The type of treatment required depends on whether the bursa is septic (caused by infection) or aseptic (not caused by infection). In most cases aseptic bursitis can be treated conservatively following self care advice.
R.I.C.E. Protocol. This stands for Rest, Ice, Compression and Elevation. The treatment protocol is often used when swelling is present.
- Rest: individuals with olecranon bursitis should avoid partaking in activities that will aggravate the bursa. These include leaning on or putting weight onto the elbow.
- Ice: the use of a cold compress applied over the swollen elbow for 10-20 minute periods a few times a day can help reduce symptoms of olecranon bursitis.
- Compression: the use of an elastic compression bandage can be used and wrapped around the elbow joint to help control the swelling.
- Elevation: lifting the affected elbow joint above the height of the heart helps to reduce blood flow to the elbow joint. In turn this helps to reduce inflammation.
Non-steroidal anti-inflammatory medication. Also known as NSAIDs, this type of medication is used to help with reducing inflammation and pain. Examples include over the counter ibuprofen and prescribed naproxen. Your doctor may also prescribe you with a medication that helps protect the lining of your stomach as NSAIDs can cause gastrointestinal problems and irritation to the stomach lining. This is also another reason why it is not recommended to take NSAIDS for an extended period of time. Always speak to your doctor before taking new medication.
Antibiotics: In cases of septic bursitis then a course of antibiotics will be prescribed to help get rid of the infection.
Aspiration. As mentioned above, aspiration of the swollen bursa is used as a medical diagnostic tool. This procedure can also be used in the medical management of olecranon bursitis. This procedure uses a needle and syringe to remove all of the excess fluid within the bursa.
Corticosteroid injection. Corticosteroid is a very powerful antiinflammatory medication and is used to help reduce pain and inflammation. During this procedure the skin around the elbow joint is numbed and a needle is inserted directly into olecranon bursa using ultrasound to guide the needle. Corticosteroid is then injected into the bursa.
Within the NICE guidelines if treatment sought through primary care has not been successful after 2 months then referral to other services is made. In some cases this may be to the surgical team. However this is very rare. There are a few different surgical procedures that may be discussed with you in terms of the best treatment for the condition. These procedures may include:
Incision and drainage: during this surgical procedure a small incision is made into the bursa and the contents of the bursa is drained.
Bursectomy: in this procedure the inflamed bursa is drained and then completely removed. Protection of the elbow after the surgery is required. This is due to several months following this procedure a new bursa will start to grow back in place of the old one (aren’t bodies amazing!).