Elbow osteoarthritis: treatment, exercises and more

Osteoarthritis can affect any joint in the body, although the elbow is usually not affected because its stable arrangement of ligaments means it can tolerate large forces. The condition occurs when progressive wear and tear damages tissue in the joints, including the spongy and protective cartilage that protects the ends of the bones. The bones then rub against each other and can become painful, swollen, and deformed.

As people get older, they become more likely to develop osteoarthritis. It usually occurs in people aged 50 and over. However, certain factors also increase an individual’s risk, including:

• obesity
• abuse
• family history
• joint injury or surgery
• joints that are not well formed

In addition, osteoarthritis of the elbow without a previous injury is more common in men than in women.

People with osteoarthritis of the elbow can experience a range of symptoms, but the most common are pain and reduced range of motion, which may not occur simultaneously.

Individuals may notice a grinding sensation in the elbow as the healthy, smooth joint surface wears down. They may also feel like the joint is locking up when loose pieces of bone and cartilage dislodge and block movement between moving joint surfaces.

The elbow joint may swell as the disease progresses, but this is usually not an initial symptom. Eventually, people may also notice that their ring finger and pinky finger go numb when the elbow swells and compresses the ulnar nerve, which is located on the inside of the elbow. Additionally, if a person cannot move their elbow within its normal range of motion, it may stiffen into a bent position, increasing the pressure around the ulnar nerve.

Doctors usually diagnose osteoarthritis of the elbow based on a person’s symptoms, a physical exam, and imaging.

The doctor looks for signs of injury during the physical examination and assesses the range of motion and instability of the elbow. They can then order standard x-rays to detect any arthritic changes. Most people do not need CT or MRI imaging.

Specific results on the x-ray can help the doctor diagnose osteoarthritis. These include:

• Narrowing of the joint space: As osteoarthritis wears away the articulated cartilage, the joint space between the ends of the bones shrinks itself. The joint space gradually becomes smaller as the disease progresses until there is no space left and the bones rub against each other.
• Bone spurs: Doctors call these bony and cartilaginous protuberances osteophytes. When joints degenerate, X-rays can detect bone spurs as the cartilage tries to repair the damage.
• Subchondral sclerosis: The layer under the cartilage is called the subchondral bone, and sclerosis means the tissue hardens. Subchondral sclerosis shows up on x-rays as areas of increased bone density in the joint surfaces of the bone.
• Subchondral cyst formation: These fluid-filled sacs that form in the joints mainly contain hyaluronic acid which lubricates the joints.
• Subluxation: This partial dislocation of a bone can result from osteoarthritis because the joints become unstable.

A doctor may also order blood tests to rule out rheumatoid arthritis or any other problem.

Find out the differences between rheumatoid arthritis and osteoarthritis.

There is no cure for osteoarthritis. Therefore, treatment is aimed at relieving symptoms and reducing the impact of osteoarthritis of the elbow on a person’s life. Doctors may recommend a joint fusion or replacement if medications, exercise, and other therapies don’t help.

Medications

Over-the-counter and prescription drugs can relieve pain and inflammation. These drugs include:

• Analgesics: These pain relievers range from over-the-counter acetaminophen to strong prescription-only opioids.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Many people use these drugs for pain and inflammation relief. They include aspirin, ibuprofen, and naproxen.
• Counter-irritants: These over-the-counter products contain ingredients that irritate the nerves, such as capsaicin, menthol, or lidocaine. The goal is to generate cold or hot feelings to distract from the pain of arthritis.
• Corticosteroids: A doctor can prescribe these anti-inflammatory drugs as oral tablets, or they can give them by injections at their clinic.
• Platelet Rich Plasma (PRP): These injections relieve pain and inflammation, but the Food and Drug Administration (FDA) has not yet approved them. Therefore, a person should discuss the possibility of this therapy with a doctor.
• Other drugs: The FDA has approved the antidepressant duloxetine (Cymbalta) and the anti-seizure drug pregabalin (Lyrica) to treat pain associated with osteoarthritis.

Exercises

Doctors often recommend physical activity as part of an osteoarthritis treatment plan. An exercise program for osteoarthritis of the elbow should strengthen the muscles around the elbows, as well as increase joint mobility and reduce stiffness.

The following exercises can help people with osteoarthritis of the elbow reduce pain and maintain more movement in the joint:

• Elbow elbow: With the arms at the sides, slowly bend one arm at the elbow until the hand touches the shoulder and hold for up to 30 seconds. Hold a weight to add additional resistance.
• Wrist flexion: Place one arm straight in front with the palm down, then bend the wrist down. Use the opposite hand to gently press the hand towards the body. Hold the stretch for 30 seconds, then straighten your wrist. Then gently bend the hand up and back towards the body, using the other hand to hold it in place for 30 seconds. Repeat three times for each hand.
• Wrist circumference: Bend the elbow to form a right angle and hold the hand with the palm facing up. Then turn the wrist so that the palm is facing down. Hold your hand here for 5 seconds, then release. Do up to 30 repetitions with a short break after each set of 10. A person can also perform this exercise with a light weight.
• Palm Elevator: Place the palm on a flat surface and place the other hand sideways on the knuckles to press on them. Try to lift the fingers of the lower hand and feel the muscles in the forearm tighten. Then exchange your hands and repeat the exercise.

Surgery

Doctors may recommend surgery if lifestyle changes and medications fail to successfully control an individual’s osteoarthritis pain. Surgery can help improve function and reduce pain.

There are several types of elbow surgery, including:

• Synovectomy: Doctors call the membrane that lines the joint capsule the synovia. During this procedure, a surgeon removes this thin layer of inflamed tissue.
• Arthroscopy: If a person has bone spurs or loose pieces of bone, a surgeon can remove them during an arthroscopy.
• Arthroplasty: This technique uses a piece of a person’s Achilles tendon to cover the ends of worn joint surfaces.
• Joint replacement: A surgeon replaces damaged parts of the elbow with a prosthesis.

The outlook for a person with osteoarthritis of the elbow will depend on their specific symptoms and the extent of loss of joint function.

Some people remain relatively unaffected by the disease, while others suffer from a severe disability that affects their daily functioning.

For some people, joint replacement surgery can provide the best long-term results.

Osteoarthritis of the elbow can develop as part of the normal wear and tear process of aging. People with this condition may experience pain, restricted movement, and swelling in the joint.

There is no cure for osteoarthritis of the elbow, but doctors may recommend regular physical activity and medications such as anti-inflammatory drugs and corticosteroids to minimize its effects on the body.

If other treatment approaches are unsuccessful, a doctor may recommend surgery to help control pain and maintain joint mobility.