Elbow bursitis is a condition involving the inflammation of the bursa, a fluid-filled sac at the tip of the elbow. This bursa normally serves as a cushion, allowing the skin to glide smoothly over the bone during movement. When irritated, the bursa produces excess fluid, leading to visible swelling and discomfort. Inflammation can be triggered by trauma, prolonged pressure from leaning on hard surfaces, or an infection entering through a break in the skin. Effective management requires understanding the range of treatment options, from home care to medical procedures.
Non-Invasive Treatments and Self-Management
Initial management for non-infected elbow bursitis focuses on conservative, self-administered care to reduce swelling and irritation. Following the R.I.C.E. protocol is a common first step, beginning with resting the affected elbow and avoiding aggravating activities. Applying ice to the swollen area for 10 to 20 minutes several times a day helps reduce inflammation and pain.
Compression, achieved by wrapping the elbow with an elastic bandage, minimizes fluid accumulation. Elevating the arm above the heart also assists in draining excess fluid from the area, supporting swelling reduction. Over-the-counter Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen or naproxen, manage both pain and underlying inflammation.
Protecting the elbow from further trauma or friction is a foundational part of self-care. This involves using a protective elbow pad, especially during work or activities that require leaning on the joint. Patients should modify daily habits to avoid resting their weight on the tip of the elbow against hard surfaces like tables or armrests.
When to Seek Immediate Medical Attention
While many cases of bursitis improve with home care, certain signs indicate the need for immediate medical attention to rule out infection. Signs of septic bursitis include intense localized redness and warmth that may spread away from the elbow, a rapid increase in pain, or pus draining from the area. Systemic symptoms, such as fever or chills, strongly indicate the infection may be spreading and require immediate medical intervention, often involving antibiotics.
Medical Procedures: Aspiration and Injections
When conservative treatments fail to resolve non-infected bursitis, a physician may recommend procedures like bursa aspiration. Aspiration involves inserting a needle into the bursa to withdraw excess fluid. This drainage reduces pressure and size, immediately relieving discomfort. The fluid sample is often sent to a lab to check for infection or crystals, such as those found in gout.
Following aspiration, the elbow may be temporarily immobilized with a compressive dressing to prevent the bursa from refilling. If the fluid is non-infected, a corticosteroid injection may be administered directly into the bursa. The corticosteroid is a potent anti-inflammatory medication intended to suppress inflammation.
Corticosteroid injections are reserved for persistent, non-infected cases because injecting steroids into an infected bursa can worsen the condition or mask symptoms. After inflammation subsides, physical therapy is introduced. Rehabilitation focuses on gentle exercises aimed at restoring the full range of motion in the elbow joint and preventing stiffness.
Surgical Treatment and Preventing Recurrence
Surgical intervention, known as a bursectomy, is reserved for challenging cases that do not respond to less invasive methods. This includes chronic bursitis persisting despite repeated aspirations and injections, or severe infected bursitis where antibiotics are unsuccessful. The procedure involves surgically removing the entire inflamed bursa sac, eliminating the source of the problem.
The surgeon may perform the bursectomy through a small incision (open surgery) or using arthroscopic techniques. After the sac is removed, a new, healthy bursa typically forms in its place over the following weeks or months. Recovery involves immobilization, wound care, and a gradual return to activity, with full recovery often taking four to eight weeks.
To prevent recurrence, long-term protective habits are necessary. Individuals whose activities involve repetitive pressure should consistently use protective padding or elbow sleeves. Avoiding prolonged leaning on the elbow and immediately cleaning any minor skin abrasions over the joint significantly reduces the risk of future inflammation or infection. Addressing underlying conditions, such as gout or rheumatoid arthritis, also helps prevent the return of bursitis.