Elbow arthritis occurs when the normal cartilage within the elbow joint becomes worn or damaged. This may be the result of a trauma sustained to the elbow or may be from age-related degenerative changes. Compared to knee or hip arthritis, elbow arthritis is much less common due to the fact that it is not a weightbearing joint. Symptoms of elbow arthritis typically include pain with activity, popping or clicking in the joint, and stiffness with loss of range of motion. Patients with rheumatoid arthritis (RA) have a much higher incidence of symptomatic elbow arthritis.
Typically your doctor can diagnose elbow arthritis with x-rays alone. Occasionally a CT scan may be helpful if there is a suspicion that loose bodies (free floating pieces of bone or cartilage) are present in the joint and the primary cause of symptoms.
Conservative treatment is usually successful at reducing the symptoms of elbow arthritis. These treatments include:
Non-steroidal anti-inflammatory medications: Over the counter medications such as ibuprofen(Advil) and naproxen(Aleve) may provide symptom relief during acute flares of inflammation. Topical anti-inflammatory gels and creams can also be effective.
Activity modification: Commonly, workplace or recreational activities are the cause of continued pain from elbow arthritis. If heavy lifting, repetitive use, or other aggravating factors can be avoided, inflammation and pain within the elbow may be reduced.
Physical therapy: Therapy should focus on gentle stretching of the elbow to help maintain motion and prevent further stiffness. Strengthening of the muscles around the elbow can provide added support and stability.
Bracing: Bracing may be effective to prevent excessive stress or stretch on the elbow during activities but should be used with caution as limiting motion may cause further elbow stiffness.
Corticosteroid injections: Injections may provide symptomatic relief from the pain of elbow arthritis by reducing inflammation within the joint. If providing 3-4 months of relief, these injections can be repeated intermittently as an adjunct to the other conservative treatments above.
If non-operative treatments fail to provide relief, then surgery may be considered. Surgical management of elbow arthritis consists of arthroscopic surgery or total elbow replacement. Arthroscopic elbow surgery is performed to debride (clean out) the joint and remove bone spurs or loose bodies within the joint. Releases to the soft tissues around the elbow can also be performed to increase range of motion. This procedure can also be performed by making a larger incision and doing similar procedures through an open elbow surgery. Total elbow replacement is typically reserved for elderly, low demand individuals and more commonly utilized in patients with rheumatoid arthritis. Elbow replacement may be performed in other individuals but patients with an active lifestyle must be willing to adhere to a strict lifetime lifting restriction after undergoing replacement surgery.
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