Elbow (Olecranon) Bursitis

CONDITION

Bursae are fluid-filled sacs that serve to reduce friction between tissues that cross each other, such as where muscles and tendons slide across bone. When a bursa becomes inflamed, irritated or swollen it is called bursitis. Elbow (olecranon) bursitis happens when the bursa over the tip or back of your elbow becomes inflamed, irritated and/or swollen (Figure 1). It’s sometimes referred to as “student’s elbow” because it commonly occurs in people who spend hours leaning on the point of an elbow while studying.

Figure 1.

• Unless the bursa is infected, olecranon bursitis usually gets better over a few weeks with little treatment. Usually, your body will slowly reabsorb the excess fluid from the bursa.
• Sometimes, olecranon bursitis can be chronic and/or recurrent, especially if you have scarring or have had a lot of bleeding in the bursa.

CAUSES

Olecranon bursitis can result from:

• a direct blow to the back of the elbow
• doing something that puts prolonged or repeated pressure on the tip or back of your elbow, such as leaning on your elbow
• infection from a puncture wound or from overlying infected skin
• inflammation from a disease such as gout or rheumatoid arthritis.

SYMPTOMS AND SIGNS

• There will be swelling over the tip or back of your elbow.
• You will usually have pain where your elbow is swollen but sometimes there is swelling without pain.
• There may be mild warmth and redness over the swollen area.
• You may have problems bending or flexing your elbow because the skin over the back of the elbow hurts and/or feels tight.
• It will usually hurt if you lean on or bump the tip of your elbow.
• Sometimes, you may feel fine grinding or notice a gristle-like texture when you press on the bursa tissue with your opposite hand.
• If you have an infected bursa, there usually will be severe pain and redness, and may also have a fever or feel tired and achy like you have the flu.

WHEN TO CALL YOUR DOCTOR

Call your doctor right away (day or night) if:

• You have redness and warmth over the tip of your elbow or in the surrounding skin.
• You have a fever associated with swelling over the tip or back of your elbow, especially if your elbow is red or warm.
• You have a puncture or a cut in the skin over the swollen bursa.
• You fell on your elbow or had another injury to your elbow that caused immediate pain and swelling.
• You have problems bending or flexing your elbow or doing so causes severe pain.

Call your doctor during regular office hours if you have the following symptoms that don’t improve with two or three weeks of self-care:

• swelling over the tip or back of your elbow that does not occur along with a fever or significant redness or warmth
• mild-to-moderate pain over the tip of your elbow that developed slowly and not after a fall or other injury
• painless swelling over the tip of your elbow that does not get better after two or three weeks of self-care.

SELF-CARE AT HOME

• Avoid prolonged pressure or leaning on the tip of your elbow.
• Avoid further injury, even minimal bumping, to the back or tip of your elbow.
• Use a soft elbow pad to cushion and protect the back of the elbow. The compression from wearing the elbow pad may prevent further swelling and help resolve the swelling you have.
  • You can usually find elbow pads at sporting goods stores, general merchandise retailers or online.
  • Those with a small, foam pad held in place by an elastic or cloth wrap work best (Figure 2).

  Figure 2.

  • Wear the pad day and night initially, with short breaks as needed. As the swelling goes down, wear the pad only when you are likely to bump or irritate your elbow.
  • If you can’t get an elbow paid, use an elastic wrap or sleeve to compress swelling and prevent further swelling. Wear the wrap as much as you need to until the swelling goes down, but be sure not to put it on so tightly that your forearm or fingers become numb or discolored.
• You may take ibuprofen (Advil®, Motrin®) or naproxen (Aleve®) for swelling and pain. (See labels for dose and risks.)
• Place an ice pack or cold pack over the back of your elbow for 20 minutes, three to six times daily to decrease pain and swelling. You may hold it in place with an elastic wrap.
  • Place a thin washcloth between the cold pack and your skin to minimize the risk of frostbite.
  • If you are busy, you may choose to ice during meals so as to save time and avoid interrupting other activities.

PREVENTION

• Avoid prolonged pressure or repeated leaning on the tip of your elbow.
• Use a small foam pad if you need to lean on the tip of your elbows frequently.