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Elbow Bursitis Symptoms Causes Treatment Preventions & More All you need to know

December 28, 2021

Elbow or Olecranon bursitis happens when there is an inflammation of the bursa overlying the olecranon process. The olecranon process is a bony protrusion at the proximal aspect of the ulna.

The olecranon bursa is located quite superficially in close contact with skin. The skin can glide smoothly over the sharp olecranon process due to the presence of this bursa. This prevents tissue tears in the underlying tendons.

Elbow Bursitis Symptoms Causes Treatment Preventions

On the other hand, the superficial placement of the bursa makes it susceptible to inflammation due to various factors.

The leading cause lies with acute injury or repetitive trauma. Rarely, the condition may occur due to an infection; the state is then called septic bursitis. Olecranon bursitis causes the elbow to swell in the form of a lump. This makes two-thirds of the non-septic cases of elbow bursitis.

Many names know olecranon bursitis;

  • Baker's elbow
  • Elbow bump
  • Liquid elbow
  • Popeye elbow
  • Student's elbow

Anatomy of the elbow bursitis

The bony tip of the elbow is due to the olecranon process of the ulna, a bone of the forearm. A thin sac of fluid or bursa lies at the point between the elbow and the skin. The olecranon bursa makes room for the elbow, allowing it to bend and unbend freely underneath the skin.

Inflammation of this bursa causes the signs and symptoms characteristic of the elbow bump.

Causes of elbow bursitis

Some of the common causes of elbow bursitis include;

  • Direct injury or fall on the back of the elbow as hitting on a hard surface
  • Repeated trauma may cause bleeding in the bursa and invite inflammation
  • Inflammatory causes include arthritis and gout etc.

Symptoms of the olecranon bursa

The sign and symptoms of elbow bursitis may appear gradually or all of a sudden and include;

  • A goose egg-on-the-elbow appearance of the affected joint
  • Stiffness of the elbow
  • A pain that is more of an aching sensation
  • Aggravation in pain with movement or pressure
  • The joint may be tender to touch
  • The joint appears red, swollen, and warm on examination
  • Sometimes, a painless swelling at the posterior end of the elbow is all a patient presents with
  • In case of injury, the overlying skin may have abrasions and contusions
  • In case of infectious bursitis, fever may accompany other symptoms
  • The End-range of flexion at the elbow may be restricted

Diagnosis of elbow bursitis

The diagnosis is evident by the history and presenting complaints. A history of recent injury may help to identify the cause.

In infectious or septic bursitis cases, it is vital to aspirate fluid from the joint and send the aspirate for culture to address the infectious agent aptly.

Treatment of elbow bursitis

Elbow bursitis often resolves within a few days or weeks. However, the condition is associated with flare-ups, and recurrence is common.

Treatment involves;

  1. Immediately after trauma to first few days
  1. RICER

Repeated action and minor injuries are the common causes of elbow bursitis. If the cause remains in a repeated behavior or habitual movement, avoidance is the key to healing and recovery.

The icing of the elbow in the first 48 hours after symptoms begin greatly helps to reduce swelling. Cold compress temporarily decreases the pain and inflammation in bursitis. Apply a cold compress for short durations, and the ice be wrapped in cloth.

Compression helps in acute injury if applied immediately after the event. It reduces swelling and improves the appearance of the joint.

Using an elbow pad to cushion your elbow while sitting, working, or sleeping may help manage symptoms. Compression decreases swelling and stiffness of the joint. It saves the elbow from further injury but also wraps and compresses the elbow.

Keeping the arm and joint elevated helps to reduce the swelling by raising the affected area.

Get referred to a specialist if symptoms worsen.

  • Medication

Taking over-the-counter (OTC) pain relievers helps reduce pain and inflammation. Topical application of analgesic cream containing capsaicin may help if there is no associated open wound or bacterial infection.

Antibiotics are required to treat an infectious case of elbow bursitis. Usually, a doctor may start with an antibiotic aimed against Staphylococcus aureus.

Corticosteroid injections help but are not recommended.

  • Aspiration of fluid

Fluid aspiration from the joint acts as a therapeutic as well as a diagnostic tool.

  • Surgery

If symptoms do not resolve within six to twelve months, the doctor may go for surgery where a part or entire bursa may have to be removed.

An approach to address the elbow bursitis includes aspiration of the joint and filling it with a mixture of 80-mg methylprednisolone and 2% lidocaine. A dry gauze dressing is applied, followed by the application of a tensor bandage or elbow brace. The brace or tensor bandage is used for 3 to 6 months. This helps to treat bursitis effectively.

  • TENS

TENS is a safe alternative to drugs for alleviating the pain of bursitis, including elbow bursitis. A TENS unit works by stimulating the nerve endings and initiating new pathways that block the pain pathways.

Place the TENS unit electrodes around the painful area over or below the elbow. Use TENS in the absence of inflammation or open wound, or injury.

  • After the first few weeks
  • Massage

Massage may not treat elbow bursitis, but it surely helps to ease the symptoms. Clinical observation is that gentle massage of the elbow, once after any inflammation has resided, helps to improve flexibility and range of motion of the elbow joint.

  • Therapeutic ultrasound

Therapeutic ultrasound also helps to enhance the healing and recovery of the bursa. Since the condition can recur and is often associated with repeated minor trauma, therapeutic ultrasound is a safe and non-invasive remedy for keeping the situation at bay.

  • Active rehabilitation

The time it takes to heal elbow bursitis varies. However, recovery is possible within two to eight weeks or less. This is made possible by implementing proper stretching and strengthening of the muscles involved in elbow bursitis.

Some exercises include;

Flexion stretch

  • Lift the affected arm and bend it at the elbow.
  • Keep your palm facing towards yourself.
  • With the other hand, press with gentle pressure on the back of the affected forearm.
  • Press till you feel a stretch in your forearm.
  • Hold the stretch for or 15–30 seconds and repeat.

Extension stretch

  • Lift your affected arm with your palm facing away.
  • Passively bend your affected wrist back. Your fingers should point towards the ceiling.
  • With your other hand, apply gentle pressure on your wrist until you feel a stretch in your forearm.
  • Hold this stretch for 15–30 seconds, and repeat.
  • Repeat the same steps but keep your fingers pointing down to the ground.

Pronation and supination stretches

  • Keep your arms straight by your side and bend the forearm at about 90 degrees.
  • Make a fist with your hand on the affected side.
  • Slowly turn your forearm so that your hand faces up and down alternately.
  • Hold your hand in each position for 6 seconds.
  • Relax for few seconds before repeating the move.

Hand flips

  • Sit in a chair and place your hand and forearm on your thigh.
  • Keep your palm facing down.
  • Keeping your forearm still on the thigh, flip your hand so that it faces up.
  • Repeat.

Prevention of elbow bursitis

Bursitis may not be preventable; however, the intensity, severity, and frequency of symptoms can be reduced.

  • Proper warm-up before exercise or any other activity helps.
  • Avoid lifting heavy loads that strain your elbow joint.
  • Strengthen your muscle.
  • Adopt appropriate posture and learn techniques for sports, work, or other activities.
  • Avoid sitting with elbows up for extended periods.
  • Use cushions and pads when you need to put weight on your elbows.
  • Taking breaks is a must if in case of a repetitive task.
  • Switch between different activities and exercises if bursitis recurs frequently
Abdur Rashid
Medically Reviewed By Abdur Rashid
MSC Public Health, MCSP, MHCPC
BSC (Hon) Physiotherapy
Consultant Neuro-spinal & Musculoskeletal Physiotherapist

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