Olecranon bursitis is inflammation of a small sac of fluid located on the tip of the elbow. This inflammation can cause many problems in the elbow.
Where is the olecranon bursa, and what does it do?
A bursa is a sac made of thin, slippery tissue. Bursae occur in the body wherever skin, muscles, or tendons need to slide over bone. Bursae are lubricated with a small amount of fluid inside that helps reduce friction from the sliding parts.
The olecranon bursa is located between the tip, or point, of the elbow (called the olecranon) and the overlying skin. This bursa allows the elbow to bend and straighten freely underneath the skin.
How does olecranon bursitis develop?
Bursitis is the inflammation of a bursa. The olecranon bursa can become irritated and inflamed in a number of ways.
In some cases, a direct blow or a fall onto the elbow can damage the bursa. This usually causes bleeding into the bursa sac, because the blood vessels in the tissues that make up the bursa are damaged and torn. In the skin this would simply form a bruise, but in a bursa blood may actually fill the bursa sac. This causes the bursa to swell up like a rubber balloon filled with water.
The walls of the bursa may thicken and remain thickened and tender even after the blood has been absorbed by the body. This thickening and swelling of the bursa is referred to as olecranon bursitis.
Olecranon bursitis can also occur over a longer period of time. People who constantly put
their elbows on a hard surface as part of their activities or job can repeatedly injure the bursa. This repeated injury can lead to irritation and thickening of the bursa over time. The chronic irritation leads to the same condition in the end: olecranon bursitis.
The olecranon bursa can also become infected. This may occur without any warning, or it may be caused by a small injury and infection of the skin over the bursa that spreads down into the bursa. In this case, instead of blood or inflammatory fluid in the bursa, it becomes filled with pus. The area around the bursa becomes hot, red, and very tender.
What does olecranon bursitis feel like?
Olecranon bursitis causes pain and swelling in the area at the tip of the elbow. It may be very difficult to put the elbow down on a surface due to the tenderness. If the condition has been present for some time, small lumps may be felt underneath the skin over the olecranon. Sometimes these lumps feel as though some- thing is floating around in the olecranon bursa, and they can be very tender. These lumps are usually the thickened folds of bursa tissue that have formed in response to chronic inflammation.
How do doctors identify the condition?
The diagnosis of olecranon bursitis is usually obvious from the physical examination. In cases where the elbow swells immediately after a fall or other injury to the elbow, X-rays may be necessary to make sure that the elbow isn’t fractured. Usually chronic olecranon bursitis is also easy to diagnose without any special tests.
If your doctor is uncertain whether or not the bursa is infected, a needle may be inserted into the bursa and the fluid removed. This fluid will be sent to a lab for tests. The results are used to determine whether infection is present. If so, the type of bacteria that is causing the infection is identified. Your doctor will use this informa- tion to know what antibiotic will work best to cure the infection.
What can be done for olecranon bursitis?
- Olecranon bursitisthat is caused by an injury will usually go away on its own. The body will absorb the blood in the bursa over several weeks, and the bursa should return to normal. If swelling in the bursa is causing a slow recovery, a needle may be inserted to drain the blood and speed up the process. There is a slight risk of infection in putting a needle into the bursa.
- Chronic olecranon bursitisis sometimes a real nuisance. The swelling and tenderness get in the way and causes pain. This can create a hardship both at work and during recreational activities. Treatment usually starts by trying to control the inflammation. This may include;
- Rest for a short period.
- Medications such as ibuprofen and aspirin may be suggested by your doctor to control the inflammation and swelling.
- Fine Needle Aspiration if the bursa remains filled with fluid, a needle can be inserted and the fluid drained. During the drainage procedure, if there is no evidence of infection, a small amount of cortisone can be injected into the bursa to control the inflammation. Again, there is a small risk of infection if the bursa is drained with a needle.
- Alternating heat and ice can help calm pain and swelling
- Ultrasound to help calm pain and swelling
- Occupations tips and strategies to avoid repetitive elbow motion and to do your activities without putting extra pressure on your elbows.