Overview
Olecranon bursitis is irritation and inflammation of the bursa over the bony tip of the elbow (the olecranon). The bursa is a small, fluid-filled sac that helps reduce friction between the skin and bone, so when it becomes inflamed it can swell and feel tender. Pain and stiffness usually worsen when the elbow is pressed against a surface or used repeatedly. In some cases, the bursa can become infected, which can lead to warmth, redness, and fever.
Symptoms
You may notice a rounded swelling directly behind the elbow that can feel soft or firm, along with tenderness to touch. The area may be sore with leaning on the elbow, bending the arm for long periods, or lifting and pushing. If the bursitis is infected, symptoms often include increasing redness, warmth, significant pain, and sometimes fever or chills. Some people also notice mild trouble fully straightening the elbow due to discomfort from the swelling.
Causes
Olecranon bursitis most often develops after repeated pressure on the elbow, kneeling or leaning, or minor trauma such as a direct bump. Overuse and friction can overload the bursa and trigger inflammation. Less commonly, bacteria enter through a skin break or abrasion and cause septic (infectious) bursitis, which usually progresses faster and more intensely.
Risk Factors
People who work or study in ways that involve frequent elbow pressure (such as trades, desk work with elbows on the armrest, or sports) are at higher risk. Gout, rheumatoid arthritis, chronic kidney disease, and diabetes can increase the likelihood of inflamed or infected bursae. A weakened immune system or recent skin injury over the elbow also raises the risk of septic bursitis.
Prevention
Reduce direct pressure on the elbow by using padding and changing positions during tasks that require leaning. Build tolerance gradually to activities that involve repetitive elbow motion, and avoid sudden increases in workload. Keep the skin over the elbow clean and protected, and treat cuts or scrapes promptly to lower the risk of infection. If you have inflammatory arthritis, managing it with your clinician can help reduce recurrent bursitis.
How the Diagnosis Is Evaluated
A clinician usually starts with a history of elbow pressure, injury, and symptom timing, including whether redness, warmth, fever, or severe pain are present. During the physical exam, the swelling over the olecranon is assessed for tenderness, warmth, skin changes, and the effect on elbow range of motion. If infection is suspected, aspiration may be recommended to analyze fluid and guide treatment, and blood tests may be added in more concerning cases. Imaging such as X-ray or ultrasound is used selectively to rule out fracture, arthritis-related problems, or other causes of swelling.
Nonsurgical Treatment Options
For noninfectious bursitis, treatment typically focuses on protecting the elbow, avoiding pressure, and using ice and activity modification to reduce pain and swelling. Over-the-counter anti-inflammatory medicines such as ibuprofen or naproxen may help if they are safe for you. Gentle range-of-motion work can help prevent stiffness while the bursa settles, and a compression wrap or elbow pad may provide comfort. If the swelling persists or pain is limiting, a clinician may perform aspiration to remove excess fluid and, in selected noninfectious cases, may add a corticosteroid injection to reduce inflammation. For septic bursitis, treatment usually includes antibiotics and drainage or aspiration when needed, along with close follow-up to ensure infection is resolving.
When to Seek Medical Attention
Seek prompt medical attention if you have fever, spreading redness, increasing warmth, worsening severe pain, or rapidly enlarging swelling, because these can suggest infection. Get urgent care if you cannot use your arm normally, have significant numbness or weakness, or notice red streaking or other signs of spreading skin infection. If symptoms do not improve after about 1 to 2 weeks of protective care, or if swelling keeps recurring, a clinical evaluation is recommended to confirm the diagnosis and rule out other causes.
Frequently Asked Questions
Septic bursitis is often more painful and warm, may involve redness and fever, and usually requires medical treatment with antibiotics; noninfectious bursitis is commonly related to pressure or minor trauma.
No, you should not attempt to drain it yourself because it can increase the risk of infection and worsen tissue injury.
Many cases improve over days to a few weeks with protection and anti-inflammatory measures, but recurrent or infected cases may take longer and need additional treatment.
Next Steps
If your swelling is mild and you have no fever or spreading redness, start by protecting the elbow from pressure and using ice and anti-inflammatory measures if safe. If symptoms are severe, rapidly worsening, or you suspect infection, arrange an in-person evaluation soon for exam and possible aspiration. If you do not see improvement within 1 to 2 weeks or it keeps coming back, get checked to confirm the cause and tailor treatment.