Two types of arthritis can be seen in the elbow complex. The first type, Osteoarthritis (OA), is the typical "wear-and-tear" arthritis, which can present at any age but typically appears in later life. In some cases, OA can present after an injury or fracture to the elbow and is called post-traumatic arthritis. The second type of arthritis is inflammatory arthritis. Rheumatoid arthritis (RA) is a common example. This arthritis affects patients at an earlier age. It typically affects multiple joints in the body (wrists, knees, etc.).
When arthritis affects the elbowr joint, the lining on one or both sides of the joint called cartilage starts to wear out. Cartilage is a very smooth surface which allows the joint to move with very little friction and no pain. When the cartilage disappears, the undersurface of the cartilage starts to rub against the opposite side of the joint. This leads to less smooth motion (crepitus) which can be felt or heard. Furthermore, this can cause significant pain with motion. As the pain becomes worse, it significantly limit motion and cause difficulties with activities of daily living (moving the elbow, lifting things, dressing).
There are four different modalities used in the management of arthritis.
Over the counter medication such as Ibuprofen, Aleve and prescription medications such as Celebrex and Mobic are non-steroidal anti-inflammatory medications which can prescribed to decrease the pain and inflammation in the elbow. These medications have proven to be effective in decreasing pain.
These injections are given into the elbow joint to decrease the inflammation in the arthritic joint. The steroid is usually mixed with a numbing medication which makes the injection less painful and helps confirm the diagnosis of arthritis. The steroid medication takes about 24-48 hours to start to work and may last up to 3-6 months.
Physical Therapy (PT)
PT is used to keep the joint flexible and the muscles surrounding the joint strong. It does not treat arthritis but keeps the joint moving more smoothly.
Surgical treatment of elbow arthritis is used to either restore range of motion or eliminate pain and restore function to the elbow. In some early stages of arthritis, an arthroscopy can be performed to debride, or "clean up" the elbow. This means taking out the loose bodies in the elbow, removing some of the inflamed tissue (synovium) and debriding the loose injured cartilage. This may help improve stiffness in the joint and restore range of motion. In more advanced stages of arthritis where stiffness and decreased range of motion is the primary concern, an incision can be made over the elbow to remove bone spurs and thickened scar tissue to help restore mobility to the joint. Finally, in very advanced elbow arthritis, the joint can be replaced with a metal prosthesis. Check the section on shoulder replacement for more information.
Further information on this injury can be found in this article on the AAOS OrthoInfo website, an orthopaedic resource center providing expert information.