Elbow Bursitis

Overview

The elbow (olecranon) bursa is a thin sac of fluid that lies between the boney tip of the elbow in the back of the arm (the olecranon) and the skin. Normally, this sac has only a minimal amount of fluid in it and the bursa acts as a cushion for the tip of the elbow. However, the bursa can fill with extra fluid and become swollen if it becomes irritated or inflamed. This condition is termed elbow (olecranon) bursitis.  

A common cause of olecranon bursitis is trauma, such as falling on the elbow or hitting the elbow on a hard surface. This can occur during any sporting event when someone has a fall on their elbow and has been described often in football, hockey, basketball, and volleyball players. Olecranon bursitis can also occur in people who rest their elbow on a hard surface for a long period of time, including when typing on a computer keyboard, and is commonly known as “student’s elbow.”

In addition to athletes and students, people in other occupations where olecranon bursitis has been shown to occur more frequently include plumbers, miners, mechanics, and gardeners. In addition, people with certain medical conditions such as gout and rheumatoid arthritis can be more prone to develop olecranon bursitis.  

Elbow (olecranon) bursitis is characterized by:

  • Swelling. The initial symptom of olecranon bursitis is often swelling that develops at the back of the elbow.  
  • Pain. Pain most often occurs with direct pressure on the elbow, such as when resting the elbow on a hard surface. Pain can sometimes occur with bending the elbow. Some people may only experience swelling without significant pain.
  • Redness and/or warmth. Occasionally, the olecranon bursa can become infected. Typical symptoms of an infected olecranon bursa include the skin becoming warm and red. A person may also develop a fever associated with an infected olecranon bursa.   

If the olecranon bursa is not infected, treatment consists initially of avoiding activities that cause direct pressure on the elbow. Applying compression with a wrap or compression sleeve and icing the elbow 15-20 minutes 2-3 times per day can help to decrease the swelling. Also, an elbow pad may be used to help cushion the elbow and provide protection if direct pressure is applied to the elbow. An oral anti-inflammatory medication such as ibuprofen or naproxen may be used to help reduce the swelling. If the swelling and pain persist despite these treatments, draining the fluid from the bursa with a needle and injecting the bursa with a corticosteroid may be performed.  

If these treatments do not work and a person is still experiencing swelling, pain, and decreased function, surgery to remove the entire bursa can be performed, but this is not common. If surgery is performed, the bursa sac will typically grow back over the course of several months.  

If there is concern that the olecranon bursa is infected, fluid will be drained from the bursa with a needle. This fluid will then be sent to the laboratory to be analyzed so that an appropriate antibiotic can be started as necessary. If the bursa is infected and does not improve with drainage and antibiotics, surgery may be performed to excise the bursa.

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