Arthritis in the elbow is much less common than other joints, but can be quite disabling.
Much like the shoulder, there are different joint surfaces to consider, each with their own associated difficulties. Evaluation by a specialist with experience in treating elbow pain can help to identify what type of treatments may be most effective for each patient on a case by case basis.
Three major types of arthritis generally affect the elbow, each with their own unique characteristic presentations:
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Osteoarthritis is a degenerative condition that destroys the smooth outer covering (articular cartilage) of bone. It usually affects middle aged people with a history of manual labor or heavy use of the extremity. The most common initial complaint is difficulty obtaining full extension, but difficulty rotating the forearm may also be present.
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Rheumatoid arthritis is a systemic inflammatory condition of the joint lining. It can affect people of any age and usually affects multiple joints on both sides of the body. Up to 50% of patients with rheumatoid arthritis will have elbow involvement. Pain is most commonly noted throughout range of motion, and severe disease may result in significant pain with associated instability of the elbow.
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Post-traumatic arthritis is a form of osteoarthritis that develops after an injury such as a fracture or dislocation of the elbow. Specific problems depend on the type of initial injury.
Treatments
Marshfield Clinic orthopedic specialists provide surgical and non-surgical treatment for a variety of injuries and conditions affecting the elbow, including relief from arthritis.
Non-surgical
Rest or change activities to avoid provoking pain; you may need to modify the way you move your arm to do things.
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Take non-steroidal anti-inflammatory medications such as ibuprofen to reduce inflammation.
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Ice the joint for 20 to 30 minutes two or three times a day to reduce inflammation and ease pain.
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If you have rheumatoid arthritis, your doctor may prescribe a disease-modifying drug such as methotrexate or recommend a series of corticosteroid injections.
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Dietary supplements such as glucosamine and chondroitin sulfate may be helpful.
Surgery
If your arthritis does not respond to either non-surgical treatments or medication, a doctor may recommend that you have surgery. Surgical treatment of arthritis of the elbow is generally very effective in reducing pain and restoring motion.
- Arthroscopic surgery: In mild to moderate stages of disease, debridement of the joint may be performed in an outpatient setting.
- Formal open debridement: In most cases of post-traumatic arthritis or with more severe affliction, a formal open approach may be necessary with a short hospital stay (1-2 nights).
- Elbow replacement: For severe stages of disease with significant bony deformity, a functional range of motion with pain relief may be achieved by replacing the joint with a hinge-type prosthesis. An inpatient stay in the hospital will be required (2-3 days) and future activity restrictions will apply (<10lbs lifting, <5lbs repetitive activity). However, these implants have demonstrated increasing success at treating the most severe forms of disease.
