Anatomy & Background
The elbow joint is a connection point between the humerus, the radius, and the ulna. A bursa is a fluid filled sac that decreases friction between two tissues. The olecranon bursa covers the olecranon process, which is the pointed part of the elbow formed by an extension of the ulna where it meets the humerus. The bursa is located between the loose skin that covers the elbow joint and the forearm bones. The bursa minimizes the friction and protects the olecranon process from injuries, however the bursa can become inflamed causing elbow bursitis.
Bursitis is often the result of repetitive injury to the bursa or the surrounding tendons. Common causes of bursitis include:
- Participating in athletic activities – like tennis – that place repetitive strain on the elbow.
- Repetitive strain injuries.
- Patients with rheumatoid arthritis, gout, calciferous bodies, or infection.
- “Overload” injuries such as lifting heavy objects or weight training.
- Prolonged pressure from leaning on the elbow, which can range from repeatedly sitting at the kitchen table with your head in your hand, to working in tight spaces where you have to lean on your elbow.
Signs and Symptoms of Elbow Bursitis
- Pain or a burning sensation in the elbow
- Moderate to severe loss of range of motion in the elbow
- Pain when moving the arm or when sleeping on the affected side
- Weakness, especially when the pain increases
- A feeling of tightness in the elbow
- Localized swelling or redness of the elbow
Treating Elbow Bursitis
If one suspects they have bursitis, initial treatment should first consist of avoiding the activities that produce any pain. A course of rest, ice, physical therapy, and non-steroidal medications to reduce inflammation is highly recommended to begin treating bursitis of the elbow. If the condition is persistent, a pain management specialist may suggest steroidal medication or injections, in conjunction with physical therapy. If there is excessive swelling, your specialist may drain the fluid from the bursa. In only the most severe cases is surgical intervention used to correct the condition.
These are procedures that your physician may recommend and perform:
- REST and ICE
- The use of NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)
- Steroidal injections to reduce the inflammation
- Pain medications to reduce discomfort
- Draining the fluid in the bursa, and injection of a corticosteroid medication, if the condition does not improve within 3-4 weeks.
- Surgery to remove the affected bursa
It is important that once the pain and inflammation is reduced, and motion and strength are restored, that the patient gradually return to full activities. Instruction in daily activities or sports will help reduce the chance of a re-occurrence of the bursitis. In most cases full return to activity will take from 2-6 weeks.
To prevent elbow bursitis or a re-occurrence of the condition individuals should:
- Make modifications in work or daily activities to avoid putting pressure on the elbow.
- Avoid highly repetitive activities whenever possible.
- Use an elbow-pad to cushion the elbow when activities that strain the elbow cannot be avoided.