What Is Bursitis/Impingement Treatment of the Elbow?
Elbow bursitis is a common condition that causes pain and swelling in the back of the elbow. Also called olecranon bursitis, elbow bursitis typically responds to simple treatment steps, although infected bursae or chronic bursitis may require more invasive treatments.
- Rest: Patients with elbow bursitis should rest and protect their elbow until the elbow bursitis has completely resolved. Usually, no special protection or bracing is needed, and simply avoiding strenuous activity and pressure on the elbow will allow the inflammation to subside.
- Ice Application: Ice application can also help to limit the amount of swelling of the elbow bursa. Usually applying an ice pack several times a day, for about 15 minutes each time, will be sufficient.
- Compression: Gentle compression with an Ace wrap or neoprene elbow sleeve may help to prevent swelling from returning. Especially useful when active, gentle compression is also a good way to remind yourself to keep pressure off the back of the elbow.
- Anti-inflammatory Medications: An oral anti-inflammatory medication is also commonly prescribed. These medications may help control symptoms of inflammation.
Patients who are prone to developing elbow bursitis are most often those people who place pressure on the point of the elbow for prolonged periods. In these patients, elbow pads can protect the elbow and help to prevent elbow bursitis.
More Invasive Treatments
If these treatments fail to provide relief of symptoms, more invasive treatments may be considered. These treatments might be provided by your physician after diagnosis and less-invasive measures:
- Draining the Bursa: Draining the fluid from within the bursa can help with more persistent cases of elbow bursitis. Typically, a needle is inserted into the bursa and drawn out through a syringe. If there is any question of the cause of bursitis (infection, gout, etc.), the fluid can be analyzed to determine the cause.
- Cortisone Injection: After removing the excess fluid, your doctor may administer a cortisone injection into the bursa. Cortisone will suppress the inflammatory response to hopefully prevent a recurrence of the swelling. There have been some studies that show a possibility of introducing infection or causing other side-effects with cortisone, so often simply draining the fluid is sufficient.
- Surgical Treatment: If bursitis does not respond to these treatments, surgery may be considered to remove the bursa sac. There are several different surgical procedures that have been described, but traditionally the sac is removed in its entirety through an incision directly over the back of the elbow. The major problem with surgery is that healing incisions on the back of the elbow can lead to wound healing problems and infection. Most surgeons recommend trying to avoid surgery for this condition if possible.