Olecranon bursitis typically is not painful. Initial treatment usually consists of a compressive ace wrap and ice. Often we drain these in the office. The big risk is getting an infected olecranon bursitis, which is more serious.
True swelling inside the elbow joint is much rarer, and may be due to arthritis, or a more severe injury. This type of swelling is marked by loss of motion and stiffness, and often pain. This type of swelling needs to be evaluated by a specialist.