In this article we provide everything you need to know about elbow bursitis and the most effective ways to treat the condition.
The Elbow Bursa or the Olecranon Bursa is a sac of fluid found in the elbow behind the Olecranon bone. The Olecranon bone is the bony prominence of the ulna, which is the long bone at the back of the elbow. The primary function of the elbow bursa is to allow smooth gliding of the olecranon bone along with the soft tissues as the individual flexes or extense their elbow. When this bursa gets inflamed, it is known as Olecranon Bursitis. As this bursa is located superficially, it is more susceptible to trauma or injury caused by direct pressure. This condition may also be referred to as tennis elbow, student’s elbow, Popeye elbow, or plumbers elbow. (1) (2) (3)
Common Causes of elbow bursitis?
Infection usually causes Olecranon Bursitis, hard blow, overuse, or elbow smashing across a hard surface. When the bursa is exposed to an injury or trauma, it can release inflammatory mediators in the body; the inflamed bursa also has a higher chance of recurrence.
The medical conditions and lifestyle choices that may increase the risk of Olecranon Bursitis include rheumatoid arthritis, Gout, Diabetes, Alcohol Use, HIV, and Psoriatic Arthritis. The infectious causes for elbow bursitis usually spread through a transcutaneous route, rather than being spread by blood Moreover the infected bursa are secondary to trauma to the skin surface, through which the pathogen gets inoculated. (4)
The Symptoms of Olecranon Bursitis
The common symptoms associated with Olecranon Bursitis include elbow pain radiating to the back of the elbow, pain radiation to the tip of the elbow, limited range of motion due to joint pain, and increasing swelling over the period of time. The appearance of the bursa in the elbow joint is usually golf-shaped due to the accumulated fluid. In the case of septic bursitis, the individual may experience redness and tenderness over the ligaments and affected bursa. Systemic spread of the infection may also lead to fever. (5) (6)
The health professionals and experts belonging to the specialty of orthopaedics may diagnose the Olecranon Bursitis by conducting a detailed medical history and physical examination. The differentiation between infection and non-infectious forms of Bursitis may be made using imaging modalities like X-rays or blood tests. However, the gold standard for Olecranon Bursitis includes Bursal Analysis and Aspiration studies. This is particularly important for septal Bursitis. When the fluid is extracted from the bursa, it is sent to the lab to rule out the risk of infection. This is done by conducting gram stain cultures, cell counts, sensitivity tests, and crystal examinations. (7)
Treatment Options for Olecranon Bursitis
The treatment options for elbow bursitis are planned according to the nature of the condition –infectious or non-infectious. The healthcare professionals may start by recommending over-the-counter anti-inflammatory medication, including NSAIDs like Ibuprofen, icepacks, splints, elbow pads, physical therapy, topical anaesthetics, and steroid injections. The acute cases of Bursitis are usually self-limiting and may be managed by only practicing adequate rest and icing the affected area. In the cases of swelling, which is interfering with the individual’s range of motion, they may also be recommended Elastic Bandages. Moreover, while corticosteroid injections may be recommended for their ability to cause efficient relief from symptoms, They may also prove to be a cause of infection transmission. However, conservative therapy may not be effective for everyone. Individuals with persistent severe symptoms that last for more than six months may require surgery by an orthopaedic surgeon. The most commonly recommended surgical procedure for these patients includes Bursectomy, which is conducted to remove any bone spurs present – promoting its recurrence. (8) (9)
Frequently Asked Questions
How long does elbow bursitis take to heal?
The majority of the cases of Elbow Bursitis are usually resolved by rest and self-care due to their self-limiting nature. The time it usually takes for Elbow Bursitis to heal using at-home remedies like icing is between three weeks to six weeks. However, as seen in septic bursitis, individuals with infection may require antibiotics to see improvements in their symptoms. These improvements may be seen once the entire course of antibiotics as recommended by the doctor is completed.
What happens if Bursitis is left untreated?
Even though Bursitis is considered self-limiting in most cases and may improve by taking adequate rest and icing the affected area – some cases may become chronic. These cases of Chronic Bursitis are often associated with thickening of the bursa lining, enlargement of the bursa, constant pain in movement, and limited range of movement. The limited range of movement may eventually lead to muscle atrophy of the affected arm, severely interfering with an individual ability to carry out physical activity and everyday functions.
What can be mistaken for Bursitis?
Bursitis of the elbow may be mistaken for several conditions, including gouty arthritis, ligament rupture, elbow fracture, tendon rupture, olecranon fracture, cellulitis, cutaneous abscess neoplasm, and other causes that may cause swelling and tenderness of the elbow. (10)
What does Bursitis in the elbow feel like?
Bursitis of the elbow is associated with swelling, which is also among the first signs of this condition. This swelling due to the build-up of fluid in the bursa eventually leads to its stretching, which may lead to significant pain. Moreover, this pain is described to worsen every time the individual flexes or extends their arm.