What is olecranon bursitis?
Bursae are small sacs that reduce friction between skin, tendons and bone. The olecranon bursa at the back of the elbow lets the skin glide over the bony point. Because it sits just under the skin, it is easily irritated by pressure or injury. When it becomes inflamed, the lining produces extra fluid and the bursa swells. A similar problem around the hip is described in our guide to hip bursitis.
Symptoms
- Swelling at the tip of the elbow, from a small bump to a large, soft lump.
- Swelling that may appear suddenly or build over days to weeks.
- Mild tenderness or pain when leaning on the elbow.
- Usually normal elbow movement, because the joint itself is not involved; very large swellings may limit bending.
- In infected bursitis: redness, warmth, increasing pain, and sometimes fever.
- In gout-related bursitis: sudden painful swelling, sometimes with chalky deposits.
Causes
- Repeated pressure: leaning on the elbows at a desk, on car armrests or during work such as plumbing.
- Direct trauma: falling onto the elbow or banging it.
- Infection: bacteria entering through a cut, scrape or insect bite over the elbow.
- Inflammatory conditions: gout, rheumatoid arthritis and other forms of arthritis.
- Some sports and hobbies: wrestling, gymnastics, darts.
- Higher risk in people with diabetes, kidney disease or weakened immunity.
How to tell if elbow bursitis is infected
Infected (septic) bursitis is more likely if the swelling is red, hot and increasingly painful, if there is a wound nearby, or if you have a fever. However, infection can be subtle, and redness can occur without infection. Doctors often draw off a small amount of fluid with a needle to look for bacteria and crystals (which suggest gout). Septic bursitis is treated with antibiotics, sometimes repeated drainage, and occasionally surgical washout.
Treatment for non-infected bursitis
- Avoid leaning on the elbow; use padding or an elbow pad at work and in sport.
- Apply ice wrapped in a cloth for 15 minutes a few times a day in the first days.
- Use a light compression bandage to help reduce swelling, if comfortable.
- Rest the arm from activities that press on the elbow, while keeping it moving.
- Anti-inflammatory tablets or gels may help if suitable for you.
- Most swellings reduce over two to six weeks, though some take longer.
- Aspiration (draining with a needle) may be offered for large or uncomfortable swellings, but fluid can return; steroid injections are used cautiously because of infection and skin risks.
When surgery is considered
Surgery to remove the bursa (bursectomy) is reserved for bursitis that keeps coming back despite treatment, chronic swelling that interferes with daily life, or infections that do not settle. It can be done through an open incision or with keyhole techniques. Wound healing over the elbow can be slow, so the elbow is usually protected for some weeks afterwards.
Other causes of a swollen or painful elbow
- Tennis elbow and golfer’s elbow: pain on the outer or inner side of the elbow with gripping, rather than swelling at the tip; see tennis elbow.
- Elbow joint arthritis or infection: pain and swelling of the whole joint with reduced movement.
- Fracture after a fall: pain, swelling and difficulty moving.
- Rheumatoid nodules or gout tophi: firm lumps near the elbow.
- Cellulitis: spreading redness and warmth of the skin.
Three common situations
- Office worker with a painless lump after weeks of leaning on a desk: likely non-infected bursitis; padding, avoiding pressure and patience are usually enough.
- Gardener with a red, hot swollen elbow after a scratch: possible septic bursitis; see a doctor the same day.
- Person with gout and sudden elbow swelling: crystals in the bursa may be responsible; the fluid can be tested and gout treated.
Preventing elbow bursitis from coming back
- Avoid resting your elbows on hard surfaces; use a cushioned pad or change your desk set-up.
- Wear elbow pads for work that involves kneeling and leaning, and for contact sports.
- Clean and cover any cuts or scrapes over the elbow promptly.
- Keep gout and other inflammatory conditions well controlled with your doctor.
Key points to remember
- Elbow bursitis causes swelling at the tip of the elbow, often from pressure or a knock.
- Most cases settle with protection, ice and time.
- Redness, heat, increasing pain or fever suggest infection and need prompt care.
- Surgery is only for persistent or recurrent cases.
Questions about elbow bursitis
These answers are general information and do not replace an examination or individual medical advice.
How long does elbow bursitis take to go away?
Non-infected bursitis usually improves in two to six weeks with protection and rest from pressure; large swellings can take a few months.
Should I drain my elbow bursitis myself?
No. Never try to drain it yourself, as this can cause infection. A doctor can aspirate it safely if needed.
Can elbow bursitis go away without treatment?
Yes, many cases resolve by avoiding pressure on the elbow. Infected bursitis, however, needs medical treatment.
Is heat or ice better for elbow bursitis?
Ice is usually better in the first days to reduce swelling. Avoid heat if the area is red or warm.
Can I keep exercising with elbow bursitis?
Yes, most exercise is fine as long as it does not involve leaning on or knocking the elbow. Avoid push-ups on the elbows, planks on hard floors and contact sports without padding until the swelling settles.
Why did my elbow swell up suddenly without injury?
Bursitis can follow minor repeated pressure you may not notice, and gout or infection can cause sudden swelling. If it is red, hot or painful, see a doctor.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.