Arthritis In Elbow

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Elderly woman woman hand holding her elbow, possibly suffering from elbow arthritis.

Elbow arthritis is a term that covers a broad range of medical conditions affecting the elbow joint. Perhaps the most common forms of elbow arthritis are osteoarthritis and rheumatoid arthritis.

Common symptoms are inflammation, pain and swelling of the joint, as well as difficulty moving the elbow. This condition can be extremely painful and inconvenient. It can make it difficult to carry out everyday tasks such as bending or straightening the joint.

Treatment of early stage elbow arthritis usually involves pain management of the condition and reducing the rate of progression of the disease. In its more advanced stages, however, there are surgical procedures that can be used to treat the disease.

Causes

Probably the most common form of elbow arthritis is rheumatoid arthritis(RA).This is an autoimmune form of arthritis. The patient’s immune system attacks the linings of the elbow joint, called the synovia. As the linings swell in response to the attacks, the space in the joint reduces, making joint movement more difficult and reducing range of motion.

However, rheumatoid arthritis does not usually stop at the joint linings. It eventually also attacks and destroys the bones and soft tissues of the joint.

In most cases, RA attacks both the left and right elbows simultaneously. It also attacks nearby joints such as the wrists and shoulder.

The second most common form of elbow arthritis is osteoarthritis (OA).This form of arthritis attacks the slick cartilage coverings over the ends of bones. The function of healthy cartilage is to enable the bone ends to move smoothly over each other without the bones themselves coming into direct contact.

OA causes the bone cartilage to deteriorate so that the bones of the elbow are in direct contact with each other. This causes pain whenever the patient tries to move the elbow.

OA is itself sometimes the result of an earlier injury to the elbow that damages bone cartilage. If this happens, it can start a process of cartilage deterioration that can eventually lead to the development of osteoarthritis.

Symptoms Of Elbow Arthritis

The main symptom of elbow arthritis is pain in the joint. However, the pain is different depending on the type of arthritis:

  • RA pain tends to start at the outer side of the elbow. It also tends to increase if the patient rotates his or her forearm;
  • OA pain, on the other hand, tends to get worse as the patient extends the elbow. As OA becomes more advanced, its pain tends to continue at night or even during rest periods.

Other symptoms of elbow arthritis include the following:

  • Swelling around the elbow (more common with RA);
  • Elbow instability;
  • Reduced range of motion;
  • A feeling that the elbow is “catching” or “locking” as you try to move it. This is more common with OA;
  • Elbow stiffness, especially if the arthritis is the result of an earlier injury.

Diagnosing Elbow Arthritis

Diagnosis of this condition usually takes place after a thorough physical examination of the elbow. This will include looking for the location of the elbow pain as well as any swelling that may be present.

The doctor may ask about any previous elbow injuries the patient may have suffered. The goal will be to identify any previous injuries that may have led to arthritis.

In addition, the doctor will check for any reduction in the elbow range of motion. He or she will want to identify the positions of the elbow that are most painful.

In addition to the physical examination, the doctor may request an X-ray scan. This will reveal whether the space of the joint is narrowing (a sign of RA) . Loose bone fragments may also show up in an X-ray and help the doctors to determine the type of arthritis that is present.

Treatment

Conservative (Nonsurgical)

In the early stages of elbow arthritis, a doctor will most likely opt for some or all of the following conservative treatment options:

  • If the patient has OA,  reducing activities that involve extensive use of the elbow can provide some pain relief;
  • Prescribing pain relief medications such as Advil or, for inflammation control as well, Ibuprofen. Patients should be careful to discuss possible side effects of these medications with their doctors;
  • Patients can get additional pain relief by using topical analgesics, a hot compress or moist heat therapy. An elbow sleeve can provide therapeutic warmth with similar benefits. The patient can also wear it while performing his or her regular everyday duties;
  • For RA, doctors can also prescribe drugs to suppress the immune system and slow down its attack on the joint lining.
  • A corticosteroid can be injected into the elbow joint as a powerful anti inflammatory agent;
  • Physical therapy exercises can help the patient regain much of the range of motion lost due to elbow arthritis;

Surgical Treatment

If the elbow arthritis is advanced, or does not respond to the above treatments, doctors may suggest a surgical approach.

The ultimate choice will depend on the patient’s age, the type of arthritis that is present and how advanced it is. However, having said this, the following surgical options are available:

Arthroscopy

Under this procedure, the surgeon makes 2 or 3 small incisions in the elbow. He or she then used tiny instruments to remove bone spurs, loose fragments of bone or a portion of the damaged synovial lining. This option is available as a potential treatment for either OA or RA.

Synovectomy

This involves the removal of the damaged synovial lining. In some cases, the surgeon may also remove a portion of bone to allow room for greater joint range of motion. Synovectomies are often performed to combat RA in its early stages.

Osteotomy

A frequent procedure for the treatment of OA. In it, the surgeon removes a portion of the bone of the elbow to prevent direct contact between bones.

Arthroplasty

This involves elbow replacement with an artificial joint . It is usually reserved for patients over 60 year of age or for those with advanced RA.

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