If you are affected by bursitis in the elbow (bursitis olecrani, ICD M70.3), you will most likely find it very painful. The bursa, which acts as a cushion between the bone and skin, swells considerably and causes feelings of tension and tenderness.
You can find out below which doctor treats bursitis in the elbow and what the treatment looks like
A bursa is the sheath that surrounds each joint and is filled with mucus. The sheath consists of mucous membrane, which constantly produces (= secretes) and absorbs (soaks up) synovial fluid.
In joints with a large range of motion, such as the hip or shoulder joint, the skin of the bursa is very wide, creating a real sac. This ensures that the large range of motion of the joint is maintained. In the event of prolonged rest, for example after a shoulder injury, the bursa shrinks very quickly, which can subsequently cause major problems with mobility. The bursa fulfills the following tasks:
One of the causes of pain in elbow bursitis is the increased production of synovial fluid. The body combats overloading of the joint or inflammation by increasing blood circulation. The area heats up and reddens. If bacteria are the cause of the inflammation, pus can also form.
As a rule, bursitis develops as a reaction of the body to prolonged overloading, an injury or a bacterial infection. In rarer cases, underlying diseases can also trigger the inflammation.
The bursa swells up considerably and feels thick and elastic. There is clear discomfort with a high sensitivity to touch and a feeling of tension. The area of the bursa reacts extremely unpleasantly to pressure. The pain is sudden and intense. The affected area is often overheated and reddened, and the joint is restricted in its movements. In rare cases, the inflammation also spreads beyond the elbow and can lead to swelling of the lymph nodes in the armpit or reddening of the hands. General inflammatory symptoms such as fever and chills can also occur.
Bursitis of the elbow is generally a visual diagnosis. This means that the diagnosis can be made solely on the basis of the externally visible combination of redness, swelling, restricted movement and pain in the area of the diseased bursa.
Careful diagnosis also involves taking a medical history, i.e. asking the patient about their movement habits, previous illnesses and exact complaints. The medical history is also used to identify or rule out other illnesses in order to decide on the right treatment approach.
During the physical examination, the painful area of the elbow is palpated and the mobility and range of motion of the joint are checked. In most cases, the diagnosis of bursitis can be confirmed by the presence of the classic symptoms and the typical palpation findings.
In some cases, additional examinations are necessary, such as an ultrasound or X-ray examination. In an ultrasound examination, the bursa appears as a pocket filled with fluid. If the bursa has thickened edges, this may be a sign of long-standing bursitis.
If there is evidence of a purulent inflammation, a puncture is usually performed to confirm or rule out the suspicion of a bacterial infection. As germs can be introduced into the bursa from outside with every puncture, the indication for this should be extremely critical.
Treatment depends on the cause of the disease. Treatment involves the administration of painkillers and anti-inflammatories, cooling compresses and possibly antibiotics. Short-term immobilization of the joint with a splint or tape is often indicated. Rest and cooling are important.
In some cases, surgical removal of the bursa is also necessary. However, this is extremely rare. Indications for the removal of a bursa include open wounds or exposed contents of the bursa.
Acute bursitis can also develop into a chronic form, but it can generally be treated well. In most cases, the earlier the treatment begins, the faster the symptoms disappear. A visit to the doctor is advisable, especially if the symptoms are severe.
Pain-relieving and anti-inflammatory medication is prescribed for acute inflammation. Mild painkillers such as ibuprofen or diclofenac (Voltaren®) are often sufficient. Depending on how intense the pain is, a local anesthetic may be injected into the joint. Cortisone preparations can also be used to treat severe pain. In the case of a bacterial infection, antibiotics are used to prevent blood poisoning, among other things.
A compress or bandage with a cooling and pain-relieving ointment or tincture almost always helps to relieve pain, reduce inflammation and reduce swelling of the bursa. Temporary immobilization of the affected joint can also help to reduce swelling and alleviate pain. For this reason, the elbow joint is almost invariably immobilized temporarily using a splint or tape.
The arm should not be loaded if possible. When taping, the special functional bandage ensures that the joint and muscles are not completely immobilized, but only that unwanted movements are prevented. Immobilization should therefore be as long as necessary but as short as possible.
It is important that the swelling and pain decrease significantly during immobilization. It is then advisable to resume movement and weight bearing quickly. Otherwise, both the bursa and the joint capsule may shrink, which can ultimately lead to a reduction in the mobility of the joint.
If conservative measures, i.e. medication and dressings, are unsuccessful, invasive measures may be necessary. This includes all procedures in which the body is "invaded" with injections, catheters or surgery.
Initially, a puncture may also be indicated to relieve the swelling. If this is not sufficient or if there is an open wound, surgery may be necessary to remove the bursa. However, this is only indicated in rare cases.
If the disease does not heal, chronic bursitis develops. This is the case if the bursitis lasts longer than three to six weeks. In these cases, surgical removal of the bursa (extirpation) is often recommended; this is a minor surgical procedure. The joint must then be immobilized. Lymphatic drainage may be necessary.
If acute bursitis in the elbow is treated in good time, it usually heals quickly. The symptoms usually last for a few weeks, after which they generally disappear. However, if the affected area of the body continues to be subjected to excessive strain, bursitis can develop again. In the long term, bursitis in the elbow can then take on a chronic course .
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