Bursae are thin, slippery sacs located throughout the body that act as cushions between bones and soft tissues. They contain a small amount of lubricating fluid that allows the skin to move freely over the underlying bone.
The olecranon bursa lies between the loose skin and the pointy bone at the back of the elbow called the olecranon.
Normally, the olecranon bursa is flat. If it becomes irritated or inflamed, more fluid will accumulate in the bursa and bursitis will develop.
Elbow bursitis can occur for a number of reasons.
- Trauma: A hard blow to the tip of the elbow can cause the bursa to produce excess fluid and swell.
- 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. People in certain occupations are especially vulnerable, particularly plumbers or heating and air conditioning technicians who have to crawl on their knees in tight spaces and lean on their elbows.
- Infection: If an injury at the tip of the elbow breaks the skin, such as an insect bite, scrape, or puncture wound, bacteria may get inside the bursa sac and cause an infection. The infected bursa produces fluid, redness, swelling, and pain. If the infection goes untreated, the fluid may turn to pus. Occasionally, the bursa sac may become infected without an obvious injury to the skin.
- Medical Conditions: Certain conditions, such as rheumatoid arthritis and gout, are associated with elbow bursitis.
Swelling is often the first symptom. The skin on the back of the elbow is loose, which means that a small amount of swelling may not be noticed right away.
In many cases, the first sign of bursitis is swelling at the elbow.
As the swelling continues, the bursa begins to stretch, which causes pain. The pain often worsens with direct pressure on the elbow or with bending the elbow. The swelling may grow large enough to restrict elbow motion.
If the bursitis is infected, the skin becomes red and warm. If the infection is not treated right away, it may spread to other parts of the arm or move into the bloodstream. This can cause serious illness.
Occasionally, an infected bursa will open spontaneously and drain pus.
After discussing your symptoms and medical history, your doctor will examine your arm and elbow.
Your Great Lakes Orthopedics & Sports Medicine orthopedic physician may recommend an x-ray to look for a foreign body or a bone spur. Bone spurs are often found on the tip of the elbow bone in patients who have had repeated instances of elbow bursitis. Your doctor may choose to take a small sample of bursa fluid with a needle to diagnose whether the bursitis is caused by infection or gout. Blood tests are not usually helpful.