Elbow (Olecranon) Bursitis
A bursa is a thin layer of tissue or sac between bone and soft tissue, such as skin. It is usually filled with a small amount of fluid to allow smooth movement between the bone and the soft tissue. In the elbow, there is a bursa right at the very tip. The bursa usually is relatively thin, but if there is injury or irritation, more fluid may develop, causing the appearance of a swollen elbow. The elbow may also become painful; this is called bursitis.
Causes of Elbow Bursitis
There are many causes of bursitis. Trauma or direct blow to the elbow may cause inflammation and swelling. Someone who places a lot of pressure on the elbow, like plumbers, mechanics, or certain athletes, may experience bursitis from repetitive and constant action on that area of the body. Bursitis may also occur from infection. If a wound, such as an insect bite, introduces bacteria into the bursa, this may lead to swelling in the elbow. It is also possible to develop an infection without an apparent open wound. At times the bacteria may travel from another source, for example, bacteria in the bloodstream. Certain medical conditions like rheumatoid arthritis and gout may also lead to bursitis.
Swelling is usually the main symptom of bursitis. The elbow area may also be painful and tender to the touch. Redness and warmth are signs of infection. An infected bursa may open and drain with fluid or pus if left untreated.
Your medical provider will perform a physical examination on the elbow and arm. They will examine the amount of swelling, feel for the presence of fluid, and check the skin for redness or warmth.
X-rays may be ordered to evaluate fractures or joint issues such as arthritis. Bone spurs usually indicate repetitive pressure being applied to the area.
A needle may be placed in the area of swelling to draw out the fluid. The fluid may be sent for testing to check for infection, gout, or blood.
Nonsurgical forms of treatment include temporary rest, ice packs for the affected area, and anti-inflammatory medications. Needle aspiration or draining the sac using a needle may be helpful. This allows the provider to obtain a sample to send for testing to identify the cause of bursitis. The patient may also get some relief from having the fluid removed. A compressive dressing may be advised to keep the bursa from filling back up with fluid after it has been drained. Antibiotics may be given if the cause is infection.
To prevent the recurrence of bursitis, elbow pads may be recommended if direct pressure on the elbow is the source of bursitis.
Surgery may be indicated in cases of infection that does not get better with antibiotic therapy. The surgery aims to remove the fluid and the entire bursa itself. In most cases, the bursa will regenerate in a couple of months. Surgery may also be offered to patients with recurrent bursitis or cases that do not improve with conservative management.
Following the surgery, the patient may be placed in a splint for a temporary time frame to allow the soft tissues to rest and recover. The skin usually heals in about 2-3 weeks.