Located at the olecranon (tip of the elbow) is the olecranon bursa, a thin, fluid-filled sac. Bursae are located throughout the body, and they are important in reducing friction between the bones and soft tissue. Olecranon bursitis occurs when the bursa in the elbow becomes swollen. This puts pressure on parts of the elbow, causing pain and discomfort.

Olecranon bursitis is commonly caused by a direct blow to the back of the elbow, which can make the bursa expand with fluid. Athletes who are at greater risk for developing elbow bursitis include those who:

• Play contact sports (e.g. football players)
• Frequently land on their elbows onto hard surfaces (e.g. volleyball players)
• Engage in repetitive motions (e.g. baseball pitchers)

Elbow bursitis is common in these sports:

• Football
• Lacrosse
• Baseball
• Basketball
• Volleyball
• Wrestling

Swelling behind the elbow is the most common  symptom of elbow bursitis. If the bursitis results from a chronic condition, like repetitive motion, swelling may develop slowly. You’re likely to notice swelling develop quickly after an acute injury. Swelling may be mild, or moderate to severe.

Usually the remainder of the elbow joint feels fine. However, as the swollen bursa puts increased pressure on the elbow, it can cause pain. Pain can intensify with activity or with bending the elbow.

Elbow bursitis can often be treated at home. However, in some cases you will want to seek medical treatment for this condition. If you experience a fever or feel sick along with swelling behind the elbow, your bursitis may be caused by an infection, called septic bursitis. See your doctor if you experience these symptoms.

If you don’t have a fever, but your elbow is getting progressively worse, you should schedule a medical appointment. A physical examination will be conducted to see if there is a tender, swollen area behind the elbow and assess your range of movement.

Your doctor may also order an x-ray to see if you have a fracture or bone spur. An ultrasound may also be helpful to show fluid  in the olecranon bursa.

If your doctor suspects your bursitis is caused by infection, he or she may want to aspirate the bursa, or remove fluid with it using a thin needle. Removal of the fluid will help alleviate the symptoms. Testing of the fluid can help determine if an antibiotic is needed for further treatment.

If your elbow bursitis is not related to infection, conservative treatment may be recommended, including:

• Rest: It is important to take the pressure off the elbow to allow the bursae to heal. Athletes, particularly those who play high impact sports, should discontinue activities that aggravate their elbow. An elbow pad may be helpful to protect your elbow.
• Ice: To help reduce swelling, you should apply ice packs to to your elbow three to four times a day for 20 minutes.
• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help alleviate symptoms.

Aspiration: Even if your bursa does not seem infected, sometimes your physician may aspirate the bursae (remove the fluid with a needle) in order to resolve the problem more quickly.

Surgical treatment for elbow bursitis is rarely needed. However, if conservative treatment options are ineffective, your doctor may recommend surgically removing the bursa.

Before returning to normal activity, your swelling should have gone down and you should have achieved full range of motion without pain. If surgical treatment is needed, you may need three to six weeks of recovery before returning to play. Wearing an elbow pad can be a helpful measure to protect from further injury.