Elbow osteoarthritis

Elbow joint osteoarthritis is a condition causing pain and stiffness in the affected elbow.

Osteoarthritis is the name given to age-related arthritis which causes the affected joint to become painful and stiff. The process of osteoarthritis involves wearing or thinning of the smooth cartilage on the joint surfaces as well as stiffening/ tightening of the soft tissue surrounding the joint. These aspects combine to produce swelling, inflammation and pain. Previous joint injury may be an underlying cause.

Most commonly, the pain is felt throughout the elbow. Some individuals may suffer from referred pain radiating into the forearm and top of the hand.

The presence of elbow osteoarthritis does not always cause pain so it is quite possible to be pain-free despite reasonably advanced arthritis.

In addition, the elbow undergoes a ‘wear and repair cycle’ so pain can improve.

Pain with gripping and rotation of the forearm and wrist such as turning a key in a lock are normally the main aggravating activities. There may be a grinding sensation (crepitus) or locking of the elbow joint with certain movements. If elbow osteoarthritis becomes more severe the movements of the elbow may become increasingly stiff with reduced range of movement.

Elbow osteoarthritis can be reliably diagnosed by your doctor or physiotherapist by taking a history of your condition and by conducting a physical examination.

The main features on examination are often a reduced range of movement and pain towards the extremes of range. Crepitus may be felt on moving the elbow joint.

X-rays are not routinely required, but may be requested if symptoms are severe enough that corticosteroid injections or an elbow replacement surgery is being considered.

Non-surgical management

In the majority of cases, the symptoms of elbow osteoarthritis can be managed effectively by non-invasive measures:

Exercises. Regular exercises to maintain flexibility and strength to the affected elbow joint.

Using painkillers when needed. Over-the-counter medications are available through pharmacies when needed. Anti-inflammatories such as Ibuprofen are sometimes used. However, as there is little or no inflammation involved in osteoarthritis, these are best avoided without discussing with your GP. Side effects are even more common than with paracetamol so please ensure to take appropriate medical advice. There is a good booklet on the Arthritis Research UK website with information about the various medication options.

Corticosteroid injection therapy. For individuals with moderate elbow osteoarthritis who continue to suffer from disabling symptoms in spite a course of non-surgical management (outlined above) or for patients who are unable to commence a supervised exercise program due to pain levels, a corticosteroid injection can be offered. 

Surgical management

Total elbow replacement surgery is an effective option for patients with advanced stage elbow osteoarthritis who:

• Have trialled a course of non-surgical management without success
• Have consistent, disabling pain, significantly limiting function and/ or affecting sleep pattern

You may be asked to complete an elbow questionnaire. This can help the clinician assess the impact of your symptoms which can be useful in assessing suitability for surgery.

Further information about Osteoarthritis – www.versusarthritis.org

Arthritis Research UK