“So what’s this little water balloon on my elbow? Doesn’t really hurt; just feels kind of weird to rest my elbow on anything. And I didn’t really do anything much to hurt it as far as I know.”
To cut to the chase, this patient had something called olecranon bursitis. Olecranon is just the name of that part of the elbow, and bursitis is just the term for an inflamed bursa. So what in the world is a bursa? It’s a fluid-filled sac that is located at a joint and serves to reduce friction over some of the moving parts of that joint. Picture a small balloon deflated until it has only a tiny amount of fluid in it that serves to help it cushion and reduce friction. There are about 160 of these bursae in the human body distributed throughout the joints. For example, the knees each have eleven bursae.
These little lubricating sacs do an amazing job reducing the wear and tear of the bones, ligaments, tendons and cartilage that are moving over a lifetime in each joint. Once in a while one of these bursa gets inflamed (actual infection is much less common), swells and may become painful. Most of us will experience one or more cases of bursitis at one joint or another over the course of a lifetime.
Typically bursitis of the knee, hip or shoulder is painful, perhaps in part because there is pressure on the inflamed bursa due to their location. The olecranon bursa sits over the point of the elbow and is free to swell without much pressure. The result is that it usually is only minimally painful or even painless (though occasional painful cases occur) and is just a funny-looking nuisance hanging off of the elbow. It may show up after falling onto the elbow or just from routinely leaning on the elbow.
As far as treating olecranon bursitis, some choose to do nothing but wait it out. If this is chosen, a neoprene sleeve or similar application may be helpful to reduce swelling and minor trauma to the elbow. With this approach the inflammation may calm, the swelling then eases out of the bursa and the problem resolves. This can take from weeks to months and sometimes doesn’t seem to be progressing at all.
The next level of treatment is to use oral anti-inflammitants (like ibuprofen or naproxen), icing and attempts to avoid putting pressure on the bursa. If this still isn’t bringing resolution, your doctor may offer to drain the fluid from the bursa and inject a small amount of cortisone (a steroid) along with a numbing medicine back into the bursa. This has a somewhat better than 50-50 chance of resolving the problem. Worst case if after a couple of these attempts the fluid just keeps coming back, an orthopedist can be consulted. The last resort is the surgical removal of the bursa if it persists in staying swollen, inflamed, and is doing more harm than good. Similar approaches are taken with other types of bursitis, many of which are significantly more painful than olecranon bursitis.
The bursae are another amazing and ingenious part of the creation that is our body. Like most of our other parts, we tend to not really appreciate and notice them until they aren’t working quite right. So if you have some joints that are still moving with a degree of smoothness, thank your Creator. If you’ve got symptoms that sound like bursitis, it might be time for a little treatment.