Elbow Arthritis

Arthritis of the elbow is usually one of two types – osteoarthritis (e.g. from “wear and tear”) and inflammatory arthritis (such as rheumatoid arthritis). Osteoarthritis most often occurs in manual laborers, heavy weightlifters, or individuals who have had a prior elbow fracture. It may also run in families. Rheumatoid arthritis may occur in individuals from any age group and regardless of activity level. No matter what the cause of arthritis, symptoms usually consist of some combination of pain and stiffness.

Arthritis of the elbow is usually one of two types – osteoarthritis (e.g. from “wear and tear”) and inflammatory arthritis (such as rheumatoid arthritis). Osteoarthritis most often occurs in manual laborers, heavy weightlifters, or individuals who have had a prior elbow fracture. It may also run in families. Rheumatoid arthritis may occur in individuals from any age group and regardless of activity level. No matter what the cause of arthritis, symptoms usually consist of some combination of pain and stiffness.

Elbow Arthritis Symptoms & Treatment

If there are loose bodies (pieces of bone spurs and cartilage that have broken off and are floating in the joint), patients may have episodes of locking and clicking. History, physical exam, and a simple X-ray are usually all that are necessary to make the diagnosis. In patients where inflammatory arthritis is suspected (and who do not already have this known diagnosis), a panel of blood tests and evaluation by a rheumatologist is necessary.

Thankfully, many individuals with severe arthritis seen on X-ray can successfully manage their symptoms. This may be due to the fact that the elbow is not usually a weightbearing joint (like a hip or knee). Avoidance of heavy lifting with the arm, maintaining motion with stretching exercises, and occasional use of anti-inflammatory medications (acetaminophen or ibuprofen, for example) is the first line of treatment. If symptoms are severe, cortisone injections to the elbow can help but these usually do not provide permanent relief of pain.

Surgical treatment of arthritis consists of either arthroscopy (to remove all loose bodies, bone spurs, and other inflammatory tissues) or total elbow replacement in the most severe of cases. Both treatment methods are very reliable in relieving pain and improving motion.

Example 1: A 63-year-old man with severe pain, clicking, locking, and stiffness in the left elbow. X-rays demonstrated severe arthritis and loose bodies in the elbow. He underwent arthroscopy to remove bone spurs and loose bodies, with significant improvement in his pain, motion, and mechanical symptoms. Preoperative X-rays are shown, along with arthroscopic photos demonstrating usage of a grasper inserted through small skin incisions to remove the loose bodies.

Example 2: A 46-year-old truck mechanic with clicking, locking, and pain when flexing the elbow. Despite physical therapy and injections, his pain continued to make work difficult for him. He underwent arthroscopic removal of bone spurs and loose bodies with resultant improvement in motion and pain. X-rays are shown above.

See how this type of arthroscopy is performed in this video.

Example 3: An 80-year-old independently living woman with progressively worsening severe pain in the right elbow. Despite modifications in activity level, multiple pain medicines and multiple cortisone injections to the elbow, the pain continued to be debilitating. She finally underwent a total elbow replacement with complete resolution of her pain. X-rays are shown above.

All images and video on this page are courtesy of Nicky Leung, M.D.

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