What Does Arthritis in Elbow Feel Like?

The elbow joint is essential for the complex range of motion required for many daily activities, from lifting a cup of coffee to throwing a ball. When this joint is compromised by arthritis, the impact on a person’s quality of life can be profound. In the elbow, it leads to the progressive deterioration of the smooth articular cartilage that cushions the bones. This post will explore what arthritis in the elbow feels like, along with underlying causes and available treatment options.

• Elbow arthritis typically manifests as a deep, dull, and persistent ache, often worsening with activity, particularly movements that involve bending, straightening, or rotating the forearm.
• The three common types of arthritis are post-traumatic arthritis, osteoarthritis (wear-and-tear), and rheumatoid arthritis (an autoimmune disorder).
• Initial treatment is often conservative, focusing on activity modification, anti-inflammatory medications (NSAIDs), physical therapy, and injections.
• When conservative measures fail, surgical options range from minimally invasive procedures like arthroscopy to more complex interventions.

The elbow is a hinge joint formed by three bones: the humerus (upper arm bone), the ulna (on the pinky side of the forearm), and the radius (on the thumb side of the forearm). The ends of these bones are covered in articular cartilage, a smooth tissue that allows the bones to glide against each other with minimal friction. The entire joint is encased in a capsule lined with a synovial membrane.

Arthritis, regardless of its specific type, disrupts the normal function of the joint through several interconnected processes. The smooth, protective cartilage that cushions the bones gradually wears away, exposing the underlying bone. As this cartilage deteriorates, the joint surfaces begin to rub directly against each other, creating friction and inflammation of the synovial membrane, a condition known as synovitis. In an attempt to stabilize the joint, the body often forms small, irregular bony projections called osteophytes or bone spurs. These spurs can restrict movement and may even break off to become “loose bodies” within the joint, further aggravating irritation.

Most patients with elbow arthritis experience a consistent pattern of symptoms. They typically describe the pain as deep-seated and persistent, which evolves from an intermittent nuisance into a constant presence.

The most common initial complaint is a dull, persistent ache deep within the elbow. This is distinct from the sharp, localized pain of a fracture or the burning sensation of nerve compression.

• Activity-Related Worsening: Activity frequently exacerbates the pain, especially repetitive motions or actions that place a rotational or compressive load on the joint, such as turning a doorknob, lifting heavy objects, or performing push-ups.
• Night Pain: As the condition progresses, many patients report pain that wakes them from sleep.
• Referred Pain: The discomfort may not be confined to the elbow itself. Patients may feel the ache radiating down the forearm toward the wrist or up into the lower part of the upper arm.

Stiffness is a direct result of the joint’s internal environment, swelling, thickening of the joint capsule, and the physical presence of bone spurs.

• Morning Stiffness: A hallmark of many arthritic conditions, the elbow may feel particularly stiff and difficult to move after periods of rest, such as first thing in the morning.
• Progressive Flexion Contracture: The most common loss of motion is the inability to fully straighten the arm (extension). This is known as a flexion contracture.
• Loss of Rotation: The elbow joint also allows for pronation (turning the palm down) and supination (turning the palm up). Arthritis can limit these rotational movements, making simple tasks like eating with a fork or shaking hands challenging.

As the cartilage surface becomes rough and irregular, and as osteophytes form, the joint may produce audible and palpable sensations.

• Crepitus: A grating, grinding, or crunching sensation or sound during movement. This is the sound of rough, damaged cartilage or bone surfaces rubbing against each other.
• Clicking or Snapping: The joint may produce a distinct, often painful, click or snap during movement. This typically occurs when a loose body (a fragment of bone or cartilage) moves within the joint space or when a bone spur catches on the joint capsule.
• Locking: This may occur when a loose body or a large bone spur physically jams the joint, preventing movement.

The symptoms described above are common to most forms of elbow arthritis, but the underlying cause typically dictates the specific progression pattern and treatment strategy. The three most common types are post-traumatic arthritis, osteoarthritis, and rheumatoid arthritis.

Post-traumatic arthritis is the most frequent cause of arthritis in the elbow. It can develop following a significant injury to the joint, even years or decades later. Any injury that disrupts the smooth joint surface, such as a fracture (especially of the radial head or distal humerus), a severe dislocation, or ligamentous injury, can initiate the arthritic process. The initial trauma may damage the cartilage directly and alter the joint’s mechanics, leading to abnormal wear patterns.

