout, it can become inflamed. A non-purulent or aseptic bursitis develops. The mucous membrane lining the elbow bursa then produces more fluid, the bag swells and causes pain. After an injury, the bursa will occasionally bleed into the bursa, making swelling and pain worse.

Staphylococci or other bacteria rarely enter the bursa through open wounds and lead to a highly painful, purulent infection. Then the doctor speaks of septic elbow bursitis.

course

Non-purulent (aseptic) inflammation is often extremely protracted if the triggers persist.

Complications

If left untreated, a purulent inflammation of the elbow bursa can sometimes lead to severe general infections (sepsis).

Diagnostic assurance

The physical examination shows significant swelling on the elbow with tenderness and possibly overheating. In acute illnesses, the doctor occasionally punctures the bursa to rule out infection or gout as the cause.

Differential diagnoses. Elbow pain also occurs in tennis elbows and golfers' elbows, upper arm fractures in the joint area, elbow dislocations, gout or rheumatoid arthritis.

treatment

Protecting the affected elbow is the first, and sometimes only, treatment measure required. In some cases it is helpful to immobilize the elbow in an upper arm brace for a short time.

Medication. To support the healing process, the doctor prescribes anti-inflammatory drugs (NSAIDs) such as diclofenac (e.g. Voltaren® or Diclac®) or ibuprofen (e.g. Dolgit® or Ibuprofen AbZ) in the form of ointments or tablets. If the pain is very severe, the doctor will inject local anesthetics directly into or on the bursa.

Puncture. If these treatment measures are not enough, some doctors decide to pierce the bursa and withdraw liquid with a syringe. Additional injections of cortisone preparations help to contain the inflammation and prevent the bursa contents from running down too quickly. For the same reason, a pressure bandage is applied after a puncture.

Antibiotics. A bacterial, purulent (septic) infection requires treatment with antibiotics. In addition, the bursa is surgically opened so that the pus can drain off.

Bursectomy. If a purulent bursitis does not improve within 2 to 3 months despite antibiotics and pus drainage, the bursa must be surgically removed (bursectomy). The same applies to severe chronic aseptic elbow bursitis that shows no improvement on conservative measures. After the bursectomy, the doctor immobilizes the operated elbow in an upper arm splint so that the wound healing proceeds undisturbed.

forecast

If the trigger is turned off, aseptic elbow bursitis usually heals well with sufficient rest. The same applies to fresh injuries in the area of ​​the bursa if the wound is cleaned and wound well in good time. In old wounds, the bursa is often so inflamed that the doctor has to remove it.

Your pharmacy recommends

What you can do yourself

Cool.

Cold helps with acute pain. Coolpacks are mostly used for this. However, because of the risk of frostbite, these should never be placed directly on the skin, but should always be wrapped in a cloth.

Prevention

Protectors.

Sports such as B. Skateboarding, mountain biking, motocross but also skiing and snowboarding have a high risk of injury to the elbows. Here it is advisable to wear elbow protectors.

Ergonomic sitting posture.

If you work a lot at your desk, you should definitely stop leaning on your elbows. There are also various aids for a good sitting and working posture. They range from matching office chairs, large exercise balls or rocking chairs to special mouse pads and forearm rests that can be attached to the desk. It is always advisable to take breaks between work units with small gymnastics insoles to loosen up your arms, shoulders and hands.

Authors

Dr. med. Michael Bedall in: Health Today, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 16:51


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.