Elbow Bursitis

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What is elbow bursitis?

Your elbow is a hinge joint, joining the bone in your upper arm to the bones in your lower arm. At the back of your elbow is the olecranon, the pointy part of your elbow. It is covered by the olecranon bursa—a thin, fluid-filled sac that allows your skin to move smoothly over your elbow as you bend and straighten your arm. Given how many times a day you do this action, the bursa plays an important role in the smooth function of your elbow. However, the bursa can become irritated and inflamed (swollen), causing elbow bursitis. Some people refer to bursitis in the elbow as ‘water on the elbow,’ but the medical term is olecranon bursitis.

Fluid on the elbow causing bursitis can be quite painful and affect your quality of life. Increasing pain can become physically limiting. Infectious bursitis can spread to other areas when left untreated. Elbow bursitis treatment from all causes is effective in most cases. Seeking help when bursitis symptoms first appear may help relieve the pain and reverse the irritation and inflammation in your elbow.

What are the symptoms of elbow bursitis?

The symptoms of elbow bursitis are restricted to the elbow. The most common symptoms are:

  • Swelling at the back of the elbow, although you may not notice it at first

  • Pain at the back of the elbow, made worse with bending, touching, or applying pressure to the elbow

  • Redness and warmth if bursitis is caused by an infection. There may also be fever and a visible sore or lesion on the skin—the entry point of infection.

If elbow swelling becomes severe, you may find it difficult to move your elbow.

Elbow bursitis is not usually a medical emergency, however, if you experience symptoms of an infection, immediate medical care is absolutely necessary to prevent the infection from getting worse. If there is no reason to believe you have an infection but the symptoms are worsening or not going away, consult with your doctor for an evaluation of your elbow. Your primary care doctor can make an accurate diagnosis (after ruling out other possible elbow injuries), and suggest treatment to ease the inflammation and pain. You may need to see an orthopedic specialist for complex or chronic bursitis.

What causes bursitis of the elbow?

There are several causes of elbow bursitis and some are preventable, but sometimes the cause is never known. Possible causes of elbow bursitis include:

  • Repetitive or prolonged pressure on your elbow such as leaning on a desk

  • Repetitive motions such as throwing a baseball

  • Infections (septic bursitis)

  • Trauma such as from a car or bike accident

  • Medical conditions, such as osteoarthritis, rheumatoid arthritis, or gout

What are the risk factors for elbow bursitis?

Bursitis of the elbow becomes more common as people age, particularly if they have any form of arthritis. People who constantly bend their elbow to perform an activity, such as an electrician who must work in a confined space or athletes who put a lot of force on their elbow, are also at risk for elbow bursitis. Not surprisingly, people who sit at desks for long periods, such as students or office workers, may be at risk for inflammation if they have a habit of leaning on an elbow.

Reducing your risk of elbow bursitis

You may be able to lower your risk of elbow bursitis by:

  • Maintaining good body mechanics and not leaning on your elbow

  • Wearing a protective brace or wrapping on your elbow if you must bend it frequently

  • Taking breaks during repetitive tasks involving your elbow

  • Monitor for infection if you have a cut or wound on your elbow, particularly over the bony part

 If you believe you are at risk for developing elbow bursitis, particularly due to a repetitive activity, speak with your doctor about measures you may take to help reduce that risk. Following your treatment plan if you have a condition (such as arthritis) that could put you at risk for developing elbow bursitis can also reduce your risk.

If you believe you have an infection, see your doctor as soon as possible. You may need antibiotics to eliminate the infection and keep it from spreading further.

How is elbow bursitis treated?

Olecranon bursitis treatment for symptoms not caused by an infection may include RICE:

Rest: Limit the use of your elbow, which gives the tissues a little R & R.

Ice: Apply ice packs to the affected part of your elbow for 20 minutes at a time, at least every two hours.

Compression: Apply a compression bandage or wrap around your elbow, but don’t cut off blood flow or compress nerves. The bandage is too tight if your hand and fingers turn blue or you experience numbness.

Elevation: Elevate your arm above your heart to reduce swelling.

Other measures include:

  • Elbow pads if you must rest your elbow on a hard surface. Elbow pads can protect them from pressure on the bursa.

  • Medications, such as nonsteroidal anti-inflammatories (NSAIDs), may help reduce elbow swelling and pain. Follow the directions on the packaging for over-the-counter NSAIDs or ask your doctor specifically how much medicine to take and for how long.

  • Tetanus shot (tetanus booster) in case of an open wound to prevent tetanus infection

  • Reduce or eliminate the activity triggering inflammation.

  • Splint or brace your elbow as you perform repetitive tasks.

If these measures don’t help relieve your pain or the pain comes back after initial improvement, your doctor may recommend removing some of the fluid in the bursa. This procedure is called aspiration. Your doctor inserts a needle into the bursa and uses a syringe to withdraw some of the fluid. Your doctor may also choose to inject a corticosteroid directly into the bursa to relieve pain and swelling. This can be done at the same time as aspiration.

Antibiotics are necessary if you have a bacterial infection. If your doctor is uncertain which antibiotic to prescribe, a sample of aspirated fluid may be sent to a test lab for analysis.

Surgery for elbow bursitis is not common but may be necessary if elbow bursitis treatment does not relieve swelling and symptoms, or if antibiotics do not effectively treat the infected bursa. In both cases, your doctor would make an incision in the skin at the back of your elbow and remove the bursa completely. This is a bursectomy, usually performed with local anesthesia. You may need to wear a splint for a short while after the surgery to protect the area as your incision heals. Full recovery and use of your elbow generally takes 3 to 4 weeks after surgery. A new bursa will regrow after a few months.

What are the potential complications of elbow bursitis?

Untreated elbow bursitis can worsen, causing more swelling and pain and affecting the range of motion in your elbow. Infectious bursitis can worsen and spread to nearby tissues or develop into a life-threatening condition called sepsis. Professional medical care is essential for infectious bursitis.

There may be some complications related to elbow bursitis treatment. Bleeding or bruising is a minor complication of needle aspiration. There is also a risk of infection. Surgery also carries a risk of infection, as well as increased pain, bleeding, and blood clots. Talk with your doctor about the risks and benefits of all your treatment options.

Aseptic elbow bursitis (bursitis not caused by an infection) can often be treated at home just by changing your activities and allowing your elbow to heal. However, if your symptoms are not improving or you develop symptoms of an infection, seek medical help to reduce your risk of complications.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 21
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