From the Guidelines
Treatment for elbow bursitis should begin with conservative measures, including rest, ice application, compression, and elevation, along with over-the-counter pain medications such as ibuprofen or naproxen to reduce pain and inflammation. The management of elbow bursitis can be informed by guidelines for the treatment of gouty arthritis, as both conditions involve inflammation of joints or bursae 1.
Key Considerations
- Rest, ice, compression, and elevation (RICE) are essential for reducing inflammation and promoting healing.
- Over-the-counter pain medications like ibuprofen (400-600mg three times daily) or naproxen (220-440mg twice daily) can help manage pain and inflammation.
- For more severe cases, aspiration of the bursa followed by a corticosteroid injection may be necessary to reduce inflammation.
- Antibiotics may be prescribed if the bursitis is infected.
- Physical therapy exercises can help maintain range of motion and strengthen surrounding muscles.
- Surgery is a last resort for chronic cases that do not respond to other treatments.
Prevention
- Protecting the elbow with padding during activities can help prevent recurrence of bursitis. The goal of treatment is to reduce inflammation, relieve pain, and prevent future episodes, thereby improving the patient's quality of life and reducing morbidity and mortality associated with untreated or poorly managed elbow bursitis 1.
From the FDA Drug Label
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.
The treatment for elbow bursitis with naproxen is to start with a dose of 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. The initial total daily dose should not exceed 1250 mg of naproxen, and thereafter, the total daily dose should not exceed 1000 mg of naproxen 2.
From the Research
Elbow Bursitis Treatment Options
- Conservative treatment is often the first line of treatment, including ice, rest, anti-inflammatory and analgesic drugs, and occasionally, bursal fluid aspiration 3
- In cases where conservative treatment is not effective, open excisional procedures or arthroscopy may be considered as alternative management modalities 3
- Arthroscopy is a minimally invasive procedure that can help avoid wound problems often associated with open excision, although it is not without complications 3
Septic Bursitis Treatment
- The treatment of septic bursitis may involve operative or non-operative management, with the choice of treatment depending on various factors such as patient age and comorbidities 4
- Patients with septic bursitis who are managed operatively tend to be younger, and are less frequently discharged to rehabilitation 4
- The most common organism isolated from bursal fluid in cases of septic bursitis is Staphylococcus aureus 4
Comparison of Treatment Options
- There is limited data to guide the choice of treatment for septic bursitis, and further study is needed to identify patients who would benefit from early surgical intervention 4
- The clinical features and outcomes of patients with septic bursitis do not appear to be significantly affected by the presence or absence of trauma, or the site of bursitis 4