Elbow Arthritis: Causes, Symptoms, and Treatment

Elbow arthritis is usually the result of an accident, for example, a broken elbow. Strong strain on the elbow joint over a longer period also promotes elbow arthritis. Also, malalignments of the bones within the elbow joint (for example, cubitus varus and cubitus valgus) can contribute to the development of arthritis.

In general, men are affected slightly more frequently, and age is also a risk factor since the signs of wear and tear are already more pronounced here than in younger people.

As a rule, elbow arthritis first becomes noticeable through pain. In the beginning, this pain only occasionally exists for a few days and then disappears entirely for a specified period. Over time, however, the pain-free episodes become increasingly rare and shorter, the pain becomes stronger and partly starts to radiate into the forearm or the shoulder.

While these complaints initially occur almost exclusively during movement, they are also noticeable at rest at some point.

Characteristically for elbow arthritis, there is also a stiffness of the joints, which is particularly noticeable in the morning. A restriction of the mobility of the elbow joint can occur when small pieces of bone or cartilage become detached in the course of advanced arthritis and are present freely in the joint.

The frequent swelling of the elbow also promotes the restriction of movement. In many patients, a classic crunching sound can be heard when moving in the joint.

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Diagnosis of elbow arthritis

The term arthritis refers to the group of chronic degenerative diseases. These are characterized by the wear and tear of the joint cartilage, which can occur on the one hand as a result of natural wear and tear during the aging process and, on the other hand, as a result of certain traumas.

In the long term, these changes in the cartilage also affect the bone, which can lead to pain, swelling, tension, and, in the worst case, to restricted movement and deformation of the joint. In principle, such arthritis can develop in any joint of the human body, but it is most frequently found in the hip or knee joint.

Elbow arthritis is usually the result of an accident, for example, a broken elbow. Strong strain on the elbow joint over a longer period also promotes elbow arthritis. Also, malalignments of the bones within the elbow joint (for example, cubitus varus and cubitus valgus) can contribute to the development of arthritis.

In general, men are affected slightly more frequently, and age is also a risk factor since the signs of wear and tear are already more pronounced here than in younger people.

As a rule, elbow arthritis first becomes noticeable through pain. In the beginning, this pain only occasionally exists for a few days and then disappears completely for a certain period. Over time, however, the pain-free episodes become increasingly rare and shorter, the pain becomes stronger and partly starts to radiate into the forearm or the shoulder.

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While these complaints initially occur almost exclusively during movement, they are also noticeable at rest at some point.

Characteristically for elbow arthritis, there is also a stiffness of the joints, which is particularly noticeable in the morning. A restriction of the mobility of the elbow joint can occur when small pieces of bone or cartilage become detached in the course of advanced arthritis and are present freely in the joint.

The restriction of movement is also promoted by the frequent swelling of the elbow. In many patients, a classic crunching sound can be heard when moving in the joint.

In most cases, the diagnosis of elbow arthritis can be made relatively reliably using X-rays, since the X-rays can show very typical changes.

The appropriate therapy of an elbow arthritis always consists of two pillars.

Firstly, the pain should be treated with medication.

Painkillers from the anti-rheumatic group (non-steroidal anti-rheumatic drugs: NSAIDs), such as ibuprofen or diclofenac, are particularly effective in this clinical picture. These not only relieve the pain but also counteract any inflammatory reaction in the joint.

Besides, physiotherapeutic measures are of particular importance in osteoarthritis. It is important for the patient to find a good middle ground by not moving and loading the joint excessively, but still sufficiently. For this reason, exercises should at least initially always be carried out under the supervision of a doctor or physiotherapist. It is advisable to train the muscles of the forearm through special exercises to stabilize the joint and support it in its movements. For this purpose, aids such as ligaments, grip devices, our therapy balls can be used.

