I see three major types of arthritis that affect the elbow and shoulder joints. Osteoarthritis is the “wear-and-tear” arthritis caused from degenerative conditions, and occurs most frequently. Rheumatoid arthritis is less common and is a systemic inflammatory condition of the joint lining (the synovium). Posttraumatic arthritis is a form of arthritis that develops from an injury, such as a dislocation or fracture.
Many patients wonder, “What is arthritis”. For any joint, arthritis means, “joint inflammation”. In the case of the elbow, if the cartilage surface of the elbow becomes worn from age or damaged, elbow arthritis occurs. If you have elbow arthritis, you probably have pain, swelling, stiffness, and loss of normal range of motion. Some people complain of a “locking” or “grating” sensation in the joint.
These sensations are related to the loss of normal smooth joint surface and when pieces of loose bone or cartilage lodge between the joint surfaces interfering with normal movement. Often, my patients may notice numbness of the ring finger and pinky finger. This is related to the pressure placed on the ulnar nerve or funny bone from the swelling.
How is elbow arthritis diagnosed?
I can diagnose elbow arthritis based on your symptoms, a simple physical examination, and standard X-rays. This disease tends to be more common in men than women, and it generally occurs in people over the age of 50 years. You are at increased risk for elbow arthritis if you have a history elbow injury, inflammatory arthritis, or a family history of arthritis. Others at risk for elbow arthritis include people who have jobs or participate in activities that place demands on the elbow joint, such as professional baseball pitchers.
How is elbow arthritis treated?
I treat elbow arthritis predominantly based on your symptoms. Factors to consider include the stage of the disease, patient goals, and your overall medical condition and physical health. Nonsurgical treatment for elbow arthritis involves measures to alleviate or reduce pain, increase range of motion, and restore function. This includes physical therapy, activity restrictions and limitations, and oral anti-inflammatory or pain medications. If these conservative measures do not work, many patients benefit from corticosteroid injections, which can give several months of relief and can be both therapeutic and diagnostic.
Surgery may be necessary if nonsurgical measures do not control and alleviate symptoms. If the damage is not too severe, I can do minimally invasive and sometimes even arthroscopic procedures to remove loose bodies and degenerative, inflammatory tissue from the joint. This smoothes out the irregular joint surfaces and provides symptom relief. If the joint space is severely worn, I may suggest a joint replacement for you.
The shoulder is made up of two joints. One of these is the acromioclavicular (AC) joint, located where the collarbone (the clavicle) meets the tip of the shoulder blade (the acromion). The other is located at the junction of the upper arm bone (the humerus) and the shoulder blade (the scapula), and this is called the glenohumeral joint. Both of these shoulder joints are often affected by arthritis. The symptoms of shoulder arthritis include pain, stiffness, decreased or limited range of motion, and crepitus. Crepitus is a “clicking” or “snapping” sound made with shoulder movement.
How is shoulder arthritis diagnosed?
I diagnose shoulder arthritis based on a thorough physical examination, symptoms, and basic X-rays. Most people with shoulder arthritis have a narrowing of the joint spaces, formation of bone spurs, and changes in the bone structure. People over the age of 50 years are at increased risk for shoulder arthritis. Also, having a history of an injury to your shoulder joint puts you at risk for developing this condition.
How is shoulder arthritis treated?
I treat shoulder arthritis based on the severity of the disease, health status and overall condition, activity level and work responsibilities, and prior history. Nonsurgical measures include oral medications, physical therapy, and activity restrictions and limitations. Patients that do not respond to these methods could have a corticosteroid or hyaluronic acid injection. When the joint is severely damaged or worn, or if the patient does not improve with conservative measures, the glenohumeral joint can be replaced with a prosthesis in a procedure called a total shoulder arthroplasty.
If necessary, the head of the humerus is replaced. For arthritis of the AC joint, a resection arthroplasty could help. I do this by taking a small piece of bone from the collarbone to leave room for movement.