From the Guidelines
Treatment for elbow bursitis should begin with nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics, as these methods are recommended as the initial treatment by the American Heart Association 1. When these methods are not effective, pharmacological treatments can be considered.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to reduce pain and inflammation, with the least risky medication being tried first, such as acetaminophen or aspirin at the lowest efficacious dose 1.
- It is essential to recognize that the safety of these medications, except for aspirin, has not been conclusively demonstrated through randomized clinical trials 1. Some key points to consider in the treatment of elbow bursitis include:
- Rest, ice application, compression, and elevation of the affected arm can help reduce pain and inflammation.
- Aspiration to remove excess fluid and corticosteroid injections may be necessary for more severe cases.
- Antibiotics may be required if the bursitis is infected.
- Physical therapy exercises should be started once acute pain subsides to maintain range of motion.
- Surgery is rarely needed but may be considered for chronic cases that do not respond to other treatments. The goal of treatment is to reduce pain and inflammation, promote healing, and prevent further irritation to the elbow joint, as recommended by the American Heart Association 1.
From the FDA Drug Label
Naproxen tablets are also indicated: For relief of the signs and symptoms of tendonitis For relief of the signs and symptoms of bursitis Management of Pain, Primary Dysmenorrhea, and Acute Tendonitis and Bursitis Because the sodium salt of naproxen is more rapidly absorbed, naproxen sodium is recommended for the management of acute painful conditions when prompt onset of pain relief is desired. Naproxen may also be used The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required.
Treatment for Elbow Bursitis: Naproxen is indicated for the relief of the signs and symptoms of bursitis. The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. 2, 2
From the Research
Treatment Options for Elbow Bursitis
- Nonsurgical management is often the first line of treatment, including ice, activity modification, and nonsteroidal anti-inflammatory drugs 3
- Local corticosteroid injection may be used in the management of olecranon bursitis, but its use in other types of bursitis may have adverse effects 3, 4
- In cases of septic bursitis, oral antibiotics may be administered, and surgical intervention may be required in some cases 3, 5, 6
Management of Septic Bursitis
- The most common organism isolated from bursal fluid is Staphylococcus aureus 5, 6
- Ultrasonography is useful for assisting in the diagnosis and guiding the aspiration of bursal fluid 6
- The management of septic bursitis varies considerably across centers, and controlled trials are needed to establish standardized recommendations regarding antibiotic treatment protocols and the indications of surgery 6
Surgical Intervention
- Surgical intervention may be required for recalcitrant bursitis, such as refractory trochanteric bursitis 3
- Open excisional procedures allow for the complete removal of pathological bursal tissue, but arthroscopy is increasingly being considered as a suitable new modality of management 7
- Patients managed operatively were younger and were discharged to rehabilitation less frequently 5