Elbow Bursitis: Symptoms

Elbow bursitis usually announces itself as swelling at the bony tip of the elbow, before any pain. The American Academy of Orthopaedic Surgeons explains why: the skin at the back of the elbow is loose, so a swelling bursa may not be noticed right away, and pain only starts once the sac has stretched enough.

Why swelling leads and pain lags

The olecranon bursa is a thin, fluid-filled sac sitting directly over the bony tip of the elbow. Normally it is flat. When it is irritated it fills, and because there is almost no tissue between it and the skin, the result is a soft, visible lump. As the fluid keeps accumulating the bursa begins to stretch, and that is what causes the pain — pain that gets worse with direct pressure on the elbow or with bending it.

StatPearls describes the swelling as fluctuant and notes it may be painless in chronic or noninfectious cases. That is the opposite pattern to a deep bursa like the hip’s, where pain arrives long before anything is visible — see bursitis symptoms for how the presentation shifts by depth, and shoulder bursitis: symptoms for a joint where night pain, not swelling, is the leading complaint.

What causes it

• Trauma — a hard blow to the tip of the elbow.
• Prolonged pressure — leaning on the elbows on a hard surface for long stretches. The AAOS gives plumbing as an occupational example; technicians who work in tight spaces propped on their elbows are described as particularly susceptible.
• Infection — bacteria entering through a scrape, cut or insect bite over the elbow.
• Medical conditions — rheumatoid arthritis and gout both feature.

StatPearls puts the annual incidence at 10 to 29 per 100,000, higher in populations with repetitive elbow trauma such as military recruits.

Telling an infected bursa from an ordinary one

The AAOS signal is simple: if the bursa is infected, the skin becomes red and warm. Add fever, or pain that escalates quickly, and the case for prompt evaluation is made. Left untreated, an infected bursa can spread to other parts of the arm or drain pus on its own. This is not an unusual complication — StatPearls reports that septic cases account for about a third of olecranon bursitis presentations.

How it is treated

Nonsurgical care first: elbow pads to cushion the area, avoiding whatever activity provoked it, sometimes a splint, and anti-inflammatory medicines. A corticosteroid injection is considered when conservative measures have not worked. Surgical removal of the bursa is a last resort. Infected bursae need antibiotics, and the fluid is usually drained.

When to see an orthopedist

Seek evaluation if the swelling does not shrink within a few days, keeps growing, or comes with redness, warmth or fever.

This content is informational and does not replace a medical consultation, diagnosis, or treatment.