What is it?
Olecranon bursitis is a condition which is relatively common. It is where repeated leaning and bumping of the tip of the elbow can cause the underlying bursa to become inflamed and swollen.
What is a bursa?
The bursa of the elbow is a thin fluid-filled sac that has a purpose to protect the soft tissues from injury by acting as a cushion between layers of soft tissue and bone.
Who does it affect?
Elbow bursitis can affect everyone and anyone. This condition can be caused by acute injuries (trauma) during sports activities because they can include any action that involves direct trauma to the posterior elbow e.g. falling onto your elbow, or a collision during a sporting game.
- Prolonged pressure: Leaning on the tip of the elbow for long periods of time on hard surfaces, such as a tabletop, may cause the bursa to swell. Typically, this type of bursitis develops over several months.
- Trauma: The bursa may create too much fluid and enlarge in response to a forceful hit on the elbow’s tip.
- Occupation/sport: Those who must squat on their knees and lean on their elbows in cramped spaces are particularly at risk. Olecranon bursitis can also be brought on by some sports-related activities, such as prolonged plank holds.
- Medical conditions: Elbow bursitis is linked to a few diseases, including gout and rheumatoid arthritis.
- Infection: When a bursa is infected, fluid, redness, swelling, and pain are produced. The fluid could evolve into pus if the condition is left untreated.
How is it diagnosed?
It is diagnosed by an assessment of clinical signs and symptoms which are:
- Localised swelling of the elbow tip. This swelling can be distinguished by the way it appears as an egg above the olecranon process.
- At the affected spot, there may be palpable tenderness.
- When an infection is present, the affected area may appear heated and red.
- Reduced range of motion (ROM) of the elbow
Imaging options/Investigations include:
- Ultrasound or MRI (magnetic resonance imaging) to detect swollen bursa.X-ray to rule out other conditions.
- X-ray to rule out other similar issues.
- A blood test to look for infection and chemical markers.
- An aspiration (fluid sample) of your affected bursa.
How is it treated?
Physical Therapy Management
- Initial treatment consists of the RICE method which consists of Rest, Ice, Compression and Elevation.
- Soft tissue releases and electrical modalities are helpful at reducing pain and swelling.
- Additionally, your physiotherapist can provide compensatory techniques for resting the injured upper extremity while healing occurs.place.
- Once healed, there may be deficits in the range of motion and strength of surrounding muscles/joints due to disuse, your physiotherapist can aid you in returning to your pre-injury state and help with prevention.
- Most cases of elbow bursitis heal between 3-6 weeks dependent on severity and whether an infection was involved.
- Treatment can include a draining procedure of the bursa, which is performed by a doctor. This can help resolve swelling and reduce pain.
- If the bursitis is infected you may need a round of antibiotics that is determined by your general practitioner.
- Surgery may be necessary if the patient doesn’t respond to conservative care and the condition worsens. After a bursal excision (bursectomy), a patient will most likely need to undergo a round of physiotherapy treatment to regain range of motion and strengthen the elbow joint and surrounding musculature.
- Nchinda NN, Wolf JM. Clinical management of olecranon bursitis: A Review. The Journal of Hand Surgery. 2021;46(6):501-506. doi:10.1016/j.jhsa.2021.02.006.