What's this big lump on my elbow? Olecranon Bursitis

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What is Olecranon Bursitis?

Firstly you need to know what the Olecranon is and secondly what Bursitis is and then it will make sense:

The Olecranon process is a bony prominence at the end of the Ulna bone, basically it is the point of your elbow.  Because of this, it is an area of potential friction on internal structures running over it. In the body where these potential friction areas exist there is usually a Bursa.
A Bursa is basically a fluid filled sac designed to reduce the friction between the bone and other soft tissues. So Olecranon Bursitis is basically inflammation of this exact Bursa.



What causes Olecranon Bursitis?

There are two types of Olecranon Bursitis:

Non-septic — this is the most common type and is basically inflammation resulting from various causes including trauma or overuse.

Septic — this type is less common and is basically an infection in the bursa.

How common is Olecranon Bursitis?

It isn’t that common, I’ve seen it a handful of times in my career. Buono et al (2012) found that it accounts for between 0.01% - 0.1% of overall hospital admissions.
It affects young to middle-aged men the most. Generally jobs which cause regular elbow trauma, load or pressure over the bursa.
It also affects athletes who play sports that involve repetitive overhead throwing or elbow movement.

How do you diagnose Olecranon Bursitis?

The main sign of Olecranon Bursitis is swelling over the tip of the elbow that appears over several hours to several days. The swelling can increase and decrease and may be tender or warm.
Pain is caused by compression at end of range bending of the elbow and sometimes when loading the triceps.
An MRI could be indicated to ascertain the presence of an abscess or osteomyelitis, but most of the time it isn’t required (Buono et al 2012).

How do you treat Olecranon Bursitis?

Most cases of Olecranon Bursitis resolve without complications; however, recurrent episodes may occur especially after recurrent minor trauma.

Management of non-septic bursitis includes:


Most people will respond to conservative treatment, which usually involves rest, compression, avoidance of any aggravating movements of the elbows, and painkillers until the symptoms improve.
Also as the triceps crosses the bursa then overuse and shortening of this muscle can be relevant so light stretches may also be beneficial.

Occasionally if the swelling is large then they may be need to aspirate it with a needle.
If this fails then a corticosteroid injection into the bursa may be considered.


If after 2 months conservative treatment isn’t working then surgery is the next step.

The surgery is basically a complete removal of the inflamed bursa, followed by a short period of immobilisation in an elbow pad to allow early recovery of range of motion, and early strengthening and stretching exercises (Buono et al 2012).

Management of septic bursitis includes:


Basically antibiotics are the treatment of choice. Initially broad spectrum but a culture can be taken to work out the exacting antibiotic required.

Again like non-septic, you can consider aspiration to improve function and comfort in the short term.
This type can be linked to other conditions so the appropriate management of these is vital. Commonly they can be gout, cellulitis, or rheumatoid arthritis.

Obviously infection can be very serious so if the septic bursitis develops into extensive cellulitis or a severe infection resulting in systemic toxicity, then you may need to be admitted to hospital.

Obviously this injury isn’t that common but as I saw one recently and their G.P. didn’t know what it was, I thought that I would write a short article on it.


If you need any further information or would like to book an appointment then call Hawkes Physiotherapy on 01782 771861 or 07866195914




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