Arthritis at the elbow can be caused by either inflammatory arthritis such as rheumatoid arthritis or by wear and tear called osteoarthritis.
Rheumatoid Arthritis is a chronic inflammatory disease. It can cause inflammation, swelling, and pain to many joints of the body. You may be surprised to know that not only is the elbow a common site for RA to affect, but it is also often one of the earliest spots to be affected.
Osteoarthritis of the elbow occurs when the cartilage surface of the elbow is damaged or becomes worn. This can happen because of a previous injury such as elbow dislocation or fracture. It may also be the result of degeneration of the joint cartilage from age.
When RA attacks the elbow, the joint may swell, become inflamed and there may even be visible bulging. The swelling in the joint can compress nerves that cause tingling and numbness. While occasional inflammation is annoying and painful, chronic inflammation can be a serious problem. Over time, the structures of the joint are damaged. One tale tale sign of rheumatoid arthritis is that it affects both elbows at the same time.
A doctor can usually diagnose osteoarthritis of the elbow based on symptoms and standard X-rays. X-rays show the arthritic changes. Advanced diagnostic imaging, such as CT (computed tomography) or MRI (magnetic resonance imaging), is typically not needed to diagnose osteoarthritis of the elbow. Elbow osteoarthritis that occurs without previous injury is more common in men than women. Onset typically occurs in patients 50 years of age or older, but some patients can have symptoms earlier.
Because RA is such as complex disorder, there are many different plans for treatment. Your doctor will discuss your case (including both your pain and your lifestyle) to determine what treatment will be most effective for you. See
RA hands for more information.
- Drug Treatments – Common NSAID’s may be used to reduce ongoing pain and swelling. However, there are other drug therapies (such as anti-rheumatic drugs) that may be required for controlling severe and lasting inflammation.
- Rest and Immobilisation – In some cases, your doctor may feel that resting the joint will be in the best interest. Restricted activity and immobilisation through the use of a splint made by a Hand therapist may be a good solution. However, it is important that the muscles are not allowed to waste from under-use so exercises are necessary to prevent this from happening.
- Surgery – Although you and your doctor would often prefer a conservative approach, sometimes surgery is the best choice for RA. Surgical interventions can restore function in the joint and may provide pain relief too.
Most patients who are diagnosed with elbow osteoarthritis have a history of injury to the elbow, such as a
fracture that involved the surface of the joint, or an elbow dislocation. Injury to the ligaments resulting in an unstable elbow can also lead to osteoarthritis, even if the elbow surface is not damaged, because the normal forces across the elbow are altered, causing the joint to wear out more rapidly. (see
thumb OA too)
Nonsurgical Treatment
- For the early stages of osteoarthritis of the elbow, the most common treatment is nonsurgical. This includes oral medications to reduce or alleviate pain and hand therapy to strengthen muscles, prevent stiffness and to introduce activity modification.
- Corticosteroid injections are sometimes used to treat osteoarthritis symptoms. Steroid medication has typically been used with good results. Although the effects of injections are temporary, they can provide significant pain relief until symptoms progress enough to need additional treatment.
- An alternative to steroids has been the injection of hyaluronic acid in various forms, called viscosupplementation. Viscosupplementation involves injecting substances into the joint to improve the quality of the joint fluid.
- Surgery is a good solution if the joint has degraded significantly. Surgery can include joint arthroscopy, the removal of loose particles in the joint fluid, or joint replacement.
At Hand Kinetics we treat you as a whole person. Elbow joints that are very stiff and painful need special treatment because you rely on them to take your hands to where they need to be to perform actions. Immovable elbows affect all aspects of daily living. That is why we look at your individual circumstances and agree a treatment target to aim towards with you. This is called "Treat the Target".
As part of your treatment we can teach you how best to protect your elbows and show you the best exercises to keep them moving.
We can make you a very comfortable elbow resting splint that will keep your elbows safe from causing secondary problems such as
ulnar nerve or
radial nerve compression. Evidence shows that splinting and staying active and exercising regularly are super beneficial.
Some people are afraid to exercise during a flare but this can lead to additional muscle wasting and loss of movement.
At Hand Kinetics we can show you exactly what to do and when to do it so you don't need to worry about doing too much or too little. We will get it just right.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
