Bursa are thin, slippery sacs of fluid that act as cushions between bones and soft tissue. Normally the olecranon bursa, which is located between the loose skin and the pointy bone at the back of the elbow is flat. If it becomes irritated or inflamed then more fluid will accumulate in the bursa and bursitis will develop. Bursitis can occur because of a direct trauma or prolonged pressure to the area, infection inside the bursa or medical conditions such as rheumatoid arthritis or gout.
Swelling is usually the first symptom, followed by pain as the bursa gets larger. Pain can be worse with direct pressure or attempting to bend the elbow. If infection is present the skin may be red and warm, this infection can spread causing serious illness if not treated.
Non-surgical: Aspiration (draining of the fluid using a needle) may be used to remove the fluid to relieve symptoms or in the case of a suspected infection the fluid can be sent for testing – which may require antibiotics. Restricting aggravating activities, the use of elbow pads or anti-inflammatory medications may also be recommended to relieve symptoms. If these methods are not successful a steroid injection may be put into the bursa (after aspiration) to relieve pain and swelling, this may only provide temporary relief.
Surgical: If non-surgical management is unsuccessful then surgery to remove the bursa may be recommended. Surgery does not affect any surrounding soft tissues and the bursa usually grows back as a non-inflamed, normally functioning bursa over a period of several months.
A splint will usually be applied after the procedure to protect the skin. Although formal physical therapy after surgery is not necessary you may be given some general exercises to improve range of motion and advised to use padding to protect your elbow for several months.