What is it?
Bursitis (ber-SEYE-tis) is swelling and pain of a bursa. A bursa is a fluid-filled sac that acts as a cushion or shock absorber between a tendon and a bone. A tendon is a cord of tough tissue that connects muscles to bones. Although you cannot feel it, the elbow bursa is behind your elbow (over the pointed tip). Normally a bursa has a small amount of fluid in it. When injured, the bursa becomes inflamed (red and sore) and may fill with too much fluid. Olecranon (oh-LEK-rah-non) bursitis is a type of elbow bursitis when the bursa in your elbow becomes inflamed. With treatment, your bursitis should go away in one to two weeks.
Your elbow bursitis may have been caused by one or more of the following:
- Constant pressure on your elbows. This includes leaning on or bumping your elbows a lot.
- Direct, hard hit to your elbow.
- Infection (in-FEK-shun).
- Medical problems such as rheumatoid (ROO-ma-toid) arthritis (ahr-THREYE-tis) or gout.
- Overusing your elbows. This is caused by doing activities or sports that use the same motions (movements) over and over again. Examples of repeating motions are swinging a pick or hammer, vacuuming, and playing tennis.
- Sometimes people do not know how they developed elbow bursitis.
Sings and Symptoms: Bursitis may be a long-term problem that comes and goes over time. Your bursitis may happen suddenly if it is caused by things like infection or a hard hit to the elbow. You may have one or more of the following:
- Lump or goose-egg type swelling in the back of your elbow.
- Decreased movement. You may not be able to move your elbow as much as you normally can.
- Pain or tenderness in your elbow.
- Redness and warmth. If the bursa is infected, the skin over the elbow may be red and hot. You may also have a fever.
- Rest your elbow as much as possible to decrease swelling and keep the bursitis from getting worse. When the pain decreases, begin normal, slow movements.
- Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain and redness). Put crushed ice in a plastic bag and cover it with a towel. Put this on your elbow for 15 to 20 minutes, three to four times each day. Do not sleep on the ice pack because you can get frostbite.
- Elevate (raise) your arm to help decrease swelling. Keep your elbow at a level above your heart by gently propping your arm on pillows.
- Caregivers may wrap your arm with tape or an elastic bandage to keep your elbow from swelling. Loosen the elastic bandage if your fingers begin to tingle or turn blue.
- Caregivers may put your arm in a sling to keep your arm close to your body with your elbow bent. This will keep your elbow still and allow the bursitis to heal. Do not put your arm over your head until the bursitis is healed.
- You may be given antibiotics (an-ti-bi-OT-iks) to fight infection if needed. Take them as ordered until they are all gone, even if your elbow begins to feel better.
- You may use nonsteroidal (non-ster-OID-al) anti-inflammatory (an-tee-in-FLAM-ah-tohr-ee) medicine (NSAIDs) to help decrease pain and inflammation (swelling). Some NSAIDs may also be used to decrease a high body temperature (fever). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
- You may be given shots of medicine called steroids (STER-oids) to decrease inflammation. Caregivers may also give you local anesthesia (an-es-THEE- zah). This medicine helps decrease bursitis pain. Because these shots decrease swelling and pain, you may feel like your elbow is healed and that you can return to heavy exercise. It is important not to exercise your elbow until your caregiver says it is OK. You could make the bursitis worse if you exercise your elbow too soon. Ask your caregiver what exercise you may do while your elbow bursitis heals.
- A physical (FIZ-i-kal) therapist (THER-ah-pist) can do treatments to help your elbows. Caregivers may use ultrasound to increase blood flow to the injured area. This may help bursitis heal faster. Exercises to make your elbow stronger and have better movement will be started after the bursitis has healed.
- Caregivers may use a needle to drain fluid from your elbow. Removing the extra fluid may help the bursitis heal faster. The fluid may be sent to a lab and checked for infection.
- You may need surgery to remove the bursa or part of your elbow bone. Surgery is usually not needed unless the bursitis is very bad, and does not heal with other treatments.
