What is Olecranon Bursitis and How is it Treated?

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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.

The symptoms of olecranon bursitis typically include the following:

• SwellingVisible 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 tendernessDiscomfort 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 motionThe 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 warmthIf 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 elbowYou may find it uncomfortable to rest or lean on 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.

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.

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 immobilizationMinimize movement of the elbow to reduce irritation. We may recommend using a brace or splint to restrict movement while it heals.
• ElevationKeeping 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 therapyApplying 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 medicationsNonsteroidal anti-inflammatory drugs, better known as NSAIDs, such as ibuprofen or naproxen can help reduce inflammation and relieve pain.
• AspirationIn 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 injectionsInjecting 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.
• RestMinimize any activities that put pressure on your elbow or cause friction, which can aggravate the bursa and make the symptoms worse.
• Physical therapyAfter the acute phase, we may recommend exercises to strengthen the muscles around the elbow and improve the range of motion.

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 drainageWe 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.
• BursectomyWe 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.
• OsteotomyBone 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.

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.