-Cyprus Orthopaedics

Elbow Bursitis

Olecranon bursitis is inflammation of the bursa on the back of the elbow. A bursa is a membrane which acts as a cushion and facilitates gliding between tissue planes - in this case the gliding of the skin over the bone. When the bursa becomes inflamed it results in swelling and collection of fluid within the bursal sac. The swelling may result from non-specific inflammation, conditions such as gout or occasionally due to infection. Sometimes the swelling is associated with wear and tear in the insertion of the triceps tendon (triceps tendinopathy).
Home-Cyprus Orthopaedics

Elbow Bursitis

Elbow bursitis is a common condition that affects the fluid-filled sacs, known as bursae, located around the elbow joint. These bursae act as cushions, reducing friction between bones, tendons, and muscles. Elbow bursitis occurs when these bursae become inflamed and swollen, leading to pain and discomfort.

What causes Elbow Bursitis?

Elbow bursitis can be caused by a variety of factors. One of the most common causes is repetitive movements or prolonged pressure on the elbow joint. This can occur in occupations that involve frequent and repetitive elbow movements, such as plumbers, painters, and carpenters. Additionally, direct trauma or injury to the elbow, such as a fall or a blow, can also lead to bursitis.

Certain medical conditions, such as rheumatoid arthritis or gout, can increase the risk of developing elbow bursitis. These conditions cause inflammation in the joints, which can spread to the bursae around the elbow. Infection is another potential cause of elbow bursitis. When bacteria enter the bursae, it can lead to an infection and subsequent inflammation.

Symptoms of Elbow Bursitis

The symptoms of elbow bursitis can vary from mild to severe and may include:

  • Swelling around the elbow joint: The affected area may appear visibly swollen and feel tender to the touch.
  • Pain and discomfort: Individuals with elbow bursitis may experience pain when bending or straightening the elbow, as well as during activities that put pressure on the joint.
  • Limited range of motion: The inflammation and swelling can restrict the movement of the elbow, making it difficult to fully extend or flex the arm.
  • Redness and warmth: The skin over the affected area may become red and warm to the touch due to the inflammation.

If you experience any of these symptoms, it is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

Diagnosing Elbow Bursitis

To diagnose elbow bursitis, a healthcare professional will typically begin by conducting a thorough physical examination of the affected area. They will assess the extent of swelling, tenderness, and range of motion in the elbow joint. In some cases, they may also order additional tests, such as an X-ray or an MRI, to rule out other conditions and determine the underlying cause of the bursitis.

If an infection is suspected, the healthcare professional may recommend a fluid aspiration procedure. During this procedure, a small amount of fluid is extracted from the bursa using a needle and syringe. The fluid sample will be sent to a laboratory for analysis to identify the presence of bacteria or other infectious agents.

Treatment options for Elbow Bursitis

The treatment for elbow bursitis depends on the severity of the condition and the underlying cause. In mild cases, self-care measures may be sufficient to alleviate symptoms and promote healing. These measures may include:

  • Rest and immobilization: Avoiding activities that aggravate the symptoms and using a brace or splint to immobilize the elbow can help reduce inflammation and promote healing.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter pain relievers, such as ibuprofen or naproxen, can help reduce pain and inflammation.

In more severe cases, when conservative measures are ineffective, a healthcare professional may recommend additional treatments, such as:

  • Physical therapy: A physical therapist can provide exercises and stretches to improve range of motion and strengthen the muscles around the elbow joint.
  • Corticosteroid injections: Injections of corticosteroids into the bursa can help reduce inflammation and alleviate symptoms.
  • Aspiration and antibiotics: If an infection is present, the healthcare professional may perform a fluid aspiration procedure and prescribe antibiotics to treat the infection.

Surgery

Elbow bursitis surgery is seldom necessary. If conservative treatments fail to alleviate your symptoms, or if you have a severe infection unresponsive to antibiotics, surgical intervention may be required.

The procedure involves outpatient surgery, allowing you to return home on the same day. Following the surgery, you’ll require a splint or brace to immobilize your elbow during the healing process, typically needing approximately a month for recovery.

Preventing Elbow Bursitis

Prevention is key when it comes to elbow bursitis. Here are some preventive measures you can take:

  • Avoid repetitive movements: If your occupation or hobbies involve repetitive elbow movements, take frequent breaks and use proper ergonomics to reduce the strain on your elbow joints.
  • Use protective gear: When engaging in activities that put your elbows at risk, such as sports or manual labor, wear protective gear, such as elbow pads or braces, to minimize the risk of injury.
  • Maintain a healthy weight: Excess weight puts additional strain on your joints, including the elbows. By maintaining a healthy weight, you can reduce the risk of developing bursitis.

The condition usually presents with a lump on the back of the elbow, which is often painless. Some patients may experience discomfort or occasionally a burning sensation on the back of the elbow, particularly when leaning on the elbow. In case of an infection, the swelling may be associated with fever.

Examination of the joint shows a soft lump on the back of the elbow. There may be redness and warmth if there is an underlying infection. An X-ray may be performed to look for bone spurs and to assess the joint surfaces. Blood tests may be arranged to exclude gout.

If the lump is painless and not causing symptoms then no treatment may be necessary.

Noninfective bursitis

Aspiration: If the lump is causing discomfort, the fluid may be drawn off with a needle using an aseptic technique to reduce the size of the lump. A sample of fluid is sent to the pathology laboratory for microscopic examination. Injection of steroid may reduce the risk of recurrence but carries additional risk. The fluid may reaccumulate after aspiration.

Surgery: Surgical treatment may be considered in some patients, in whom symptoms are troublesome or interfere with sports or work, or if the lump is large and unsightly. The elbow is explored through an incision on the back of the elbow, the fluid is drained and the lining of the sac is removed to prevent recurrence. In selected cases this may be accomplished with arthroscopic surgery. A new bursa will reform over a period of time.

Infective bursitis

Aspiration: Drawing the fluid off with a needle and syringe will reduce the size of the lump and the associated discomfort and provides a sample of fluid for microbiological examination to help identify the causative organism.

Antibiotics: When treated early an infective bursitis may respond to treatment with a course of appropriate antibiotics. Ideally, antibiotics should not be started until a sample of fluid has been aspirated for microscopic examination

Surgery: If the swelling is large or has recurred despite treatment with antibiotics, then surgery should be considered to drain the infected fluid and remove the lining of the bursa in its entirety. 

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