Elbow Bursitis
(Olecranon Bursitis)

The olecranon bursa is a thin, fluid-filled sac located at the bony tip of the elbow (the olecranon). Its purpose is to allow the skin to glide smoothly over the underlying bone during movement. When this bursa becomes irritated, inflamed, or infected, the condition is known as olecranon bursitis — commonly referred to as “elbow bursitis.” The swelling can range from mild puffiness to a large, golf ball-sized lump at the back of the elbow.

What Causes Elbow Bursitis?

Olecranon bursitis can develop from a variety of causes, including:

• Prolonged pressure: Leaning on the elbow for extended periods on hard surfaces (sometimes called “student’s elbow” or “miner’s elbow”) can irritate the bursa over time.
• Trauma: A direct blow or fall onto the tip of the elbow can cause the bursa to produce excess fluid and swell.
• Repetitive motion: Repeated bending and extending of the elbow, especially in occupations or sports requiring these motions, can cause chronic irritation.
• Infection: A cut, scrape, or insect bite near the tip of the elbow can introduce bacteria into the bursa, causing septic bursitis — a more serious form of the condition that requires prompt medical attention.
• Medical conditions: Conditions such as rheumatoid arthritis, gout, or kidney disease requiring dialysis can increase the risk of developing bursitis.

Symptoms of Olecranon Bursitis

The most common signs and symptoms include:

• Swelling: A noticeable lump at the tip of the elbow is often the first sign. The swelling may develop gradually over time or appear suddenly after an injury.
• Pain: The elbow may be painful, especially when bending the arm, leaning on it, or applying direct pressure to the swollen area.
• Limited range of motion: Significant swelling can make it difficult to fully bend or straighten the elbow.
• Redness and warmth: If the bursa is infected, the skin over the elbow may become red, warm to the touch, and increasingly painful. Fever may also be present.

Diagnosis

Dr. Hessing will conduct a thorough physical examination of the elbow, evaluating the degree of swelling, tenderness, range of motion, and any signs of infection. Diagnostic steps may include:

• X-rays: To rule out a fracture, bone spur, or foreign body near the elbow.
• Fluid aspiration: If infection is suspected, fluid may be drawn from the bursa using a needle (aspiration) and sent to a laboratory for analysis. This helps determine whether the bursitis is caused by an infection (septic) or is non-infectious (aseptic).
• Blood tests: May be ordered if an underlying systemic condition such as gout or rheumatoid arthritis is suspected.

Treatment Options

Non-Surgical Treatment

Most cases of olecranon bursitis can be treated without surgery. Non-surgical approaches include:

• Activity modification: Avoid leaning on the elbow or placing direct pressure on the affected area. Use elbow pads or cushioning when resting the arm on hard surfaces.
• Ice: Apply ice to the swollen area for 15–20 minutes several times per day to reduce inflammation.
• Compression: An elastic bandage or elbow sleeve may help reduce swelling.
• Medication: Over-the-counter anti-inflammatory medications (such as ibuprofen or naproxen) can help manage pain and swelling. Consult with your physician before starting any medication.
• Aspiration: Excess fluid may be removed from the bursa with a needle to relieve pressure and reduce swelling. This may be combined with a corticosteroid injection to reduce inflammation.
• Antibiotics: If the bursitis is caused by an infection, antibiotics will be prescribed and are essential to prevent the infection from spreading.

Surgical Treatment

Surgery may be recommended if non-surgical treatments fail to resolve the condition, or in cases of chronic or recurrent bursitis. The surgical procedure, called a bursectomy, involves removal of the inflamed bursa through a small incision at the tip of the elbow. The body gradually regenerates a new, healthy bursa over several weeks following surgery. In cases of infected bursitis that does not respond to antibiotics and drainage, surgical removal of the bursa may be necessary.

Recovery

• Non-surgical: Most patients experience significant improvement within a few weeks of conservative treatment. The key to recovery is avoiding further irritation of the bursa by protecting the elbow from direct pressure and trauma.
• Post-surgical: After a bursectomy, patients typically wear a splint for a short period. Gradual return to normal activities is encouraged as healing progresses, usually over 3–4 weeks. Physical therapy may be recommended to restore full range of motion and strength.

When to See a Specialist

You should seek evaluation from an elbow specialist if you experience:

• A noticeable lump or swelling at the tip of the elbow that does not resolve within a few days
• Increasing pain, redness, or warmth over the elbow
• Fever or chills accompanying elbow swelling (which may indicate an infection)
• Recurrent episodes of elbow bursitis
• Difficulty bending or straightening the elbow due to swelling

If you are experiencing symptoms of olecranon bursitis, schedule an appointment with Dr. Hessing for a comprehensive evaluation. Related conditions include tennis elbow, golfer’s elbow, cubital tunnel syndrome, and elbow arthritis.