Introduction
A bursa is a small sac-like structure that contains a small amount of fluid, we have numerous bursae in many joints of our body. The main function of a bursa is to act as a ‘shock absorber’ between the bones and tendons or even skin, and to reduce friction where structures move over one another.
The olecranon is the bony prominence which forms the ‘point’ of the elbow and the bursa that covers the surface of this bone is known as olecranon bursa. This bursa helps the skin to glide over the bone freely.
Signs & Symptoms
- Often a painless swelling at the back of the elbow.
- Direct pressure over this swelling can cause pain i.e. leaning on the elbow.
- Heat and redness at and around the point of the elbow.
Causes
This structure can become inflamed following sudden trauma such as a fall on the elbow, repetitive and increased movement of the elbow, or mild & repeated compression (i.e. leaning on the elbow – for this reason, this condition is also known as ‘student’s elbow /plumber’s elbow’). Arthritis of the elbow joint or an infection where bacteria can make it’s way into the bursa through an open wound can also cause inflammation.
Assessment & Diagnosis
Normally the signs and symptoms will help your physiotherapist or GP to diagnose the condition. However, if there was a history of direct trauma to the olecranon process they may send you for an X-ray to rule out any fractures. Once your diagnosis is confirmed, the most effective treatment and management strategy can begin right away so that optimal outcomes are achieved. Your Physio will help you set personalised goals so that your treatment is geared towards achieving a full recovery. We see value in regular re-assessment to measure your progress and to adjust your treatment as required.
Self-Management
Physiotherapy is not always necessary as this condition may improve on its own. However, a Physiotherapist can help you by providing personalised advice on how to control inflammation with adequate rest and activity modification.
Other non-operative management includes corticosteroid injection with or without aspiration of the bursa, non-steroidal anti-inflammatories such as naproxen or ibuprofen, and antibiotics if the GP suspects an infection causing your bursitis.
Escalation of Treatment
If the symptoms become persistent and are not responding favourably to conservative management, your GP may consider sending you for a bursectomy (excision of the inflamed bursa). Note that olecranon bursitis rarely needs surgical management.
