Olecranon Bursitis: What is it and how to manage it, a Physiotherapists perspective.

Hopefully this article will help the reader learn about the symptoms, causes, and effective treatments for olecranon bursitis, how to manage this common condition and get relief from elbow pain.

What is Olecranon Bursitis?

Olecranon bursitis is a common condition that causes swelling and inflammation of the bursa (a small, fluid-filled sac) located at the tip of the elbow. The Bursa’s purpose is to reduce friction between the Skin and Boney surfaces during elbow motion. Aseptic Olecranon Bursitis is not typically serious, it tends to present as a large golf ball over the back of the elbow and it can cause pain and impede the affected elbow/arm. 

What causes it?

It can be caused by a variety of factors, including; 

• Trauma or blow to the elbow, 
• Repetitive pressure such as leaning on your elbows for long periods, 
• Friction or microtrauma on the elbow joint such as racket sports or painting. 
• Less commonly it can be caused by crystalline diseases and inflammatory conditions such as gout and rheumatoid arthritis. 

Septic olecranon bursitis (while beyond the scope of this article) can arise from skin infections or from direct trauma it will often be accompanied by erythema (redness), pain, aches, a feeling of being generally unwell and possibly fever and chills - this should be assessed and treated by a Dr as soon as possible. 

What are the symptoms of Olecranon Bursitis?

The symptoms of Aseptic olecranon bursitis can vary depending on the severity of the condition. However, some common signs to look out for include:

• Swelling and visible lump or mass on the elbow, 
• Pain or discomfort when moving the affected arm, 
• Stiffness or limited range of motion in the elbow joint, 
• Redness or warmth around the affected area. 

Management of Olecranon Bursitis:

The good news is that most cases of olecranon bursitis can be effectively managed conservatively. Here are some steps you can take to manage this elbow condition:

• Protect the elbow: Sounds obvious, but you really will have to avoid hitting it or over using it if you want it to settle down. A simple practical option here is to slip a protective neoprene sleeve around it, it won’t “fix” it, but it will help to protect it.
• Rest the affected elbow: If possible, avoid activities that may exacerbate the pain or swelling in your elbow, such as heavy lifting or repetitive motions. A sling is rarely necessary and movement of joints is our body’s natural way of helping mobilise effusions when they are no longer active. However, in some cases or at certain times a sling may be useful in the acute early phase for some protection or relief but not 24/7. 
• Apply Ice/Compression: Applying cold therapy to the affected area can help reduce pain and compression wraps can help to mobilise the effusion, facilitating the body's natural process.
• Anti-Inflammatories: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help to reduce inflammation. Be sure to follow the recommended dosage instructions and check with your Dr before taking any new medication.
• Seek medical attention: If your symptoms are severe or do not improve with conservative treatments, consult with your Dr. Your Dr may recommend additional treatment options, which may include draining the fluid from the bursa with a needle, prescribing antibiotics if an infection is present, or (although not well supported by the evidence) in some cases using corticosteroid injections.
• Prevent future episodes: Wearing elbow pads or cushioning when participating in activities that put stress on the elbow joint, avoiding repetitive motions that can irritate the bursa, may help when considering trying to prevent recurrent episodes.

In conclusion, olecranon bursitis is a common condition that can cause pain and discomfort in the elbow joint. While it can be caused by a variety of factors, most cases can be effectively managed with a combination of simple and effective conservative options.  If you experience symptoms of olecranon bursitis, be sure to consult with your Physiotherapist or Doctor to determine the best course of treatment for your individual needs.

References:

Arthritis Foundation. (2021). Olecranon bursitis. Retrieved from https://www.arthritis.org/diseases/olecranon-bursitis

Mayo Clinic. (2021). Olecranon bursitis. Retrieved from https://www.mayoclinic.org/diseases-conditions/olecranon-bursitis/symptoms-causes/syc-20375972

American Academy of Orthopaedic Surgeons. (2015). Elbow (Olecranon) Bursitis. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/elbow-olecranon-bursitis/

Nchinda NN, Wolf JM. Clinical Management of Olecranon Bursitis: A Review. J Hand Surg Am. 2021;46(6):501-506. doi:10.1016/j.jhsa.2021.02.006

Schermann H, Karakis I, Dolkart O, Maman E, Kadar A, Chechik O. Olecranon Bursitis in a Military Population: Epidemiology and Evidence for Prolonged Morbidity in Combat Recruits. Mil Med. 2017;182(9):e1976-e1980. doi:10.7205/MILMED-D-16-00402

Laupland KB, Davies HD; Calgary Home Parenteral Therapy Program Study Group. Olecranon septic bursitis managed in an ambulatory setting. The Calgary Home Parenteral Therapy Program Study Group. Clin Invest Med. 2001;24(4):171-178.