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Carrying groceries is difficult with elbow arthritis.
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According to the Centers for Disease Control and Prevention, arthritis is the leading cause of disability in the United States. Arthritis in the elbow causes pain and limited range of motion, significantly affecting daily tasks. Two main types of arthritis -- osteoarthritis and rheumatoid arthritis -- can develop in the elbow joint. It is possible to suffer other types of arthritis in the elbow, including gouty arthritis and psoriatic arthritis.
The elbow joint is formed by the humerus -- upper arm bone -- and two bones in the forearm, the ulna and radius. It is a hinge joint, capable only of bending and straightening. Osteoarthritis causes breakdown of cartilage -- the padding between bones in the joint. This type of arthritis can develop in one or more joints in the body, but it doesn't frequently affect the elbow. When it does, it usually develops in the dominant arm of middle-aged men who have a long history of manual labor or sports participation. Osteoarthritis in the elbow more commonly develops after trauma, particularly after a fracture that did not heal correctly. Symptoms include pain and limited ability to bend or straighten the elbow. X-rays and clinical findings are used to diagnose osteoarthritis in the elbow.
Rheumatoid arthritis is an inflammatory disorder that affects all systems in the body but significantly targets the joints. It is an immune system disease, meaning the body mistakenly attacks healthy joint tissue. This disorder causes inflammation of the synovial membranes, tissues that create the fluid that lubricates the joints. The inflamed membranes slowly destroy the bone and cartilage in the joint. When one elbow is affected, the other is, too. Joint stiffness -- particularly in the morning or after a period of sitting still -- is a common effect of rheumatoid arthritis. Symptoms also include swelling, pain, stiffness, redness and warmth of the skin. Rheumatoid arthritis is diagnosed with blood analysis and clinical findings. Blood tests are used to assess for high levels of rheumatoid factors -- certain antibodies that are common in people with this disease. These tests also examine the level of inflammation in the body, which is elevated with rheumatoid arthritis. Nodules -- firm lumps -- also develop under the skin, commonly in the elbow.
Elbow arthritis is first treated with conservative measures. Anti-inflammatory medications are prescribed to reduce pain and swelling in the joint. Painful activities are temporarily stopped to allow the joint to rest. Corticosteroid medication is injected directly into the elbow joint to decrease inflammation and reduce pain. Rheumatoid arthritis is also treated with medications that slow the progression of this disease. Physical therapy interventions use treatments such as heat, ultrasound and electrical stimulation to decrease pain in the arthritic elbow. Range of motion exercises are prescribed to maintain joint mobility and improve function. Education is provided to teach people with arthritis how to adapt daily tasks to reduce strain on the painful elbow joint.
Surgical intervention is sometimes required to reduce pain and improve range of motion in the arthritic elbow. Osteoarthritis causes bones in the elbow to rub together as the cartilage deteriorates. Sections of bone are removed with elbow debridement surgery to increase space in the joint and reduce pain. Synovectomy -- removal of diseased synovial tissue -- is effective for reducing elbow pain caused by rheumatoid arthritis. During this procedure, a portion of the end of the radius -- the bone on the thumb side of the forearm -- is often removed to improve elbow bending. A severely arthritic elbow caused by osteoarthritis or rheumatoid arthritis may require joint replacement -- total elbow arthroplasty. The ends of the humerus and radius bones are removed, and metal stems are inserted into each one. These stems come together at a metal and silicone hinge joint. A study published by Acta Orthopaedic in 2009 demonstrated an approximately 88 percent survival rate -- no need for revision surgery -- of the elbow prosthesis seven years after surgery. According to the Agency for Healthcare Research and Quality, approximately 3,000 Americans had total elbow replacement surgery in 2010.