A 57 year old male patient came to our clinic with a chief complaint of localized aching pain on right elbow in a scale of 5/10 and had been experiencing for the last four weeks. Symptoms are worse upon elbow flexion and direct pressure. There was no reported trauma that might have been the cause. Focal swelling was also noted around the elbow, specifically around the olecranon bursae. Based on the assessment and examinations made, patient is suffering from olecranon bursitis.
Elbow or olecranon bursitis can occur for a number of reasons.
- Prolonged pressure: Leaning on the tip of the elbow for long periods of time on hard surfaces.
- Medical conditions: Certain conditions, such as rheumatoid arthritis and gout, are associated with elbow bursitis.
Medications are used in cases of olecranon bursitis primarily to decrease pain and inflammation. Thus, the most commonly used medications are oral NSAIDs and if very painful or persistent, focal corticosteroid injection; in conjunction with the rest of the rehabilitation plan. Physical therapy modalities (phonophoresis, electrical stimulation) also may be helpful in further reducing pain and inflammation, although this may even resolve in time alone. Individuals are also advised to apply the RICE (rest, ice, compression, elevation) method of treatment. As well as avoiding activities that cause direct pressure to the elbow.
On same cases, if a bursitis is due to an infection, he or she may recommend aspirating (removing the fluid from) the bursa with a needle. If it does not improve with antibiotics or by removing fluid from the elbow, surgery to remove the entire bursa may be needed.
One of our patients has been taking some oral NSAIDs and physical therapy sessions to speed up his recovery. After two treatments there was no pain upon palpation, direct pressure or any elbow movements. Swelling has gone down with little residual swelling.
Monica Laine DG. Gonzales, PTRP