THE HAND AND WRIST® INSTITUTE
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What is Olecranon Bursitis and How is it Treated?

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Hidden beneath the skin at the tip of the elbow is a small, fluid-filled sac known as the olecranon bursa. You may never know it’s there until it becomes infected or inflamed. When this happens, this tiny sac can become extremely painful, making it difficult to perform daily activities.

Understanding the nature of olecranon bursitis and how to recognize the symptoms is key for diagnosing and managing this often painful condition. In this article, our experts at the Hand and Wrist Institute in Dallas explore what olecranon bursitis is, what the symptoms are, the common treatment methods, and when to seek medical attention.

What Is Olecranon Bursitis?

Person sitting with their elbows resting on their knees

Olecranon bursitis is a fairly common elbow condition where a small fluid-filled sac located at the tip of the elbow, known as the olecranon bursa, becomes inflamed. The bursa acts as a cushion between the skin and the bony part of the elbow and allows for smooth movement.

When the bursa becomes inflamed, it causes swelling, tenderness, and occasionally pain at the back of the elbow. In some cases, the swelling can grow significantly, causing a noticeable lump or a feeling of fullness at the elbow joint. This condition can be caused by various factors, such as trauma, repetitive pressure or strain on the elbow, an infection, or even an underlying medical condition such as arthritis.

What Are the Symptoms of Olecranon Bursitis?

The symptoms of olecranon bursitis typically include the following:

  • **Swelling:**Visible swelling at the back of the elbow is a key symptom. You may notice that the affected area seems enlarged, feels tender to the touch, or forms a noticeable lump.
  • **Pain or tenderness:**Discomfort or tenderness at the tip of the elbow, particularly when you apply pressure or move the elbow. In some cases, the condition may not cause significant pain.
  • **Limited range of motion:**The swelling and tenderness can restrict your elbow’s range of motion. This can make it difficult to bend or fully extend the arm.
  • **Redness or warmth:**If your bursitis has become infected, you may notice signs of redness, warmth, or even pus draining from the site. This tells you that you have an underlying infection.
  • **Difficulty using the elbow:**You may find it uncomfortable to rest or leanon the affected elbow due to the swelling and tenderness.

These symptoms can vary in severity from mild discomfort to more pronounced swelling and pain, depending on the underlying cause and the extent of inflammation in the bursa.

How Is Olecranon Diagnosed?

In most cases, our Dallas hand and wrist specialists can diagnose olecranon bursitis with a physical examination. However, we may rely on diagnostic tests to rule out any other potential causes or to diagnose an infection. We may perform an X-ray, ultrasound, or MRI, and take fluid samples or conduct blood tests.

How Is Olecranon Bursitis Treated?

Treatment for olecranon bursitis varies from at-home treatment for mild cases to in-clinic treatment for moderate to severe cases. Treatment aims to reduce inflammation, manage pain, and address any underlying causes. At the Hand and Wrist Institute in Dallas, common treatment methods include:

  • **Rest and immobilization:**Minimize movement of the elbow to reduce irritation. We may recommend using a brace or splint to restrict movement while it heals.
  • **Elevation:**Keeping the affected elbow at or above the height of the heart can help reduce blood flow to the area. This can help reduce inflammation and any associated discomfort.
  • Ice therapy: Applying ice packs to the affected area can help reduce swelling and pain. Wrap the ice in a cloth and apply it to the elbow for about 15-20 minutes several times daily.
  • **Anti-inflammatory medications:**Nonsteroidal anti-inflammatory drugs, better known as NSAIDs, such as ibuprofen or naproxen can help reduce inflammation and relieve pain.
  • Aspiration: In severe cases when you have significant swelling, we may need to drain excess fluid from the bursa using a needle and syringe. This can help reduce your discomfort and bring the swelling down.
  • **Steroid injections:**Injecting corticosteroids into the bursa can help reduce inflammation and provide relief, especially when conservative treatments are not proving to be effective.
  • **Antibiotics (if needed):**If the bursitis is caused by an infection, we may prescribe antibiotics to treat the underlying bacterial infection.
  • **Rest:**Minimize any activities that put pressure on your elbow or cause friction, which can aggravate the bursa and make the symptoms worse.
  • **Physical therapy:**After the acute phase, we may recommend exercises to strengthen the muscles around the elbow and improve the range of motion.

Surgery

In cases where at-home or in-clinic treatments are not able to provide relief or if the condition is recurring or chronic, we may consider surgical intervention to remove the bursa. However, surgery is usually a last resort when other less invasive treatments have been ineffective or in the case of septic elbow bursitis. We may perform one or more of the following procedures:

  • **Incision and drainage:**We make an incision into the inflamed bursa to drain any fluids. This procedure is usually performed when we suspect septic bursitis and if aspiration is not possible.
  • Bursectomy: We drain and then remove the bursa. Keep in mind that a new bursa will usually grow back in place of the one that was removed a few months after surgery, so it’s important to continue to protect the elbow.
  • Osteotomy: Bone spurs are common in patients over 50 years old and are not a cause for concern. However, bone spurs in the elbow may irritate the bursa and cause bursitis. We may perform an osteotomy alone to remove the bone spurs or alongside a drainage or bursectomy procedure.

When To Seek Medical Attention

If you’re experiencing intense pain or excessive swelling, or your elbow is suddenly getting larger, seek immediate medical attention as soon as possible. This can help determine the underlying cause of the symptoms and ensure that you receive suitable treatment to alleviate pain, reduce swelling, and prevent potential complications associated with olecranon bursitis. Have you noticed any symptoms affecting your elbow? Contact us today to book an appointment. Our Dallas hand surgeons can provide an accurate diagnosis and treatment plan, getting you on the road to recovery.

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