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 like ibuprofen or naproxen, as these approaches prioritize reducing morbidity and mortality by minimizing inflammation and promoting healing. When considering the management of elbow bursitis, it's crucial to prioritize approaches that minimize complications and promote quality of life. According to the most recent guidelines, such as those discussed in the context of chronic elbow pain 1, conservative management is often the first line of treatment. This typically includes:
- Rest to avoid further irritation
- Ice application for 15-20 minutes several times daily to reduce inflammation
- Compression with an elastic bandage to help reduce swelling
- Elevation of the affected arm to decrease fluid accumulation
- Over-the-counter pain medications like ibuprofen (400-600mg three times daily) or naproxen (220-440mg twice daily) to manage pain and inflammation
If these conservative measures do not provide relief within 1-2 weeks, or if there are signs of infection (such as warmth, redness, and fever), medical intervention may be necessary. This could include:
- Aspiration to remove fluid from the bursa, sometimes followed by a corticosteroid injection to reduce inflammation
- Oral antibiotics, such as cephalexin (500mg four times daily for 7-10 days), for infected bursitis In severe or recurring cases, surgical removal of the bursa (bursectomy) might be recommended. It's essential to avoid activities that put pressure on the elbow during recovery and to gradually reintroduce normal activities as symptoms improve. Physical therapy exercises can help maintain range of motion once acute inflammation subsides, as discussed in the context of managing chronic elbow pain 1.
From the Research
Elbow Bursitis Treatment Options
- Conservative management is often the first line of treatment, including: + Ice + Rest + Anti-inflammatory and analgesic drugs + Bursal fluid aspiration (as mentioned in 2)
- For unresponsive patients, minimally invasive procedures such as arthroscopy may be considered (as mentioned in 2)
- In cases of septic bursitis, treatment may include: + Oral antibiotics + Parenteral antibiotics + Surgical wash-out of the affected bursa (as mentioned in 3)
- Local corticosteroid injection may be used in the management of olecranon bursitis, but its use in other types of bursitis may be limited (as mentioned in 4)
Management of Nonseptic Olecranon Bursitis
- Conservative methods such as rest, ice, compression, orthosis wear, and nonsteroidal anti-inflammatory medications are often effective (as mentioned in 5)
- Intrabursal corticosteroid injections and surgical bursectomy may be considered, but recent literature has demonstrated adverse effects compared to noninvasive management (as mentioned in 5)
Management of Septic Bursitis
- Differentiating aseptic from septic bursitis usually requires examination of aspirated bursal fluid (as mentioned in 6)
- Ultrasonography is useful for assisting in the diagnosis and guiding the aspiration (as mentioned in 6)
- Staphylococcus aureus is responsible for 80% of cases of superficial septic bursitis (as mentioned in 6)
- The management of septic bursitis varies considerably across centers, and controlled trials are needed to establish standardized recommendations (as mentioned in 6)