What Causes Elbow Bursitis?

Also known as Popeye’s elbow, elbow bursitis has the characteristic look of a bulbous lump on the tip of one’s elbow. 

Elbow bursitis is caused by a hard blow to the elbow, an extended period of pressure on the tip of the elbow, an infection, or certain medical conditions like arthritis and gout. Most cases of this painful swelling can be treated non-surgically in under six weeks.

Elbow Anatomy

Elbow Anatomy

Your elbow, medically referred to as the olecranon, has a protective fluid-filled sac on its tip called a bursa. Elbow bursitis is specific to the inflammation of this bursa. Inflammation in the connective tendons of the elbow is called tennis elbow

We have many bursae between the bones and soft tissue throughout our bodies. Bursae act as cushions and lubricating agents for proper joint movement. Normally these bursae are flat, but when they fill with fluid due to inflammation or irritation, it is called bursitis. The pain caused by bursitis may be immediate or develop over time.

Elbow Bursitis Causes

The most common causes of elbow bursitis are injury, prolonged pressure, infection, and certain medical conditions. 

elbow bursitis

Injury: The most common cause of olecranon bursitis is injury. A hard, traumatic blow to the end of the elbow can cause the bursa to swell from excess fluid production. According to the Cleveland Clinic, over 66 percent of cases of non-infectious bursitis are caused by injuries. 

Pressure: Bursitis due to extended periods of pressure usually takes several months to develop. Students, workers in certain fields, and athletes are susceptible to elbow bursitis due to leaning on their elbows for long periods or repetitive motions that put repeated pressure on their bursa.

Infection: Most cases of elbow bursitis caused by infection result from cuts, scrapes, or insect bites. Since the bursa sac is so close to the skin, bacteria enters through these wounds and leads to infection. As with other bursitis-causing events, the bursa swells and produces excess fluid. If the infection is untreated, the fluid turns into pus. 

Other medical conditions: Conditions like rheumatoid arthritis, diabetes, thyroid disease, and gout can lead to olecranon bursitis. 

Elbow Bursitis Symptoms

The first and most obvious symptom of bursitis of the elbow is swelling. As the swelling continues, the bursa stretches to accommodate extra fluid, which causes pain. This pain is typically at its worst when you lean on or bend your elbow. The swollen, painful elbow becomes hard to move.

bursitits of elbow

If an infection caused your bursitis, additional symptoms like redness and being warm to the touch are often present. In cases of olecranon bursitis associated with a wound, pus may drain from the infection. If the infection remains untreated, it can spread to the rest of the arm or throughout the body. 

Tests and Diagnosis 

An orthopedic specialist might use a physical exam, X-ray, ultrasound, or MRI to diagnose elbow bursitis. It’s important to determine whether the bursitis is acute or chronic and septic or aseptic. These determinations allow the elbow specialist to develop a proper treatment protocol.

Additional tests may be necessary for chronic cases to determine whether the swelling is from a bone spur or an underlying condition. Septic cases require bursal fluid or blood testing. Testing determines the infection’s cause and proper treatment to prevent the infection from spreading to the body.

Elbow Bursitis Treatment at Home

Initial treatment of bursitis of the olecranon includes resting the elbow and avoiding any activities that put direct pressure on the elbow. Compress the elbow and ice it for 15 to 20 minutes 2 to 3 times daily to help with the pain and swelling. Use an elbow pad to cushion and protect the elbow. Take a non-steroidal anti-inflammatory like ibuprofen as directed by your orthopedic doctor.

Another standard treatment for elbow bursitis is to aspirate the bursa. This is an outpatient procedure where your specialist uses a needle to drain the built-up fluid. Aspiration helps relieve symptoms, and testing the fluid helps determine the cause of the swelling. 

If the bursitis is due to infection (septic bursitis), your provider will prescribe antibiotics. Most cases resolve with at-home treatments in under six weeks.

If the pain and swelling from a case of elbow bursitis continue for weeks into months or are particularly disruptive to your day-to-day life, your orthopedic elbow specialist may use a corticosteroid injection to relieve the pain and swelling. 

elbow bursitis brace

Surgical Treatments for Elbow Bursitis 

Surgery for elbow bursitis is rare but may be necessary if the bursitis is due to an infection. If neither aspiration of the bursa nor antibiotics resolve the issue, an orthopedic surgeon may remove the infected bursa. A new, normal bursa usually grows back over the coming months. 

You may be required to wear an elbow bursitis brace post-surgery. Long-term casts are usually unnecessary. 

Extensive physical therapy is also typically unnecessary. Your orthopedic surgeon will likely recommend a few exercises to help you regain full range of motion as you heal. 

The timeline for surgical recovery is usually reasonably short. You will likely be released to use your elbow after a few weeks. It is best to use a pad or elbow protector for several months to prevent further injury. 

Bursitis Prevention

The best way to prevent elbow bursitis is to avoid putting excess pressure on your elbows. Give yourself periods of rest between jobs or intense exercise sessions, and wear proper protective elbow pads when necessary. 

See an orthopedic specialist if you have elbow swelling, pain that interferes with your daily activities, soreness that is not improving, redness and warmth around your elbow, or bursitis that continues to return. 

If you would like to talk to one of our orthopedic specialists or if you have questions about an elbow injury or symptoms, please get in touch with us or comment below. 

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