From the Guidelines
Treatment for Mrs. Olecranon bursitis should begin with conservative measures, including rest, ice application, compression, and elevation, as well as over-the-counter NSAIDs like ibuprofen or naproxen to reduce pain and inflammation. According to 1, initial treatment should focus on nonpharmacological approaches, and pharmacological treatments should be considered if symptoms are not controlled. The use of NSAIDs is recommended for musculoskeletal symptoms, including bursitis.
Some key considerations for treatment include:
- Rest, ice application for 15-20 minutes several times daily, compression with an elastic bandage, and elevation of the affected arm to reduce pain and inflammation
- Over-the-counter NSAIDs like ibuprofen (400-600mg three times daily with food) or naproxen (220-440mg twice daily) to help reduce pain and inflammation
- Protecting the affected elbow from further trauma by avoiding leaning on it and possibly using an elbow pad
- Considering medical attention if these measures don't provide relief within 1-2 weeks, or if the bursitis is severe or infected
It's also important to note that olecranon bursitis can be caused by repetitive pressure, trauma, infection, or systemic conditions like rheumatoid arthritis or gout, leading to fluid accumulation and inflammation. If infected bursitis is suspected, oral antibiotics like cephalexin may be prescribed. Surgery is rarely needed but may be considered for recurrent or chronic cases. As stated in 1, the least risky medication should be tried first, with escalation only if the first medication is ineffective.
From the Research
Diagnosis and Management of Olecranon Bursitis
- Olecranon bursitis is a disease characterized by inflammation of the olecranon bursa, most often due to microtrauma 2.
- The condition is often self-limited and resolves with conservative methods such as rest, ice, compression, orthosis wear, and nonsteroidal anti-inflammatory medications 2.
- The first treatment line is conservative, including ice, rest, anti-inflammatory and analgesic drugs and, occasionally, bursal fluid aspiration 3.
Treatment Options
- Nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management 4.
- Corticosteroid injection for aseptic bursitis is associated with increased overall complications and skin atrophy 4.
- Aspiration does not increase the risk of bursal infection for aseptic bursitis 4.
- Recently, there is more supporting evidence for the use of conservative management over surgical intervention in treating olecranon bursitis 5.
Causes and Complications
- Olecranon bursitis can be caused by local injury or penetration of bacteria through the skin, and can also originate from systemic diseases such as gout and rheumatoid arthritis 5.
- Chronic inflammation may lead to complications such as persistent drainage and bursal infection 4.
- Aseptic bursitis is associated with a significantly higher overall complication rate compared to septic bursitis 4.