Revealing... Osteoarthritis In The Elbow

Often Ignored, Sometimes Discounted, Brutally Misdiagnosed...

The Short Answer – Your elbow may not be the first place you expect to get osteoarthritis (unless you play baseball), but the truth is that many people suffer osteoarthritis in the elbow and assume it is something else – until it is too late.

This article reviews the potential reasons you might develop osteoarthritis in your elbow and the early signs/ symptoms to watch out for.

Understanding Osteoarthritis In Your Elbow

Your elbow is one of the least of likely places to develop osteoarthritis – but that certainly does not mean you won’t develop it there.

The advantage of your elbow is that it isn’t weight-bearing like your knees or your hips. It also has very well-matched joint surfaces surrounded by strong muscles and ligaments.

All of this means the chances of your elbow becoming unstable and exerting considerable force on just one part of the joint, are fairly unlikely.

This raises complications for recognising and diagnosing osteoarthritis in the elbow, because (as pointed out in Orthopaedics & Traumatology: Surgery & Research),

“the clinical manifestations are often at variance with the radiological findings.”

In other words, the elbow causes a problem because scans such as x-rays that are commonly used to diagnose osteoarthritis often show different findings to the pain and symptoms presented to the doctor.

Furthermore, the percentage chance of osteoarthritis in the elbow being caused by a previous injury that has altered the elbows’ strength/ natural stability is much higher – simply because the other causes are less likely in the elbow.

Then we have to add in the fact that because osteoarthritis in the elbow is fairly rare, there is the possibility that it is confused initially with tennis elbow or simply a standard strain.

This is especially true given that the pain of tennis elbow frequently does not subside for some considerable time.

The end result is the difficult situation that elbow osteoarthritis goes undiagnosed in the vital early stages.

By the time it is clear that your elbow pain is not tennis elbow, you may find that your osteoarthritis has already advanced to a later stage.

Given that osteoarthritis has no cure and that it is very difficult to wind back it’s progress, it is then essential to understand the difference in causes and signs/ symptoms.

Sexual Bias..
Another unusual bias is that, whereas most areas affected by osteoarthritis are more likely to appear in women than men, when it comes to the elbow the opposite is true.

Partly down to the heavy causative reliance around physical injury, osteoarthritis in the elbow actually has a slight bias towards men, not women.

Indeed, as pointed out by Gramstad et al in The Journal Of Bone and Joint Surgery… 

“Elbow osteoarthritis typically affects middle-aged men who engage in strenuous manual activity.”

This is very different to the traditional model, with a bias towards women and the elderly.

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Causes of Osteoarthritis In The Elbow

The exact causes of osteoarthritis still remain unknown, but we can now at least narrow it down a list of most likely suspects.

In ‘the old days’ the only real considered cause of osteoarthritis was wear and tear. Modern understanding though, is that osteoarthritis is a condition that affects the entire matrix of the joint – including all the surrounding muscles, tendons and supporting ligaments (Journal of Prolotherapy).

This has led to a wider understanding that certain environments/ conditions are much more likely to lead to osteoarthritis in the elbow than others.

Although no one single factor can be labelled as responsible for the initial development of osteoarthritis in the elbow, ignoring the potential causes and early symptoms is certainly the worst action to take.

The Potential Causes Can Be Listed As Follows –

1. Injury To Your Elbow. Any injury can cause an imbalance in your joint, even one normally as balanced as your elbow.

Indeed in the case of osteoarthritis in the elbow, this is the most likely causes of developing osteoarthritis later in life.

2. Surgery On Your Elbow That Does Not Return It To It’s Original State Or Causes A Loss Of Cartilage. The elbow is a very well balanced joint, but something that removes part of it’s normal structure may be fine in the short term, but cause lasting damage.

3. Age. As we all forms of osteoarthritis, age will weaken the supporting tissues and muscles around your joint, leaving it more vulnerable as it no longer has the stabilising support it is used to.

4. Bodyweight. In the case of your elbows, it is not the physical number on the scales that is the problem – since your elbows are not weight bearing anyway.

However, overweight people have been found to be much more likely to suffer with inflammation and this inflammation can lead to damage around the joints, including your elbow.

5. Occupation. Jobs that involve excessive throwing such as baseball or crab fishing are very likely to lead to a destabilised elbow joint in the future.

6. Genes. There is still a heavy predisposition towards inheritance of osteoarthritis from your family.

Symptoms of Osteoarthritis In The Elbow

There are certain key symptoms to look out for with osteoarthritis in your elbow, that differentiate it both from other more common elbow injuries and a simple strain.

These can be listed as –

  • Pain that increases during the day
  • Stiffness after waking up or after a period of inactivity that loosens up after less than 30 minutes.
  • Loss of range of motion
  • A grating sensation when moving the elbow
  • A locking from time to time (caused by loose pieces of bone becoming trapped between the joint surfaces)
  • Swelling (albeit in the case of elbows this tends to happen later in the diseases development
  • A ‘Tingling Sensation’ caused by the elbow joint putting pressure on the nerves around the ‘funny bone’
  • A bumpy appearance caused by bone spurs or ‘osteophytes’ – extra bits of bone growing in the wrong places
  • Elbow instability/ weakness caused by a breakdown of the surrounding matrix

Diagnosis Of Osteoarthritis In The Elbow

As with most forms of osteoarthritis, any diagnosis from a doctor will most likely follow the same format, albeit with different characteristics looked for when it relates to your elbow.

This format is as follows –

  • Review of your history. Your doctor will be looking for a family history of osteoarthritis, whether you’ve ever had surgery on your elbow and details of any possible injuries (including muscle strains).
  • A physical Examination. Consideration will be given to your bodyweight, the current range of movement in your elbow, any locking or crunching feelings and the nature of your joints’ stiffness.
  • X-Rays. Again these look for reduced spaces between your joints, tiny pieces of bone that may have broken off or fresh growths of bone spurs – and any other signs of damage to your joint.
  • CT/ MRI Scans. Only in the event that your X-rays fail to show enough clear detail on the condition of your elbow.

The Final Word –

Your elbow is certainly not the most expected area to find osteoarthritis – nor is it the most well studied. However, every day people develop it and ignore it or put it down to tennis elbow, leaving diagnosis until a later stage.

By then however, your osteoarthritis may have develop extra, irreversible symptoms, making it’s management an even harder task.

For you to avoid this, you will need to know the early signs yourself and be particularly aware of its’ likelihood if you have
an occupation that caused you to flex your elbow a lot or
an elbow injury in the past.

Those are the two most likely causes for you to develop osteoarthritis in your elbow.

But, as always, knowing the early signs puts you one step ahead – getting an early diagnosis puts you further up and starting a wide ranging treatment plan asap will give you the hat-trick and the best chance of continuing with the minimum disruption to your life.

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References Used –

1. M.Chammas. (Nov 2013). Post-traumatic osteoarthritis of the elbow. Orthopaedics & Traumatology: Surgery & Research
2. Gregory D Gramstad and Leesa M Galatz. (Feb 2006). Management of Elbow Osteoarthritis. The Journal Of Bone And Joint Surgery, American Volume.
3. Mark T. Wheaton MD & Nichole Jensen. (2010). The Ligament Injury Connection to Osteoarthritis (Extended Version – Online Only). Journal Of Prolotherapy.

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