Home Health Noticing two elbows on one arm? It could be bursitis
Noticing two elbows on one arm? It could be bursitis
Written by Ken Chisholm, RN; BS; CNOR; CRNFA; OPA   
Thursday, 10 June 2010 14:35

Recently, a friend of mine asked me to take a look at her arm. It seems she grew an “extra elbow,” according to her description.

There was a big, ugly balloon-like bulge over her elbow, but what in the world was it?”

She couldn’t remember any injury, but did note that the elbow had been sore for some time before she noticed her “friend.”  

If you have ever experienced this yourself or know someone who has, then you know that I’m describing what is known as olecranon bursitis, or, bursitis of the elbow.

The olecranon is that portion of the forearm bone called the ulna that has a bony prominence opposite the fold on the front side of the elbow joint. When you rest your face in your hands while sitting at your desk daydreaming, you’re resting on your olecranon processes.

From an information perspective, bursa sacs exist in many other areas of the body as well. Their function is to provide cushioning and protection to various bony prominences and structures. They also allow the skin to move freely over these prominences.


Bursae (plural for bursa) can also be found over the patella (knee cap), the greater trochanter of the hip (the bump of the hip you can “feel” along the outer seam of your pants) and in the space between the rotator cuff and the acromion, or bony roof, of the shoulder. Under normal circumstances, the olecranon bursa, like the others, is essentially flat, although there is typically a small amount of fluid inside.

What causes elbow bursitis?
Several factors can cause this condition, including trauma to the elbow, repetitive pressure exerted on the bony prominence and systemic conditions such as gout.

In instances of chronic or repetitive pressure and irritation, perhaps from work activities that involved long periods of time with elbows resting on hard surfaces, inflammation can cause the sac to become swollen, thickened and filled with fluid. Sometimes, as a result of injury or repetitive flare-ups, a small bone spur can develop on the olecranon process, which then acts as a source of chronic irritation.

In the early, milder forms of the condition, just altering activity in order to avoid direct pressure on the elbows can allow things to settle down and the inflammation to subside. Non-steroidal anti-inflammatory drugs can also help reduce symptoms. Many people use supportive devices such as neoprene or knitted elbow sleeves to provide external compression and padded protection to the area(s).

If the bursitis is severe and/or chronic enough, the bursa sac can be drained of the fluid, and occasionally injected with cortisone to battle the inflammation. Care must be taken with cortisone injections because of its local immune-suppressive (suppressing the body’s ability to fight infection) properties, because of the increased risk of infection. Occasionally, despite all best efforts, the fluid in the bursa sac can become infected. In these instances, surgical removal of the infected fluid and sac is typically the treatment of choice.

So, if you’re wondering why you suddenly developed “two elbows” and you don’t know what that large, soggy bulge is under the skin, you probably have olecranon bursitis. Get it checked out buy your physician sooner rather than later – and quit day-dreaming at your desk.

A side note: Beginning in July, I’ll be posting a funny, weird or otherwise interesting medical fact with each article for your reading pleasure.

Chisholm’s expertise in nursing, orthopedics and surgery spans more than 30 years. For more information on orthopedic-related topics, visit Submit questions or comments to Ken at This e-mail address is being protected from spambots. You need JavaScript enabled to view it . This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Trauma to the elbow, repetitive pressure exerted on the bony prominence or systemic conditions such as gout can cause gout. Photo courtesy of



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