What it is

Olecranon bursitis is swelling of the bursa at the tip of the elbow. It follows repeated pressure, a knock, or occasionally infection. The bursa fills with fluid, causing a soft lump and local tenderness.

Most cases settle with protection and adjustments to activity. Infection needs urgent care.

What happens when it occurs

The bursa reacts to friction or impact by producing fluid. If bacteria enter, the bursa becomes hot and painful. Protection and compression help with non-infectious cases, while antibiotics and drainage address infections.

Common causes and risk factors

  • Leaning on hard surfaces, crawling, or frequent kneeling with elbows on the ground
  • Direct blows during sport or work
  • Skin breaks, psoriasis, or gout increase the risk of infection

Who is most affected

Trades, gardeners, students leaning on desks, and contact sports.

Typical symptoms

  • Soft, sometimes fluctuant swelling over the elbow tip
  • Local tenderness and stiffness with deep flexion
  • Warmth and redness in infective cases

When to seek care

Immediately, if the bursa is hot, red, and very tender, or if you have a fever. Otherwise, if swelling and pain persist.

How we diagnose

Clinical examination. Ultrasound confirms fluid. Aspiration is used to diagnose an infection when it is suspected.

Management

  • Protective padding and avoiding pressure
  • Compression and short periods of immobilisation for comfort
  • Gradual return to loading and strength
  • Antibiotics and drainage for septic bursitis

Rehabilitation milestones

Phase 1 weeks 0 to 2: swelling control, avoid direct pressure, gentle range.

Phase 2 weeks 2 to 6: progressive strength, return to tasks.

Phase 3, weeks 6 to 12: work capacity and sport drills as required.

Readiness to progress

  • The swelling trend is down, and the skin is healthy
  • Full range without pain
  • Tasks completed without next‑day swelling

Prevention

  • Use pads for desk or floor work
  • Avoid leaning on the elbow tip
  • Protect skin and treat cuts early

Australia snapshot

  • Common in trades and students
  • Primary care and physiotherapy manage most non-infectious cases
  • Public and private pathways available for aspiration and antibiotics

Latest insights

Calm the bursa, then restore capacity. Infection changes the plan—seek care early if you suspect it.

Padding and habit changes prevent recurrence.

Frequently Asked Questions

No. Aspiration should be sterile and only when indicated.

No, unless infected. Septic bursitis is typically treated with antibiotics and, in some cases, drainage.

Yes, with exercises that avoid direct pressure and heavy elbow flexion early.