The elbow joint is one of the joints that are least affected by osteoarthritis, which is a slow wear-and-tear process.
Most elbow arthritis is caused by an injury earlier in life, usually a fracture or dislocation.
There are a number of potential treatments available for elbow arthritis, from simple pain relief from the pharmacy, to physiotherapy and surgery.
Symptoms
Most patients will complain of slowly increasing pain in the elbow and slowly impaired movement.
The pain can initially be improved with rest or simple analgesics, like panadol. As the arthritis becomes more severe, it is often constant and affects your sleeping.
Some patients may report a ‘grating’ feeling or sudden ‘locking’ of the elbow. This ‘grating’ feeling is caused by the damaged cartilage. While the ‘locking’ of the elbow is due to the presence of loose cartilage or bone in the joint. Your elbow may also become swollen.
In the later stage, some people notice tingling and numbness sensation on their ring finger and small finger of the effected arm. This is caused by the pressure put on the nerve (the ulnar nerve) that supplies those fingers.
Causes
The elbow joint is formed by three bones, which are called the humerus, radius and ulna.
The ends of these bones are covered with a tough tissue called cartilage. This cartilage acts as a cushion, allowing the bones to move and glide smoothly. Any previous injury such as an elbow dislocation or fracture can damage the cartilage, causing it to wear out. As a result, the bones rub together causing the pain and swelling at the joint.
However, in many people, the cause is unknown, and arthritis develops despite no known past injuries.
Elbow arthritis may also be related to age or existing bone disease.
Risk Factors
There are factors that lead to elbow arthritis
- A fracture, dislocation or other injury to the elbow
- Osteochondritis dessicans
- Developmental defects of the joint
- Certain diseases (eg. Rheumatoid arthritis, haemophilia or diabetes)
Jobs or activities that involve regular heavy lifting may put the elbow at higher risk of developing osteoarthritis.
Investigations
Elbow arthritis can be easily diagnosed with an x-ray
An X-ray may show
- Narrowing of the joint space
- Spikes of bone (known as osteophytes) at the edges of the joint.
- Fragments of bone or flakes of cartilage floating in the joint
- Scarred or ‘sclerotic’ bone
These signs tend to develop over many years, and as a result you may have significant pain but fairly minor signs on an X-Ray.
Complications
Elbow arthritis is a very debilitating condition. The significant pain can have significant effects on levels of functioning at work and in the home.
Treatment
Your doctor will discuss with you the available options, depending on your individual circumstances.
Treatment options include:
- Medications. Such as pain relieving tablets.
- Change in activities. Simple changes in the way you do things can help with your pain. It is best to avoid heavy use of the affected elbow like lifting heavy things or pushing a door.
- Injections. Injections of steroid into your joint can give temporary relief.
Your orthopaedic surgeon may perform:
- Arthroscopy (key hole surgery)
- An arthroscopy helps to remove the loose body and smooth out irregular the cartilage surfaces.
- Elbow joint replacement
- Elbow replacements are major operations which can offer great pain relief and improve the movement of your elbow. However, like all joint replacements and operations, the pros and cons must be considered carefully with the help of your surgeon.
Seeking Advice
Your Family Doctor (GP)
Your Family Doctor will be able to diagnose and help treat your problem. He or she will be able to
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
Your Physiotherapist
A physiotherapist can examine your elbow to help
- Determine the cause of your symptoms
- Prescribe exercises to relieve your pain or reduce the risk of secondary injuries developing
- Provide pain relief
Your Orthopaedic Surgeon
An Orthopaedic Surgeon is a specialist in treating elbow arthritis with surgery.
These options include:
- Elbow key hole surgery (arthroscopy)
- Elbow replacement
Prevention
Preventing injuries such as fractures and dislocations can prevent the development of elbow arthritis.
If you have elbow pain after a fall or other injury, it is important to see you doctor to have it investigated and treated.
It’s especially important to ensure that you perform the exercises prescribed by your physiotherapist or doctor when you’ve had an injury in your arm. The elbow is particularly prone to become stiff when kept still for some time.
F.A.Q. | Frequently Asked Questions
How is elbow arthroscopy done?
Elbow arthroscopy or key-hole surgery is performed under general anaesthetic. Two or small cuts are made in the skin so that the cameras and other equipment can be placed into the elbow joint. During the surgery, your surgeon can remove loose bodies and clean up cartilage damage.