In the case of an acute relapse, it can also be useful to cool the painful joint. Only if all these measures have failed to improve the symptoms even after a long period and the elbow joint has still not regained its full range of motion, or if there are very pronounced deformities, should surgery be performed.

An operation can be performed open or by arthroscopy.

Depending on the existing findings, such a procedure smoothes the cartilage surface, cleans the joint surfaces, removes loose fractions of cartilage or bone tissue, or loosens adhesions. In extreme cases, as with any other joint, the elbow joint can be removed and replaced by a prosthesis.

Through the different treatment options for elbow arthritis, almost all patients can achieve a considerable reduction of symptoms and often even freedom from symptoms.

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Symptoms of elbow arthritis

The symptoms of elbow arthritis, i.e., the progressive damage to the joint cartilage in the elbow joint, are manifold and partly also present in other diseases.

However, pain is almost always present, which is mainly felt during movement and strain and can also occur at rest and night as the disease progresses.

These can also radiate into the shoulder and forearm. Besides, the intensity of pain increases, and the duration of the phases in which no pain is felt becomes shorter. As additional symptoms of elbow arthritis, one can hear and feel cracking or rubbing noises, called crepitations.

Due to the continuous irritation caused by elbow arthritis in the joint, the surrounding tissue swells, and the elbow becomes thick. A typical symptom of elbow arthritis is the phenomenon that one has initial difficulties in moving the arm entirely in the morning or after long breaks. Other symptoms include muscle tension. Some people notice a slight worsening of the symptoms in cold or wet weather.

Overall, elbow arthritis can thus restrict the freedom of movement of the joint. Patients can no longer fully extend or bend their arms. The extent to which mobility is reduced by pain, swelling, and other symptoms varies from case to case and depends on the degree of elbow arthritis. In severe cases, the joint can become completely stiff, aided by small detached fragments of cartilage or bone.

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Therapy of elbow arthritis

In the therapy of elbow arthritis, conservative therapy concepts must be distinguished from surgical approaches.

The conservative therapy has the goal to achieve an improvement of the symptoms without surgery and thus to make the joint more mobile and painless or painless again. The advantage of this therapy is that no surgery is required, and the associated risks are avoided. This procedure is recommended for mild to moderately advanced elbow arthritis.

The first pillar of conservative therapy is drug treatment with drugs from the group of so-called non-steroidal anti-inflammatory drugs (the best-known example is aspirin).

These are substances that, on the one hand, have an excellent pain-relieving effect and, on the other hand, act against inflammatory processes in the joint. The preparations to be mentioned, which are used in elbow arthritis, are ibuprofen or diclofenac, which are used in many orthopedic diseases. It is also possible to inject small amounts of cortisone, another anti-inflammatory drug, directly into the joint.

Besides medication, the most important measure in the conservative therapy of elbow arthritis is extensive physiotherapy. Under professional guidance, various exercises are performed to make the elbow joint more mobile or to keep it mobile (movement therapy). The exercises are done with ligaments, balls, but also underwater.

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Additionally, specific treatments with cold or heat can be applied. In some cases, however, it is also advisable to immobilize the joint briefly with certain splints (orthoses), especially if a severe inflammation is underway.

Surgery of the elbow joint is advisable if the measures mentioned above are not sufficient and show no improvement or if the elbow arthritis is very advanced. Then, either openly or arthroscopically, i.e., under camera view and through a tiny incision, the joint cavity can be freed of free fragments, and cartilage and bone can be smoothed.

Finally, there is the possibility of artificially replacing the entire joint by inserting a total elbow prosthesis. In this case, an artificial titanium joint is inserted into the upper and lower arm bones under general or partial anesthesia with special cement, whereby the majority of the bones are preserved.

Usually, this procedure takes about 1-2 hours, and the hospital stay is on average one, a maximum of two weeks. Following this operation, it is important to have specific physiotherapy, with which most things in everyday life can be managed again after about six weeks. However, heavy loads are no longer possible after this.

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