Osteoarthritis, often called “wear-and-tear” arthritis, is the most common form of arthritis overall, but it is less common in the elbow than in weight-bearing joints like the knee or hip. OA is frequently linked to occupations or sports that involve heavy, repetitive use of the elbow, such as manual labor, weightlifting, or throwing sports (e.g., baseball pitchers). Chronic, high-impact stress can cause the cartilage to break down over time.

Rheumatoid arthritis is a systemic, autoimmune disease where the body’s immune system mistakenly attacks the synovial lining of the joints, leading to widespread inflammation. RA is a polyarticular disease, meaning it usually affects multiple joints simultaneously, often symmetrically (both elbows, both wrists).

A precise diagnosis is the foundation of an effective treatment plan. The diagnostic process for elbow arthritis typically involves a combination of clinical evaluation and imaging. Your doctor may begin by taking a detailed medical history, focusing on the nature of the pain (when it started, what makes it better or worse).

A physical examination will generally assess range of motion, areas of tenderness and swelling, stability, and any mechanical signs. Following the medical history and physical exam, imaging studies may be taken to support the diagnostic suspicion.

X-rays are usually the first step and can reveal common signs of arthritis such as cartilage loss, bone spurs, and loose fragments. In more complex cases, a CT scan may be used to get a detailed view of the bone structure, while MRI helps assess cartilage and soft tissue damage.

The goal of treating elbow arthritis is to reduce pain, control inflammation, and preserve joint function. Treatment typically progresses in stages, beginning with the least invasive options and advancing only when necessary.

Many patients with mild to moderate elbow arthritis find relief through conservative care. Common approaches include activity modification, medications, physical therapy, and occasional injections.

Activity modification helps reduce stress on the joint by avoiding repetitive or heavy movements such as lifting, throwing, or gripping. Over-the-counter anti-inflammatory medications like ibuprofen or naproxen can ease pain and swelling, while topical NSAID gels may help with localized discomfort. Physical therapy focuses on maintaining flexibility and strength in the elbow and shoulder to improve stability and prevent stiffness. In some cases, corticosteroid injections can provide temporary but significant relief from inflammation and pain. During flare-ups, a brace or splint may be used to rest and support the joint.

When non-surgical treatments no longer provide adequate relief or when stiffness and pain significantly limit daily activities, surgical options may be considered. The specific approach depends on the type and severity of arthritis, as well as the patient’s age and activity level.

Elbow arthroscopy involves inserting a small camera and instruments through tiny incisions to remove loose bodies, shave down bone spurs, or remove inflamed tissue. For cases with extensive damage or large bone spurs, an open approach may be used.

In patients with advanced arthritis, surgeons may perform a total elbow replacement. They replace the damaged bone ends with metal and plastic components that function as a hinge, aiming to relieve pain and improve function.

Arthritis in the elbow is a chronic, progressive condition characterized by deep, aching pain, debilitating stiffness, and mechanical symptoms like clicking and locking. Whether the cause is a past injury (post-traumatic), chronic overuse (osteoarthritis), or an autoimmune disorder (rheumatoid arthritis), the underlying pathology is the same: the loss of smooth, protective cartilage.

The journey to managing elbow arthritis often begins with a precise diagnosis, utilizing a combination of clinical examination and advanced imaging. For many patients, a comprehensive, non-surgical approach may provide substantial relief and preserve function. When conservative care is no longer sufficient, a range of surgical options is available.

The location and nature of the pain may be key differentiators. In patients with tennis elbow, pain is typically sharp, localized to the bony bump on the outside of the elbow (lateral epicondyle), and is most painful when gripping or extending the wrist against resistance. It is a tendon issue. For elbow arthritis, pain is generally a deep, generalized ache within the joint, often worse with bending/straightening and rotation, and may be accompanied by stiffness and loss of motion.

Patients typically begin physical therapy within a few days to a week. Many patients can return to light daily activities within a month and can resume more strenuous activities or sports within 2 to 3 months, depending on the extent of the procedure and the patient’s commitment to rehabilitation.

Early symptoms often include a dull ache deep in the joint, mild stiffness after rest, and occasional clicking or catching during movement. Many patients notice discomfort when performing simple tasks like turning a doorknob or pushing up from a chair.