Elbow Arthritis

What elbow arthritis is

The elbow is not one joint but three working inside a single capsule. The hinge between the upper arm bone and the ulna carries most of the bending and straightening. The head of the radius meets the end of the humerus and takes part in that hinge as well as in rotation. A third surface, between the radius and ulna, lets the forearm turn the palm up and down. All are lined with articular cartilage, and arthritis means that lining has thinned or been lost.

The elbow follows a different pattern from the hip or knee. Because it does not bear weight, simple age related wear is less common there. Many arthritic elbows are instead post-traumatic, developing after a fracture or dislocation left the joint surface irregular, and rheumatoid arthritis can involve the lining diffusely. What distinguishes the elbow is what happens at the margins: bone spurs build up in the small hollows where the joint seats at the ends of motion, and loose fragments can break free inside. The ulnar nerve runs in a shallow groove on the inner side and may be crowded by that extra bone, which is why arthritis here sometimes announces itself through the hand.

Symptoms that often bring people in

• Difficulty straightening the arm fully, noticed when reaching or carrying a bag.
• Pain at the very end of bending or straightening rather than through the middle of the arc.
• Catching, locking or a sudden jam in the joint, which can suggest a loose fragment.
• Numbness or tingling into the ring and little fingers, or aching along the inner elbow.

How it is evaluated

Assessment starts with the history: whether the elbow was ever fractured or dislocated, and whether the trouble is pain, stiffness, mechanical catching or hand symptoms, since those point in different directions. Examination records how far the elbow bends, straightens and rotates and compares those arcs with the other side. Tenderness is mapped, stability is checked, and the ulnar nerve is assessed where it passes behind the inner bump of the elbow. Plain X-rays show joint space, spur formation and the outline of any old injury, and CT is sometimes discussed when a clearer three dimensional picture of spurs or loose bodies is needed.

Treatment options in general terms

Non-surgical measures are usually explored first, aimed at reducing irritation while protecting the motion that remains.

• Load management. Adjusting the tasks or tools that push the elbow to its painful end range.
• Therapy. A supervised program to preserve motion and strengthen the muscles crossing the elbow, sometimes with splinting.
• Medication categories. Anti-inflammatory or pain relieving options discussed in the context of your general health.
• Injections. Corticosteroid injection into the joint is one option considered during a flare.

When stiffness, mechanical symptoms or pain persist, surgical options may be raised, depending on which part of the problem dominates.

• Arthroscopic debridement. Removal of loose fragments, inflamed lining and impinging spurs through small portals.
• Open joint preserving surgery. A more direct approach when spurs and capsular scarring are extensive, sometimes combined with releasing pressure on the ulnar nerve.
• Elbow arthroplasty. Replacement of the joint surfaces in selected cases; lifting limitations are part of that discussion.

What to expect when you consult Dr. Wolfson

Dr. Wolfson is board certified in the United States and Canada and sees patients in San Francisco. A visit usually includes careful measurement of motion, examination of the nerve as well as the joint, and an explanation of the options that fit your particular elbow.

This page provides general information about elbow arthritis and is not medical advice. It is not a substitute for examination, imaging and diagnosis by a qualified physician. Every case is different and requires individual evaluation. If you have severe pain, an obvious deformity, loss of function, fever, or an injury from a significant accident, seek medical care promptly.

Contact Dr. Wolfson if you would like to setup an appointment. If you are a new patient, please book all in-person appointments with Dr. Wolfson via telephone.

If you live outside of the San Francisco Bay Area, you can request a complimentary phone consultation with Dr. Wolfson to assess your case. Please call or e-mail us to set up your complimentary consultation.

Call: (415) 221-4400

E-mail: [email protected]