Elbow bursitis occurs in the olecranon bursa, a thin, fluid-filled sac that is located at the boney tip of the elbow (the olecranon).
There are many bursae located throughout the body that act as cushions between bones and soft tissues, such as skin. They contain a small amount of lubricating fluid that allows the soft tissues to move freely over the underlying bone.
Normally, the olecranon bursa is flat. If it becomes irritated or inflamed, more fluid will accumulate in the bursa and bursitis will develop.
Swelling. The first symptom of elbow bursitis is often swelling. The skin on the back of the elbow is loose, which means that a small amount of swelling may not be noticed right away.
Pain. As the swelling continues, the bursa begins to stretch, which causes pain. The pain often worsens with direct pressure on the elbow or with bending the elbow. The swelling may grow large enough to restrict elbow motion.
Redness and warm to the touch. If the bursa is infected, the skin becomes red and warm. If the infection is not treated right away, it may spread to other parts of the arm or move into the bloodstream. This can cause serious illness. Occasionally, an infected bursa will open spontaneously and drain pus.
Elbow bursitis can occur for a number of reasons.
Trauma. A hard blow to the tip of the elbow can cause the bursa to produce excess fluid and swell.
Prolonged pressure. Leaning on the tip of the elbow for long periods of time on hard surfaces, such as a tabletop, may cause the bursa to swell. Typically, this type of bursitis develops over several months.
People in certain occupations are especially vulnerable, particularly plumbers or heating and air conditioning technicians who have to crawl on their knees in tight spaces and lean on their elbows. Certain athletic activities may also prompt the development of olecranon bursitis, such as long holds of the plank position.
Infection. If an injury at the tip of the elbow breaks the skin, such as an insect bite, scrape, or puncture wound, bacteria may get inside the bursa sac and cause an infection. The infected bursa produces fluid, redness, swelling, and pain. If the infection goes untreated, the fluid may turn to pus.
Occasionally, the bursa sac may become infected without an obvious injury to the skin.
Medical conditions. Certain conditions, such as rheumatoid arthritis and gout, are associated with elbow bursitis.
If your doctor suspects that bursitis is due to an infection, he or she may recommend aspirating (removing the fluid from) the bursa with a needle. This is commonly performed as an office procedure. Fluid removal helps relieve symptoms and gives your doctor a sample that can be looked at in a laboratory to identify if any bacteria are present. This also lets your doctor know if a specific antibiotic is needed to fight the infection.
Your doctor may prescribe antibiotics before the exact type of infection is identified. This is done to prevent the infection from progressing. The antibiotic that your doctor prescribes at this point will treat a number of possible infections.
If the bursitis is not from an infection, there are several management options.
An elbow pad may be used to cushion your elbow.
Avoid activities that cause direct pressure to your swollen elbow.
Oral medications such as ibuprofen or other anti-inflammatories may be used to reduce swelling and relieve your symptoms.
If swelling and pain do not respond to these measures after 3 to 6 weeks, your doctor may recommend removing fluid from the bursa and injecting a corticosteroid medication into the bursa. The steroid medication is an anti-inflammatory drug that is stronger than the medication that can be taken by mouth. In some patients, corticosteroid injections work well to relieve pain and swelling. However, some patients do not have any relief of symptoms with corticosteroid injections.
Surgery for an infected bursa. If the bursa is infected and it does not improve with antibiotics or by removing fluid from the elbow, surgery to remove the entire bursa may be needed. This surgery may be combined with further use of oral or intravenous antibiotics. The bursa usually grows back as a non-inflamed, normally functioning bursa over a period of several months.
Surgery for the noninfected bursa. If elbow bursitis is not a result of infection, surgery may still be recommended if nonsurgical treatments do not work. In this case, surgery to remove the bursa is usually performed as an outpatient procedure. The surgery does not disturb any muscle, ligament, or joint structures.
Your doctor will apply a splint to your arm after the procedure to protect your skin. In most cases, casts or prolonged immobilization are not necessary.
Although formal physical therapy after surgery is not usually needed, your doctor will recommend specific exercises to improve your range of motion. These are typically permitted within a few days of the surgery.
Your skin should be well healed within 12 to 16 days after the surgery, and after 3 to 4 weeks, your doctor may allow you to fully use your elbow. Your elbow may need to be padded or protected for several months to prevent reinjury.
CONTACTING DR. PERLMUTTER
Texting is preferred by Dr. Perlmutter for communication (717-836-6833). Please contact him ASAP, should you have any concerns whatsoever. Many patients fail to contact Dr. Perlmutter when they should have because they are "afraid of bothering him." This is a potentially dangerous attitude and Dr. Perlmutter will always welcome every opportunity to make his patients feel more comfortable. Please feel comfortable sending photographs to add perspective to your questions. Please turn on your flash, aim directly at the body part that you wish to show, and use an evenly colored, dark, and non-reflective background.
If you cannot text, you may call Dr. Perlmutter, however, you must use a confirmed caller ID unblocked telephone or he will not be able to return your call. If you need help turning off this feature you may:
1) Try pushing *82 prior to dialing, or
2) Use a different phone.
Your failure to do so will absolutely compromise your care and hurt your outcome!
If Dr. Perlmutter cannot be reached on his cell phone or by text, please contact the hospital operator to assist in reaching him or a member of his team. They can be reached at NASH: 252-962-8000. ECU Edgecombe: 252-641-7700.
IF YOU PERCEIVE AN EMERGENCY, PLEASE CALL 911 OR GO TO THE EMERGENCY ROOM ASAP.
All of the opinions expressed within the educational information delivered within the provided links are those of their authors and not necessarily those of either your treating doctor or CRO.
This site is for educational purposes only!!
Copyright Disclaimer under Section 107 of the copyright act 1976, allowance is made for fair use for purposes such as criticism, comment, news reporting, scholarship, and research. Fair use is a use permitted by copyright statutes that might otherwise be infringing. Non-profit, educational, or personal use tips the balance in favor of fair use.