Elbow Arthritis

What is Elbow Arthritis?

Elbow arthritis is a type of joint disease that affects the elbow, causing inflammation, pain, stiffness, and often leading to decreased range of motion. It typically occurs when the cartilage that cushions the bones in the elbow wears down over time or becomes damaged, leading to bone-on-bone contact that can cause pain and affect elbow function.

How Does Elbow Arthritis Impact Your Anatomy and Health?

In a healthy elbow, smooth cartilage covers the ends of the bones and allows them to move smoothly against each other. When arthritis strikes, this cartilage can become worn or damaged. This can lead to bone rubbing against bone, which can cause pain and limit the elbow's range of motion.

Over time, elbow arthritis can lead to the development of bone spurs or osteophytes, further affecting elbow function. It can also impact overall health, affecting a person's ability to perform daily activities like lifting objects, driving, or even simple tasks like cooking or dressing.

Who is Most at Risk for Elbow Arthritis?

Elbow arthritis is often seen in individuals over 50, as the risk of developing arthritis increases with age. Those with a previous elbow injury, such as a fracture or dislocation, are also at higher risk, as are people with jobs or hobbies requiring repetitive elbow movements. Additionally, individuals who are overweight or obese, or those with a family history of arthritis, may be more susceptible.

Causes of Elbow Arthritis

Elbow arthritis can be caused by several factors, often associated with natural wear and tear and other health conditions:

• Ageing: As we age, the cartilage that cushions our joints begins to deteriorate and become less flexible, which can lead to arthritis. This type of arthritis, known as osteoarthritis, is the most common cause of elbow arthritis in older adults.
• Previous Injury: If you've had an elbow injury, such as a fracture or dislocation, you may be at increased risk for developing arthritis in the elbow. This is known as post-traumatic arthritis, which can occur years after the initial injury.
• Overuse: Repetitive strain on the elbow joint, often due to certain types of physical work or sports, can cause gradual wear and tear on the joint and eventually lead to arthritis.
• Rheumatoid Arthritis: An autoimmune disease where your body's immune system attacks the lining of your joints, causing inflammation and joint damage. Rheumatoid arthritis can affect any joint in the body, including the elbow.
• Gout: A form of arthritis that occurs when urate crystals accumulate in your joints, causing inflammation and intense pain. Gout most commonly affects the big toe but can also occur in the elbow.
• Genetics: Some people may have a genetic predisposition to developing arthritis due to family history.

Symptoms of Elbow Arthritis

Elbow arthritis symptoms can vary in intensity and duration. These symptoms can also be influenced by the type of arthritis (e.g., osteoarthritis, rheumatoid arthritis). However, common symptoms often include:

• Pain: The most common symptom, this can vary from mild, nagging discomfort to severe, debilitating pain. The pain often worsens with activity or movement of the arm.
• Stiffness: A feeling of stiffness in the elbow joint, particularly upon waking up or after periods of inactivity, is a common sign of arthritis. It can make it difficult to straighten or bend the arm fully.
• Swelling: Inflammatory forms of arthritis like rheumatoid arthritis often lead to swelling around the elbow joint. The swelling can further limit movement and cause discomfort.
• Decreased range of motion: As arthritis progresses, it can become increasingly difficult to use the elbow normally. This could include challenges with bending and straightening the arm and even rotating the forearm.
• Crepitus: A crackling or grating sensation inside the joint that can occur when you move your elbow. It is caused by roughened cartilage surfaces rubbing against each other.
• Catching or locking: Some pieces of bone or cartilage can break from the main bones and float in the joint.  They can lodge between moving surfaces causing the joint to become stuck for a few seconds or minutes, with accompanying pain.
• Instability: Some people with elbow arthritis may feel a sense of looseness or instability in the joint, as if the elbow might give out.
• Deformity: In severe or advanced cases of arthritis, joint shape or appearance changes may occur.

Types of Elbow Arthritis

Elbow arthritis generally falls into three primary types:

• Osteoarthritis: A degenerative type of arthritis that typically results from wear and tear over time. With osteoarthritis, the cartilage that cushions the ends of the bones in your elbow gradually wears away, leading to pain and stiffness. This type of elbow arthritis is most common in people over 50 and those who have previously injured the elbow.
• Rheumatoid Arthritis: A chronic autoimmune disease affecting any joint, including the elbow. In RA, the body's immune system mistakenly attacks the synovium, the thin membrane that lines the joints, causing inflammation that can eventually damage joints. RA often affects joints symmetrically, meaning if one elbow is affected, the other likely will be too.
• Post-Traumatic Arthritis: This develops after an injury to the elbow, such as a fracture or dislocation. It can occur months or even years after the initial injury. Post-traumatic arthritis can cause pain and instability in the elbow.

