The olecranon bursa, a flat, slippery sac between the loose skin and the bones of the elbow, is located at the tip of the elbow. The bursa allows the skin to move freely over the underlying bone. A condition known as bursitis develops if the bursa becomes irritated or inflamed.
Swelling is often the first symptom. The skin on the back of the elbow is loose, which means that a small amount of swelling may not be noticed right away. As the swelling continues, the bursa grows and causes pain as the bursa is stretched, because the bursa contains nerve endings. The swelling may grow large enough to restrict motion of the elbow.
If the bursitis 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 and can cause serious illness.
Elbow bursitis can occur for a number of reasons.
Trauma: A hard blow to the tip of the elbow could cause the bursa to produce excess fluid and begin to 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 would develop over several months.
Infection: If the tip of the elbow has an injury that breaks the skin, such as an insect bite or a scrape, bacteria may get inside the bursa and cause an infection. The infected bursa produces redness, fluid, and swelling.
Medical Conditions: Certain conditions such as rheumatoid arthritis and gout are associated with the development of elbow bursitis.
If your SBO hand surgeon suspects that bursitis is due to an infection, he may remove fluid (aspirate) from the swollen area. Fluid removal helps relieve symptoms and provides a sample that can be looked at in a laboratory to identify if any bacteria are growing. This also lets your doctor know if a specific antibiotic is needed to fight the infection.
If the bursitis is not from an infection, there are a number of treatment options:
- Elevate the elbow and apply ice.
- An elbow pad may be used to cushion the elbow.
- Direct pressure to the swollen elbow should be avoided.
- Oral medications such as ibuprofen or other anti-inflammatories may also be used.
If swelling and pain do not respond to these measures, the doctor may recommend removing fluid from the bursa and inject a corticosteroid medication into the bursa. If the bursa is infected and it does not improve with antibiotics or by removing fluid from the elbow, surgery may be needed.
Physical therapy after surgery is not always needed. Postoperative casting or prolonged immobilization is not typically required.