Elbow Arthritis

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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What is Elbow Arthritis?

Elbow arthritis is a condition where the cartilage surface of the elbow becomes worn out or damaged. The elbow, a hinge joint comprising the humerus, ulna, and radius, relies on its cartilage for smooth movement and function. As the cartilage degrades, the bones in the elbow joint may start rubbing against each other, leading to symptoms such as pain, stiffness, swelling, and a limited range of motion.

Elbow arthritis, while not curable, can be managed effectively through various treatment options designed to alleviate symptoms and improve quality of life.

Causes of Elbow Arthritis

Elbow arthritis can develop due to various factors, each contributing to the wear and tear of the joint’s cartilage.

  • Traumatic Injury
    Fractures or dislocations around the elbow, particularly those involving the joint surfaces or ligament injuries, can precipitate osteoarthritis. These injuries can alter the normal forces across the elbow, causing the joint to degenerate more rapidly.
  • Activity-Related Stress
    Individuals engaged in work or activities that place excessive stress on the elbow joint may be more likely to develop arthritis. This is particularly seen in cases where the joint is subjected to demands beyond its bearing capacity. For example, professional athletes like baseball pitchers often experience high-shear forces across the elbow joint, leading to cartilage breakdown.
  • Inflammatory Conditions
    Autoimmune diseases such as rheumatoid arthritis, psoriatic arthritis, and metabolic conditions like gout can lead to inflammatory elbow arthritis. These conditions cause inflammation within the joint, contributing to the degradation of cartilage.
  • Age-Related Wear and Tear
    Osteoarthritis, a common type of arthritis affecting the elbow, is often associated with the ageing process. The cartilage cushioning the bones of the elbow softens and wears away over time, leading to the bones rubbing against each other.

Symptoms and Signs

The symptoms and signs of elbow arthritis can vary, but commonly include:


  • Pain and Stiffness: Individuals often experience pain which may be exacerbated by movement. This is often accompanied by a general stiffness in the elbow joint.
  • Loss of Range of Motion: The elbow may lose its flexibility, making it difficult to fully extend or bend the arm.
  • Grating or Locking Sensation: As the smooth cartilage wears away, a grating sensation can be felt during movement. Small fragments of bone or cartilage may also become loose, causing a locking sensation in the joint.
  • Swelling: Swelling in and around the elbow joint is often experienced. This may become more pronounced as the condition progresses.
  • Numbness: In some cases, arthritis can cause numbness in the ring and small finger. This is due to nerve irritation, often caused by swelling in the elbow joint exerting pressure on the nerves.

Diagnosis

The diagnosis of elbow arthritis typically involves a combination of clinical assessment and imaging studies.

  • Clinical Evaluation: An elbow specialist conducts a thorough examination, assessing the patient’s symptoms and medical history, and performing a physical examination of the elbow.
  • X-ray Imaging: X-ray imaging can help visualise changes in the bones and joint space within the elbow joint, such as joint space narrowing, the presence of bone spurs, or other abnormalities.
  • Blood Tests: In some cases, blood tests may be conducted to determine the underlying cause of arthritis, especially if an inflammatory condition is suspected.

Non-Surgical Treatment Options

For individuals diagnosed with elbow arthritis, especially in its early stages, non-surgical treatment options are often considered. These options focus on managing symptoms and improving joint function.

Activity Modification

For less severe cases, the elbow specialist may suggest modifying daily activities to avoid movements that exacerbate pain or put undue stress on the elbow joint.

Medications

Oral pain and anti-inflammatory medications can help reduce discomfort and swelling associated with elbow arthritis.

Physical Therapy

Engaging in physical therapy helps in maintaining or improving the range of motion and strengthening the muscles around the elbow. This helps to stabilise the joint and reduce symptoms.

Corticosteroid Injections

In some cases, corticosteroid injections are used to alleviate symptoms. These injections can provide temporary relief, allowing for improved joint function until further treatment is required.

Surgical Treatment Options

When non-surgical interventions are insufficient in managing the symptoms of elbow arthritis, surgical options may be considered.

Arthroscopic Surgery

For early-stage arthritis, arthroscopic surgery can be an option. This minimally invasive procedure involves making small incisions around the elbow to remove inflamed tissue, unstable cartilage fragments, or bone spurs, and to smooth out irregular joint surfaces.

Total Elbow Replacement

In advanced elbow arthritis where the joint surface has severely deteriorated, total elbow replacement may be required. This procedure involves removing the damaged cartilage and bone and replacing them with an artificial joint (prosthesis), restoring elbow function.

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Prevention Strategies

While it is not always possible to prevent elbow arthritis, some strategies can reduce the risk and mitigate the progression of the condition.

  • Preventing Joint Injury - Protect the elbow from injuries, such as fractures or dislocations. Proper technique and safety measures during sports and physical activities can help prevent these injuries.
  • Regular Exercise and Muscle Strengthening - Maintaining strong muscles around the elbow helps stabilise the joint and distribute forces more evenly, reducing the risk of cartilage wear.
  • Using Proper Techniques to Avoid Joint Damage - Individuals engaged in sports or occupations that place high stress on the elbow should ensure proper technique and use of equipment to reduce the risk of joint damage.
  • Managing Underlying Conditions - For those with inflammatory conditions, such as rheumatoid arthritis, effective management of these conditions can help prevent secondary elbow arthritis.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany

 

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38 Irrawaddy Road, #08-62/63
Singapore 329563
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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    Can I Continue Using My Arm with Elbow Arthritis?

    Those with elbow arthritis can generally continue using their arm given they do not engage in activities that exacerbate the pain. Gentle exercises and movements can be beneficial for those with the condition to help maintain joint flexibility and muscle strength.

    What Happens If Elbow Arthritis Goes Untreated?

    If left untreated, elbow arthritis may progressively worsen, potentially leading to increased pain, stiffness, and reduced mobility. Timely consultation with an elbow specialist can help guide effective management strategies to control symptoms and slow disease progression.

    What Exercises Can Help Treat Elbow Arthritis?

    Certain exercises can help maintain or improve joint flexibility and strengthen the muscles around the elbow. These exercises involve gentle stretching and strengthening, to avoid overstraining the joint. Patients with elbow arthritis can consult an elbow specialist to help determine the most suitable exercise regimen.