Stages of Elbow Arthritis

Elbow arthritis typically progresses through a series of stages, ranging from mild to severe. While the exact progression can vary from person to person depending on the type of arthritis and individual health factors, the general stages are as follows:

• Early Stage: In the early stages, a person may experience occasional discomfort or pain in the elbow, especially after heavy use or strenuous activities. Stiffness after periods of inactivity, such as waking up in the morning, may also be noticed.
• Moderate Stage: As the arthritis progresses, the frequency and intensity of pain and stiffness may increase. The elbow may hurt during and after use, and the discomfort may interfere with daily activities. There may also be some noticeable limitations in the elbow's range of motion.
• Advanced Stage: In advanced stages, pain may be present even at rest or at night. The range of motion in the elbow may be significantly limited, making it difficult to straighten or bend the arm fully. The joint may feel unstable, and a grinding or clicking sensation may be felt when moving the elbow.
• End Stage: This is the most severe stage of elbow arthritis. The cartilage in the elbow may be largely worn away, leading to bone-on-bone contact that can cause intense pain and greatly restrict movement. Deformities in the joint may become apparent, and the use of the arm can be severely compromised.

Elbow Arthritis Diagnosis

Elbow arthritis is typically diagnosed through a medical history review, physical examination and diagnostic imaging. Here's how the process generally unfolds:

• Medical History Review: Your doctor will start by asking about your symptoms, the duration and frequency of these symptoms, and whether you have a history of elbow injury or repetitive use. You'll also discuss your overall health and any family history of arthritis.
• Physical Examination: Your doctor will then examine your elbow, checking for areas of tenderness, swelling, warmth, and deformity. They'll assess the range of motion in your elbow and might ask you to perform certain movements to see how well your elbow functions.
• Imaging Tests: If arthritis is suspected, your doctor will likely order imaging tests to confirm the diagnosis and evaluate the extent of the disease. These could include:
• X-rays, which can show bone spurs, joint space narrowing, or other changes associated with arthritis.
• MRI, which provides a more detailed view of the joint and shows damage to cartilage, ligaments, or tendons that might not be visible on an X-ray.
• Blood Tests: If rheumatoid arthritis is suspected, your doctor may order blood tests to look for certain markers associated with this type of autoimmune arthritis.
• Joint Fluid Analysis: In some cases, your doctor may take a sample of fluid from your elbow joint to help determine the type of arthritis you have. This can help rule out gout or infectious arthritis.

Elbow Arthritis Treatments

Treatment for elbow arthritis aims to reduce pain, improve joint function, and slow the progression of the disease. It typically involves a combination of non-surgical and surgical methods depending on the severity of the disease and individual circumstances.

Non-Surgical Treatments

• Physical Therapy: A physiotherapist can teach you exercises to maintain the range of motion of your elbow and strengthen the muscles that support the joint. This can help reduce pain and improve your elbow's function.
• Pain Relief Medications: Over-the-counter pain relievers like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be recommended to manage pain.
• Corticosteroid Injections: If other non-surgical treatments don't relieve your symptoms, your doctor may suggest a corticosteroid injection into the elbow joint. These injections can provide temporary relief from pain and inflammation.
• Lifestyle Modifications: Losing weight (if overweight), eating a balanced diet, quitting smoking, and regular exercise can help manage symptoms and slow the progression of arthritis.

Surgical Treatments

If non-surgical treatments do not provide sufficient relief, your doctor might recommend surgery, particularly in advanced cases. Surgical options may include:

• Arthroscopy: This minimally invasive procedure can remove loose bodies or inflamed tissue from the joint, relieving pain.
• Joint Replacement (Arthroplasty): In severe cases of elbow arthritis, replacing the damaged joint with a prosthetic one can significantly reduce pain and improve function.
• Joint Fusion (Arthrodesis): In some cases, permanently fusing the bones of the elbow joint can help alleviate pain, but it does limit the joint's mobility.

What if Elbow Arthritis is Untreated?

If left untreated, elbow arthritis can lead to chronic pain and significant loss of function, affecting a person's quality of life. It can limit one's ability to perform daily tasks and result in permanent loss of elbow mobility.