Medicines for Olecranon bursitis

What it is

Olecranon bursitis is inflammation and swelling of the bursa at the tip of the elbow — a small, fluid-filled sac (the olecranon bursa) that sits over the pointy bone at the back of the elbow and normally helps the skin glide over it. When this bursa becomes inflamed and fills with extra fluid, it causes a soft, sometimes squishy swelling at the tip of the elbow (which can become quite large, sometimes likened to a golf ball), and can be tender. It is sometimes called "student's elbow" because leaning on the elbow (as when studying) is a common cause. Causes include repeated pressure or leaning on the elbow, a knock or injury to the elbow, prolonged pressure, and, in some, underlying conditions such as gout or rheumatoid arthritis. Importantly, the bursa can also become infected (septic bursitis) — for example if bacteria get in through a break in the skin — in which case it becomes red, hot, more painful, and the person may feel unwell, which needs treatment. Most non-infected (simple) olecranon bursitis is not serious and settles with simple measures, but it is important to recognise the signs of infection, which needs prompt treatment.

How it is treated

Management depends on whether the bursitis is simple (non-infected) or infected. Simple olecranon bursitis often settles on its own with conservative measures over a few weeks: avoiding pressure on and leaning on the elbow (for example using an elbow pad, or changing habits that put pressure on it), resting the elbow, simple pain relief, and sometimes ice; treating any underlying cause (such as gout) helps. Sometimes, for a large or persistent simple bursa, the fluid is drained with a needle, though it can refill. If the bursa becomes infected (septic bursitis) — suggested by increasing redness, warmth, pain, and feeling unwell — it needs treatment with antibiotics, and the fluid may need to be drained or the bursa assessed further; a doctor may take a sample of the fluid to check for infection. For recurrent or persistent troublesome bursitis, or infection not settling, further treatment (occasionally including surgery to remove the bursa) is considered. Avoiding the cause (such as leaning on the elbow) helps prevent recurrence. The reassuring message is that most olecranon bursitis is not serious and settles with avoiding pressure on the elbow and simple measures, but that signs of infection (redness, warmth, increasing pain, feeling unwell) should prompt prompt medical treatment.