Elbow bursitis, also known as olecranon bursitis, is treated by a range of medical professionals, from general practitioners to specialized surgeons. This condition involves the inflammation of the bursa, a small, fluid-filled sac located at the tip of the elbow that cushions the bone and skin. When the sac becomes irritated, often due to trauma, prolonged pressure, or infection, it fills with excess fluid. This results in noticeable swelling and pain. Effective treatment ranges from simple conservative measures to more involved medical or surgical interventions.
Initial Medical Contact and Diagnosis
The first step in treating elbow bursitis typically involves seeing a primary care physician (PCP) or family doctor. They perform the initial assessment and begin conservative management. PCPs are skilled in differentiating olecranon bursitis from other conditions, such as a fracture or cellulitis. For non-infectious cases, initial treatment often includes rest, ice, compression, and elevation (RICE), along with nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling.
Patients may seek care at an urgent care clinic or emergency room if swelling is rapid or accompanied by signs of infection, such as redness, warmth, or fever. In these settings, the immediate concern is ruling out septic bursitis, a bacterial infection. If infection is suspected, the clinician performs a bursal aspiration, withdrawing fluid for laboratory testing, including a cell count and culture. If analysis confirms a bacterial infection, the doctor starts the patient on antibiotic therapy, sometimes for a course of at least 14 days. Repeat aspirations may be performed if the fluid reaccumulates.
Specialists Focused on Definitive Treatment
If conservative treatment fails, or if the case is chronic or complex, the patient is often referred to a specialist, most commonly an orthopedic surgeon. Orthopedic surgeons are experts in musculoskeletal conditions and frequently perform in-office procedures for non-septic bursitis that does not resolve with initial measures. These procedures include a sterile aspiration of the bursa fluid, often followed by a corticosteroid injection directly into the sac to reduce inflammation. However, this injection carries a small risk of introducing infection.
Surgical intervention, known as a bursectomy, is reserved for chronic, recurring, non-septic cases that have not responded to six to twelve months of other treatments. It is also used for severe infected bursitis that does not clear up with antibiotics. During this outpatient procedure, the surgeon removes the entire bursa sac. A new, non-inflamed bursa naturally forms over a period of a few months.
A rheumatologist is the appropriate specialist when elbow bursitis is a symptom of a broader systemic disease. These physicians specialize in inflammatory and autoimmune conditions affecting the joints, muscles, and bones. Conditions like gout or rheumatoid arthritis can cause secondary olecranon bursitis due to the underlying inflammatory process. The rheumatologist focuses on managing the systemic disease with non-surgical treatments, such as specific medications, to control the inflammation causing the flare-up.
Rehabilitation and Long-Term Recovery Providers
Following acute treatment, physical therapists (PTs) and occupational therapists (OTs) play a significant role in long-term recovery and prevention. A physical therapist develops a tailored exercise program to restore the elbow’s full range of motion, which can become limited after prolonged swelling or immobilization. They also focus on strengthening the surrounding muscles in the forearm and upper arm to provide better joint support.
Occupational therapists concentrate on functional recovery, helping the patient modify daily activities to prevent recurrence. This involves instructing the patient on proper body mechanics, recommending protective elbow pads, and making ergonomic adjustments. For complex or recurring cases, a physiatrist, specializing in physical medicine and rehabilitation, may provide consultative oversight. The physiatrist focuses on maximizing functional ability and addressing chronic pain through a comprehensive, non-surgical treatment plan.