VHI’s Dr Bernadette Carr: Bursitis and Tinnitus

Since he started college this term, my 19-year-old son has been complaining of pain in his elbow. He tends to lean on his elbows and is probably doing that in lectures and when studying. The left elbow does look inflamed.

It is possible that your son has an inflammation (bursitis) of the olecranon which is a bone at the top of ulna (one of the bones in the forearm). The olecranon is the bony part of the elbow that you lean on.

The bursa, which is a small fluid filled sack that acts as a cushion between the tendons and the bones, becomes inflamed often due to repetitive movement (s). As students tend to lean on their elbows, an inflammation in this joint is known as student’s elbow. This is more common in males.

Other joints that are commonly affected are the shoulder, knee (housemaid’s knee) and the hips. In addition to repetitive movement or injury, bursitis can be caused by an infection in the bursa. The bursa can sometimes fill with extra fluid and become swollen; movement of the joint is not usually affected.

Bursitis can be treated by resting the elbow and using an ice pack to reduce the inflammation. You could suggest to your son that the changes his position at frequent intervals rather than sitting for long periods of time in the same position or use an elbow pad or compression bandage to minimise direct pressure on the swollen elbow. Painkillers such as paracetamol and ibuprofen will help to relieve the pain. The pain usually does improve within a few weeks but if there is fluid in the bursa it may take longer to go down.

As your son is experiencing pain in the joint this does need to be investigated. I would advise that he makes an appointment with his GP, who can examine the joint and advise on the most appropriate treatment.

My husband is in his 50s and has recently started to experience ringing sounds in his head. The sounds can come and go and happen in both ears and it is more noticeable at night when he is going to sleep. Could he have tinnitus or some type of ear infection?

Tinnitus is the name given to the abnormal sounds that can be heard from inside the body and may rarely be heard by others. Although most people describe the sound they hear as ‘ringing’, people can experience different sounds — buzzing, roaring, to clicking, hissing or whistling — the sounds can be in one or both ears, constant or some of the time. It is usually caused by ‘feedback’ from within the ear itself, and the noise can be more noticeable when everything is quiet, such as when in bed at night when there is no background noise to distract you.

Less commonly it can arise from an actual noise such as blood flowing.

Everyone generates this type of ‘feedback’ noise in their ears, however in some circumstances it can become much more pronounced, and for some people it can be a very distressing and debilitating problem.

There are many causes of tinnitus and these include:

* A build up of wax in the outer ear.

* Hearing loss (noise induced, age related).

* Fluid in the middle ear such as after a head cold or ear infection.

* Certain middle ear conditions.

* Injury to the head or eardrum.

* Damage to the inner ear such as after exposure to loud noise.

* Infections.

* A side effect of some medicines including certain antibiotics and aspirin.

* Tinnitus can be a feature of a number of conditions outside the ear, including anaemia, high blood pressure and over active thyroid.

* Damage, pressure or injury to the nerves of hearing system.

As your husband is experiencing these sounds regularly, it is important to visit his GP who will assess the problem, examine his ears, and advise on the most appropriate management plan for him.


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