Olecranon Bursitis

Q1. What is olecranon bursitis?

Olecranon bursitis is inflammation of the bursa, a small, fluid-filled sac located at the tip of your elbow (the olecranon). Normally, the bursa acts as a cushion between the skin and the bone, allowing the skin to slide smoothly over the joint. When it gets inflamed, it fills with extra fluid, causing a visible swelling that often looks like a soft ball or "goose egg" on the back of your elbow.

Q2. What are the common causes of olecranon bursitis?

Olecranon bursitis is usually caused by:

• Repetitive pressure: Leaning on your elbows for long periods on hard surfaces, such as desks or tables (often called "student's elbow").
• Trauma: A direct blow, hit, or fall onto the tip of the elbow.
• Infection: A cut, scrape, puncture, or insect bite that allows bacteria to enter the bursa sac.
• Medical conditions: Certain conditions like gout, rheumatoid arthritis, or kidney failure can make you more prone to developing bursitis.

Q3. What are the symptoms of olecranon bursitis?

The most common symptoms include:

• Rapidly developing or gradual swelling at the tip of the elbow.
• Pain when bending the elbow or when pressure is applied to the tip.
• Redness and warmth if the bursa is infected or severely inflamed.
• Tenderness and discomfort when touching the back of the elbow.

Q4. How can I tell if my swollen elbow is infected?

An infected elbow bursa (known as septic bursitis) is a serious concern that requires immediate medical care. Signs of infection include:

• The skin over the swelling becomes very red, hot to the touch, and increasingly tender.
• Pus or fluid draining from a cut or scrape near the bursa.
• Fever, chills, body aches, or a general feeling of being unwell.
• Increasing pain and progressive difficulty moving or bending your arm.

Q5. How is olecranon bursitis diagnosed?

Dr. Veillette will diagnose olecranon bursitis through:

• Physical examination: Checking your elbow for swelling, redness, warmth, tenderness, and range of motion.
• X-rays: Rule out an elbow fracture, bone spurs, or loose bodies inside the joint.
• Fluid aspiration: Drawing fluid from the bursa with a needle to test for bacteria (infection) or crystals (gout).
• Blood tests: Checking for signs of infection or inflammatory conditions.

Q6. What are the first-line non-surgical treatments for non-infected bursitis?

For simple, non-infected swelling, treatment focuses on relieving symptoms and reducing inflammation:

• Rest and activity modification: Avoid activities that put direct pressure on your elbow.
• Ice: Apply ice packs for 15-20 minutes several times a day.
• Compression: Use an elastic elbow sleeve to help support the joint and reduce swelling.
• Padding: Wear a protective elbow pad during daily activities to prevent further irritation.
• Medication: Over-the-counter anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and swelling.

Q7. Is it safe to drain the fluid from my elbow bursa?

Draining the fluid (aspiration) using a sterile needle can immediately relieve pressure and pain, and allows the fluid to be tested. However, Dr. Veillette only performs this in the clinic when necessary (such as to rule out infection or if the swelling is very large and painful), because there is a small risk of introducing bacteria and causing an infection.

Q8. When are corticosteroid injections used for olecranon bursitis?

If swelling and pain do not improve with rest, ice, and padding, Dr. Veillette may recommend a corticosteroid injection. This powerful anti-inflammatory medication is injected directly into the bursa to help reduce swelling. It is only used if an infection has been completely ruled out, as steroids can worsen an infection.

Q9. How is infected (septic) olecranon bursitis treated?

If the bursa is infected, treatment must start immediately:

• Antibiotics: Oral or intravenous (IV) antibiotics will be prescribed to kill the bacteria.
• Aspiration: The infected fluid may be drained to relieve pressure and identify the specific bacteria.
• Close monitoring: You will need to check the elbow daily to ensure the redness and swelling are resolving.
• Surgery: If antibiotics do not clear the infection, surgery may be needed to drain or remove the bursa.

Q10. How long does it take for olecranon bursitis to heal?

Simple bursitis caused by pressure or minor trauma often resolves within 2 to 4 weeks with proper rest, padding, and anti-inflammatory treatment. Infected bursitis or chronic (long-lasting) bursitis may take several weeks to months to fully heal and may require ongoing medical management.

Q11. Do I need to wear a brace or elbow pad?

Yes, wearing a protective elbow pad or a soft elbow sleeve is highly recommended during recovery. It cushions the bursa, prevents direct contact with hard surfaces, and applies gentle compression to keep the swelling down. You should wear it during daily activities and especially if you must sit at a desk.

Q12. Can physical therapy help with olecranon bursitis?

While physical therapy is not the primary treatment for the swelling itself, a therapist can help you:

• Maintain and restore full range of motion in your elbow.
• Strengthen the muscles around the joint once the inflammation subsides.
• Learn ergonomic changes to avoid putting pressure on your elbows during work or daily tasks.

Q13. When is surgery recommended for olecranon bursitis?

Surgery is considered in two main situations:

• Persistent Infection: The bursa is infected, and antibiotics or needle drainage have failed to clear it.
• Chronic, Painful swelling: The bursa continues to swell and cause significant pain or limit your activity despite months of non-surgical treatment (such as rest, padding, and injections).

Q14. What does olecranon bursitis surgery involve?

The procedure is called an olecranon bursectomy. It involves making a small incision at the back of the elbow and removing the entire inflamed or infected bursa sac. The body will naturally grow a new, healthy bursa sac in its place over the following weeks. This surgery is typically performed as an outpatient procedure under local or general anesthesia.

Q15. How can I prevent olecranon bursitis from coming back?

You can prevent recurrence by:

• Avoiding leaning on your elbows on hard desks, tables, or armrests.
• Wearing protective elbow pads if your job or hobbies require kneeling or leaning.
• Practicing good hygiene by cleaning any elbow scrapes or cuts immediately with soap and water to prevent infection.
• Maintaining healthy elbows and stretching regularly.

We encourage you to write down any specific questions you have and discuss them thoroughly with your surgeon, doctor, or physical therapist. They are your best resource for personalized advice and care.

Disclaimer: This brochure provides general information and is not a substitute for professional medical advice. Always consult your doctor or qualified healthcare provider with any questions you may have regarding your specific medical condition and treatment plan.