Elbow bursitis: a swollen lump on the point of the elbow
A soft, egg-like swelling on the point of the elbow often appears almost overnight. It looks alarming, but it's usually olecranon bursitis, sometimes called student's elbow or Popeye elbow, and most cases settle without much intervention.
What is elbow bursitis?
The olecranon bursa is a thin sac between the skin and the bony point of the elbow. When irritated, it fills with fluid and swells into a soft lump that can be the size of a golf ball.
What causes it?
Leaning on the elbows for long periods at a desk or bench, a direct blow or fall onto the elbow, and repeated friction, such as from mats in grappling. It's also associated with gout and rheumatoid arthritis, and it can become infected, particularly after a graze or insect bite over the elbow.
What does it feel like?
A soft swelling right on the tip of the elbow. Non-infected bursitis is often painless or only mildly tender, with pain mainly when you lean on it. The elbow joint usually bends and straightens normally.
How do I know if it's infected?
Signs of infection include redness, warmth, increasing pain, a break in the skin over the elbow, fever and feeling unwell. A review notes fever, a clearly warmer area of skin over the bursa and skin lesions as the findings that point to infection (Baumbach et al., Archives of Orthopaedic and Trauma Surgery, 2014). See a doctor the same day if you have any of these.
How is elbow bursitis treated?
For non-infected bursitis: stop leaning on the elbow, protect it with a padded sleeve, use compression and ice, and give it time. Anti-inflammatory medication may help if suitable for you. Infected bursitis needs antibiotics and sometimes drainage.
What does the research say about treatment?
A systematic review of 29 studies covering 1,278 patients found non-surgical management was significantly more effective and safer than surgery. It also found that corticosteroid injection for non-infected bursitis was associated with more complications, including skin thinning, and that drawing off the fluid did not increase the risk of infection (Sayegh and Strauch, Archives of Orthopaedic and Trauma Surgery, 2014). The evidence was mostly low-level studies.
Should I have it drained?
Draining is useful when infection needs to be ruled out or the swelling is large and uncomfortable. It often refills, and many cases settle without it. Your GP can advise.
How long does it take to go away?
Non-infected bursitis commonly settles over three to six weeks once the pressure is removed, though it can take longer and the area may stay slightly thickened.
Can I keep training and working?
Yes, while protecting the elbow. Wear an elbow pad or sleeve, avoid resting on it, and avoid exercises that press on the point of the elbow, such as planks on the forearms and skull crushers on a bench edge. Grapplers can wear a sleeve and avoid posting on the elbow.
See our post on BJJ elbow injuries.
How do I stop it coming back?
Change how you sit so you aren't leaning on your elbows, use a gel pad on the desk or armrest, and wear protection for work or sport that involves elbow contact.
Is it related to tennis elbow?
No. Tennis and golfer's elbow are tendon problems on the outer and inner sides of the elbow, with pain on gripping and no visible lump. Bursitis is a swelling on the tip.
See our post on tennis elbow vs golfer's elbow.
Could the lump be something else?
Gout can cause a hot, very painful swollen bursa and firm lumps called tophi. Rheumatoid arthritis can cause nodules near the elbow. A hard, fixed or growing lump should be checked by a doctor.
Does compression help?
A snug elastic sleeve or bandage, worn through the day, helps limit swelling and reminds you not to lean on the elbow. It shouldn't be tight enough to cause tingling or swelling in the hand.
Will the lump go away completely?
In most cases the fluid goes, though the bursa lining can stay slightly thickened, and you may feel small firm nodules where it was. That's harmless.
How can an osteopath help?
We confirm it's the bursa and not the joint, screen for infection and other causes that need your GP, advise on protection and activity, and treat any associated elbow, shoulder or neck stiffness.
When should I see a doctor?
See a doctor the same day for redness, heat, severe pain, fever or a wound over the elbow. See your GP for swelling that isn't settling after a few weeks, or if you have diabetes, gout, rheumatoid arthritis or a weakened immune system.
See our elbow and wrist pain guide. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
Sources
Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
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