To mark Arthritis Awareness Month, we are looking at the causes of one of the less common forms of arthritis – elbow arthritis. Although elbow pain is a common problem it is rarely caused by arthritis and is more normally due to soft tissue problems, such as tennis elbow or golfer’s elbow, or the result of injury.
What types of arthritis affects the elbow?
As with other joints in the body, however, the elbow can be affected by a range of different types of arthritis, including:
Primary osteoarthritis: This is the most common form of arthritis throughout the body, although less common in the elbow. Also called wear and tear arthritis, osteoarthritis is caused by a loss of cartilage, which is a tough, rubbery coating on the end of the bones that helps to protect the joints. The cartilage may become rough and begin to wear away, which can cause the bones to start to rub together. Bony spurs may develop and there can be an increase of fluid in the joint. Osteoarthritis of the elbow only tends to occur more commonly in men, especially those who have a heavy manual job.
Rheumatoid arthritis: This is an autoimmune condition. It is caused by the body’s immune system, which normally fights infection, attacking healthy joints as well as other tissues in the body and organs. Whereas osteoarthritis may only affect one joint, rheumatoid arthritis tends to attack the same joint on both sides of the body in a symmetrical fashion, and is more common in women than men.
Post-traumatic arthritis: This type of arthritis develops after an injury such as an elbow fracture, severe sprain or ligament tear. The misshapen or unstable bones wear down the cartilage unevenly, eventually resulting in bone-on-bone articulation. It may develop several years after the original trauma, and can nearly always be prevented by prompt and accurate treatment of the original injury.
Gout: Gout is a form of arthritis that is caused by a build-up of uric acid in the blood. It is predominantly an inherited problem, but can be worsened by eating certain foods such as seafood and red meat, and drinking alcohol.
Psoriatic arthritis: This is linked to the skin condition psoriasis which causes patches of red, raised skin and white or silvery flakes. It is an autoimmune condition like rheumatoid arthritis that is caused by the body’s immune system attacking healthy tissue. It causes a lot of inflammation in the joint, which results in destruction of the cartilage and sometimes the bone too.
Symptoms of elbow arthritis
Symptoms can vary in severity depending what type of elbow arthritis you have and how far advanced the condition is. Among the most common symptoms are:
- Pain in the elbow joint and upper forearm
- Stiffness and inability to fully bend or straighten the elbow
- Swelling in the elbow, especially on the outer side
- Pain and/or stiffness on rotating the forearm.
Related Reading: Why is My Elbow Stiff?
Diagnosis of elbow arthritis
It is important to seek a diagnosis from a doctor or orthopaedic specialist if you suspect you may have elbow arthritis. You might be experiencing elbow pain that has no obvious cause, or pain that doesn’t improve within a week or two or that is worsening.
If your symptoms are affecting everyday activities or if your elbow is swollen and stiff it is important to seek medical advice.
To diagnose the problem, the doctor will carry out a physical examination and ask about any symptoms. You may be asked to move your elbow in certain ways to assess its range of motion. In some cases you will be referred for an X-ray which can show up bony growth or small pieces of loose bone in the joint.
Sometimes a CT scan is needed to show the bone in more detail. If the arthritis is early or subtle then an MRI scan to assess the cartilage and joint lining may also be needed.
Treatment of elbow arthritis
If you are diagnosed with elbow arthritis, the recommended treatment plan will depend on the type of arthritis you have and how advanced it is. It may include:
- Physiotherapy to build up strength in your elbow and increase flexibility.
- Injections of corticosteroids which may provide short-term pain relief.
- Injections of hyaluronic acid which can act as a lubricant and shock absorber to help the elbow function better.
- Elbow surgery may include removing bony growths or loose pieces of bone and freeing up the contracted lining of the joint to improve motion. This is done arthroscopically (keyhole surgery) where it safe to do so, but there are many vital nerves around the elbow joint, so often an open operation is needed to minimise the risk to you. In the case of severe symptoms, you may be offered elbow replacement surgery although this is a less common procedure than other types of joint replacement and is generally only offered to older patients or people with rheumatoid arthritis.
If you are experiencing symptoms of elbow arthritis, it is important to get an accurate diagnosis so you know what is causing the problem. Your orthopaedic surgeon can then discuss the most suitable treatment options with you.