In a recent article, I mentioned Val Kilmer’s elbow condition from the movie, Heat. I’d like to give you an overview of that problem from a more clinically useful perspective.
Olecranon bursitis overview
Olecranon bursitis (elbow bursitis) is an inflammation of a fluid-filled sac at the tip of the ulna bone, on the back side of the elbow.
A bursa is a part of your anatomy that allows two other parts to move smoothly together (outside of a joint). They’re all over the body, from the knees to the shoulders.
The olecranon bursa gets irritated and fills up with fluid easily because it’s right at the tip of the elbow just under the skin where you rest your elbow all the time.
This can happen suddenly, when you fall and land on the elbow, or slowly, which may take months.
Olecranon bursitis causes
- pressure: repeated leaning on the elbow on a hard surface, like a table
- trauma: a hard fall on the tip of the elbow may stir up some swelling in the bursa
- infection: a cut or scrape on the elbow may get infected and spread deeply into the bursa tissue
- medical problems: some patients with gout or rheumatoid arthritis may develop olecranon bursitis more frequently than other patients
Symptoms of olecranon bursitis
- swelling: as fluid builds up inside the bursa sac, the tip of the elbow becomes swollen
- redness and heat: this usually happens only if the bursal sac gets infected
- pain: most patients do not have pain; painful olecranon bursitis may be a sign of infection, or septic bursitis
When should you get treatment for bursitis?
If the elbow is painful, has limited motion, is draining fluid, or associated with redness or fever, see your physician or other health care provider.
Diagnosis and testing
The diagnosis is usually straightforward – sometimes finding out exactly what the underlying cause is can be challenging.
An x-ray is only useful if arthritis or trauma is suspected. If you have an infected bursa, an x-ray may verify that the bone underneath is healthy. Sometimes an elbow x-ray will show a small bone spur connected to the ulna bone, but it’s not usually a sign of arthritis.
If your doctor suspects infection, he may want to drain a small sample of fluid from the bursa and get it tested in the lab.
Treatment of olecranon bursitis
Treatment at home may involve the following (details below):
- resting the elbow – no strenuous activity!
- padding the elbow
- elevating the elbow
The simplest treatment is the most common one – protecting the elbow from trauma and keeping the swelling down. This usually involves a padded elbow sleeve and wrapping the elbow daily with an ace wrap. This may take several weeks to reduce the swelling.
Elevating the elbow at or above heart level when you are resting at home will help decrease swelling. Occasional ice packs applied to the elbow will help with swelling as well.
Anti-inflammatory medicines may be recommended for pain and swelling.
Infections need to be drained and treated with antibiotics. Sometimes this needs to be done in the operating room in surgery, and may require a short stay in the hospital.
Avoiding unnecessary drainage procedures
If an elbow bursa is not infected, I don’t ordinarily recommend drainage. In fact, if proper technique is not used, putting a needle in a healthy but swollen bursa may cause an infection.
Other names for olecranon bursitis
- lunger’s elbow
- miner’s elbow
- student’s elbow
- Popeye elbow
Olecranon bursitis video
In this video, you’ll see the anatomy of elbow bursitis and it’s exact location in the elbow.