From the Research
Conservative management, including rest, ice, compression, and elevation, along with nonsteroidal anti-inflammatory medications, is the recommended initial treatment for olecranon bursitis, as it has been shown to be effective in reducing inflammation and promoting recovery 1, 2. The treatment of olecranon bursitis can be divided into conservative and surgical approaches, depending on the severity of the condition.
- For mild cases, the RICE protocol (rest, ice, compression, elevation) is recommended initially, along with activity modification to avoid pressure on the elbow.
- Over-the-counter NSAIDs like ibuprofen (400-800mg three times daily) or naproxen (500mg twice daily) can help reduce pain and inflammation.
- Aspiration of the bursa fluid may be necessary for more severe or persistent cases, but corticosteroid injections are associated with a higher risk of complications, including bursal infection and skin atrophy 1.
- Antibiotics are essential if infection is present, with options including cephalexin (500mg four times daily) or clindamycin (300-450mg four times daily) for 7-10 days.
- Prevention strategies include wearing elbow pads during activities that put pressure on the elbow, avoiding leaning on hard surfaces, and taking regular breaks from repetitive elbow movements.
- Physical therapy exercises to strengthen surrounding muscles can help prevent recurrence. Surgery (bursectomy) is typically reserved for cases that don't respond to conservative treatment or for recurrent cases, as it is associated with higher rates of overall complications, persistent drainage, and bursal infection 3. The most recent and highest quality study 1 supports the use of conservative management over surgical intervention in treating olecranon bursitis, highlighting the importance of a non-invasive approach to reduce the risk of complications and promote recovery.