I've had chronic swellbow since I was 12. There are now pretty decent sized permanent bumps on my elbows. I get them constantly, but they never hurt beyond the initial slam. I've had 'em the size of an egg, maybe larger, but no pain.
Weird thing is I just got one, the slam hurt as bad as I can remember, it swelled up, but it was totally gone the next day. Usually they last about a week or so. And this one bruised and still hurts.
Weird.
Never gone to the doctor or anything.