The bursa in the elbow lies just beneath the skin, and its delicate membrane can be easily irritated and inflamed, leading to a condition called elbow bursitis. Elbow bursitis can have a variety of underlying causes, ranging from an acute injury to the elbow to a systemic disease, such as rheumatoid arthritis.
Elbow injury or trauma
A fall or a blow to the elbow can cause the bursa to fill with blood, which may irritate and inflame the bursa's synovial membrane. Even though the body reabsorbs the blood, the membrane may stay inflamed, causing bursitis symptoms.
Repetitive pressure on the elbow
Bursitis can be caused by frequent "mini-traumas," which can cause the same problems as a single, more serious trauma. People who rest their elbows on hard surfaces are more likely to get elbow bursitis. Repeatedly resting weight on the elbows may especially increase risk.
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History of inflammation of the olecranon bursa
Once a bursa has been inflamed, it can become more easily inflamed again in the future. Therefore, patients who have had elbow bursitis in the past have an increased chance of developing it again.
Another underlying condition
Elbow bursitis is more likely to occur in people who have certain medical conditions, such as psoriasis, rheumatoid arthritis, gout, and pseudogout. Experts estimate that anywhere from 33% to 74% of people with elbow bursitis have another associated medical condition. 1 Laupland KB, Davies HD. Olecranon septic bursitis managed in an ambulatory setting. The Calgary Home parenteral therapy program study group. Clin Invest Med 2001;24:171-8. As cited in Reilly D, Kamineni S. Olecranon bursitis. J Shoulder Elbow Surg. 2016 Jan;25(1):158-67. doi: 10.1016/j.jse.2015.08.032. Epub 2015 Nov 11. Review. PubMed PMID: 26577126. , 2 Raddatz DA, Hoffman GS, Franck WA. Septic bursitis: presentation, treatment and prognosis. J Rheumatol 1987;14:1160-3. As cited in Reilly D, Kamineni S. Olecranon bursitis. J Shoulder Elbow Surg. 2016 Jan;25(1):158-67. doi: 10.1016/j.jse.2015.08.032. Epub 2015 Nov 11. Review. PubMed PMID: 26577126. Increased risk may be related to a condition itself or to medications used to treat a condition. 3 Blackwell JR, Hay BA, Bolt AM, Hay SM. Olecranon bursitis: a systematic overview. Shoulder Elbow. 2014;6(3):182–190. doi:10.1177/1758573214532787.
When the bursa is infected, the condition is called septic bursitis. Infectious bacteria or other microbes can reach the olecranon bursa through a cut, puncture or even an insect bite at the elbow. It is possible to have septic bursitis without an obvious cut or scrape; sometimes the root cause of infection is unknown.
Research suggest that the people most likely to have septic elbow bursitis are young and middle-aged people who do manual labor, participate in sports, or perform elbow crawls for military drills. 4 Truong J, Ashurst JV Septic Bursitis. Jan 2019; Last Updated Feb 2019. Review. PubMed PMID: 29262131. , 5 Schermann H, Karakis I, Dolkart O, Maman E, Kadar A, Chechik O. Olecranon Bursitis in a Military Population: Epidemiology and Evidence for Prolonged Morbidity in Combat Recruits . Mil Med. 2017 Sep;182(9):e1976-e1980. doi: 10.7205/MILMED-D-16-00402. PubMed PMID: 28885965.
In addition, certain medical conditions and medications suppress people's immune systems and make them more susceptible to developing septic bursitis. 6 Roschmann RA, Bell CL. Septic bursitis in immunocompromised patients. Am J Med 1987; 83: 661–665. For example, people with diabetes, cancer, and chronic obstructive pulmonary disease (COPD) are more likely to get septic bursitis.