The commonest type of arthritis in the elbow is osteoarthritis which is a mechanical wearing out of the joint surfaces. As the joint wears and becomes less smooth the surrounding tissues become irritated and inflamed causing pain in the joint. Certain patterns osteoarthritis can run in families. Fractures or injuries that involve the bones or joints may also increase the risk of this sort of arthritis developing.
Elbow arthritis can sometimes occur as part of an inflammatory arthritis. In this sort of arthritis the problem starts with inflammation within the joint lining. This inflammation then produces chemicals which attack and damage the bony surfaces causing the joint to wear out. The original cause of the inflamed lining is not always completely clear. Factors implicated in causing this sort of arthritis include the immune system, your genes and various environmental stimuli such as infections. Rheumatoid arthritis is the commonest type of inflammatory arthritis and is thought to largely be caused by the immune system. The inflammatory process can also affect tendons, the soft tissues around the joints and other organs in the body.
Common symptoms from an arthritic joint include pain, swelling and stiffness. Osteoarthritis is often worse after activity and often affects joints asymmetrically around the body. Patients often say it is worse in cold weather. In the elbow catching or locking of the joint can also occur (see relevant page on this condition). Some patients experience irritation of the ulnar nerve when their elbow becomes arthritic. This nerve runs very close to the elbow. Symptoms of ulnar nerve irritation include numbness and tingling in the little and ring fingers of the hand which is often worse when the elbow is maximally bent.
After some time there are characteristic changes visible on x-ray with different types of arthritis but in the early stages the xrays may be normal.
Blood tests may be helpful in confirming some types of arthritis but they are normal in simple osteoarthritis.
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In is important to try and keep any arthritic joint as mobile as possible and to use the muscles around the joint, as these help support the joint movements. During periods when the joint is very inflamed it is often helpful to rest the joint for a brief period. Cold compresses are sometimes useful but some patients also find warmth relieves their symptoms. Steroid injections into the joint can sometimes help settle down a painful joint and make the symptoms more manageable.
Surgery might be considered to improve the range of movement of a very stiff joint (arthrolysis) or to remove loose bodies and stop the elbow from locking. In extreme circumstances an elbow joint replacement might be considered but the long term results of this surgery are less reliable than for hip and knee replacements and a life time maximum of 15lbs lifting with a replaced elbow is usually recommended. The vast majority of patients with elbow arthritis never need any surgery at all.
The elbow becomes stiff very quickly and following periods of inflammation exercises and stretches are recommended to try and regain movement as quickly as possible.
After any elbow surgery exercises and stretches are again essential. You will be given exercises sheets to practice and referred on to physiotherapy if necessary, depending on exactly what sort of operation you have had.