Following are things you can do to help prevent bursitis from returning:
- Keep pressure off your elbows. Do not lean on your elbows a lot, such as when working at a desk.
- Avoid hitting or bumping your elbows. Wear elbow pads or protectors when you begin normal activities. Continue to wear them whenever you do activities that could cause bumping or hits to your elbows.
- Do not grip small items too tightly. This includes using tools and writing with pens or pencils. Try not to clench your fists.
- Take breaks when doing activities or exercises that use repeated movements. This may help prevent injury caused by overusing or over-exercising your elbows. Wear an elbow strap when playing sports that use repeating movements, such as tennis.
- Warm-up and cool down. Start exercising when caregivers say that it is OK. Always warm up your muscles and stretch gently before exercising. Do cool down exercises when you are finished. This will loosen your muscles and decrease stress on your elbow.
- Start treatment right away if you feel bursitis signs and symptoms. Follow the R.I.C.E. plan (rest, ice, compression and elevation) whenever you have swelling, warmth or pain in your elbow.
Herbs and Supplements:
Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.
- Acupuncture decreases bursitis inflammation.
Other ways of treating your symptoms :
Talk to your caregiver if:
- You would like medicine to treat bursitis.
- Your symptoms have not gone away or improved by these self-help measures.
- Your pain and swelling increase.
- You get new, unexplained symptoms.
- You have a fever.
- You have questions about what you have read in this document.
Care agreement: You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
1. American Academy of Othopaedic Surgeons. Elbow bursitis. 2002. Available at: http://orthopaedics.hss.edu/services/conditions/arm_elbow/elbow_bursitis.asp (cited 3/1/04).
2. American Academy of Orthopaedic Surgeons. What are NSAIDs? December 2002. Available at: http://orthoinfo.aaos.org (cited 3/4/04).
3. Arthritis Foundation. Bursitis, tendinitis and other soft tissue rheumatic syndromes (online brochure). September 26, 2003. Available at: http://www.arthritis.org/AFStore/singleproduct.asp?idproduct=3320&idcat=8 (cited 3/4/04).
4. Berliner MN, Bretzel RG, Klett R. Successful radiosynoviorthesis of an olecranon bursitis in psoriatic arthritis. Ann Rheum Dis 2002; 61(2):187-188.
5. Cardone DA, Tallia AF. Diagnostic and therapeutic injection of the elbow region. Am Fam Physician. December 1, 2002; 66(11):2097-2100.
6. Ceccherelli F, Gagliardi G, Matterazzo G et al: The role of manual acupuncture and morphine administration on the modulation of capsaicin-induced edema in rat paw: a blind controlled study. Acupunct Electrother Res 1996; 21(1):7-14.
7. Clymann BB. Selected periarticular soft tissue problems in the elderly. Journal of the American Medical Directors Association 2003; 4(3):167-170.
8. Mayo Foundation for Medical Education and Research. Bursitis. December 18, 2003. Available at: http://images.mayoclinic.com/invoke.cfm?id=DS00032 (cited 3/2/04).
9. Mayo Foundation for Medical Education and Research. Injections. November 19, 2002. Available at: http://www.mayoclinic.com/invoke.cfm?id=PN00046 (cited 3/1/04).
10. Nettina SM. The Lippincott Manual of Nursing Practice, 7th ed. Philadelphia, PA. Lippincott; 2001.
11. Pinter E & Szolcsanyi J: Systemic anti-inflammatory effect induced by antidromic stimulation of the dorsal roots in the rat. Neurosci Lett 1996; 212(1):33-36.
12. Schoen AM: Acupuncture for musculoskeletal disorders. Probl Vet Med 1992; 4(1):88-97.
13. Schoen RT. Bursitis, tendonitis, myofascial pain, and fibromyalgia. In: Rakel RE, Bope ET (eds). Conn's Current Therapy 2004. Philadelphia, PA: Saunders 2004; 1040-1042.
14. Zhang WY & Li Wan Po A: The effectiveness of topically applied capsaicin: a meta-analysis. Eur J Clin Pharmacol 1994; 46(6):517-522.
Thomson Micromedex. All rights reserved.