Degeneration or inflammation of the elbow joint leading to pain and stiffness.
The elbow is a more complex joint than it might appear, made up of three separate articulations that work together to allow both bending and rotation of the forearm. Arthritis, wear or inflammation of the joint surfaces, is less common here than in the hip, knee or hand, but when it does occur it can be particularly troublesome because of how much the elbow is used in positioning the hand for everyday tasks.
Elbow arthritis falls into two broad categories with different underlying processes: osteoarthritis, generally related to previous injury or years of heavy load, and rheumatoid arthritis, an inflammatory condition where the body's immune system affects the joint lining. Both cause pain and stiffness, but they are assessed and managed somewhat differently.
Osteoarthritis of the elbow is less common than in weight-bearing joints such as the hip or knee, and it often follows a previous injury to the joint, such as a fracture or dislocation, rather than developing without any clear cause. It is also more common in people who have placed heavy, repetitive load through the elbow over many years, such as through manual labour or certain sports.
Rheumatoid arthritis and other inflammatory forms of arthritis affect the elbow differently: rather than wear from load, the joint lining (synovium) becomes inflamed, which can progressively damage the cartilage and underlying bone if the underlying condition is not well controlled.
Common symptoms of elbow arthritis include:
Symptoms tend to progress gradually, though a rheumatoid flare can cause a more sudden increase in pain and swelling.
Assessment includes a history and examination of elbow movement and stability, together with X-rays to assess the joint surfaces and look for loose bodies or bony spurs. Rheumatoid arthritis is usually managed jointly with a rheumatologist, alongside orthopaedic input for the joint itself.
Non-surgical treatment is the starting point for most patients: activity modification, physiotherapy to maintain movement and strength, anti-inflammatory medication, and a corticosteroid injection to settle a painful flare.
Where symptoms persist, surgical options depend on the stage of arthritis. Earlier disease with mechanical symptoms such as locking or catching may be helped by elbow arthroscopy, removing loose fragments and bony spurs. For more advanced arthritis with significant pain and stiffness, particularly in older or lower-demand patients, elbow joint replacement may be considered.
Symptom relief with appropriate treatment is generally good, whether managed non-surgically or with surgery matched to the stage of disease. Arthroscopic clean-up procedures can meaningfully reduce pain and improve movement in earlier-stage arthritis, though they do not reverse the underlying joint wear.
Elbow replacement generally provides good pain relief and restored function for more advanced arthritis, though because of the forces the elbow experiences, patients are usually advised to observe lifting restrictions afterward to protect the longevity of the implant.
Elbow arthritis is less common than arthritis of the hip or knee, but it can meaningfully affect daily activities because of the elbow's role in positioning the hand. Treatment ranges from activity modification and injections through to arthroscopic clean-up or joint replacement in more advanced disease, with the right option depending on the severity of arthritis and the demands placed on the joint. Persistent elbow pain, stiffness or swelling is worth having assessed.
