Rheumatoid arthritis can affect any of the joints in the body, including the elbow joint. This long-term condition causes inflammation, stiffness, and pain around affected joints.

Rheumatoid arthritis (RA) in the elbow can be very uncomfortable, and it may affect daily tasks, such as reaching for objects and carrying bags. It can cause permanent damage to the elbow joint and even change its shape.

In this article, we take a close look at how arthritis can affect the elbow. We also cover treatment options, including exercise, surgery, and steroid injections.

How does rheumatoid arthritis affect the elbow?

When RA affects the elbow, it causes inflammation, pain, and stiffness in and around the joint. The swelling can lead to reduced mobility in the elbow joint.

The elbow joint connects the upper arm to the forearm. It is a complex joint comprising three bones and several smaller parts. The elbow joint affects the movement of the hand and forearm, so people rely on its mobility to carry out many everyday tasks.

In the early stages of RA, people may only feel pain when they lift objects or strain the elbow joint. Although movements that involve the elbow can be uncomfortable, there is usually little impact on the range of motion.

However, the pain often becomes worse over time. Some people will experience a persistent throbbing pain in the elbow, even when it is at rest. Others may only notice the pain at certain times of day, such as in the morning.

Over time, it is also possible for RA to cause permanent damage to the elbow joint. Chronic inflammation can damage the tissues in the joint that prevent the bones from rubbing against each other. This primarily affects the synovial tissue that lines the joint. People may also experience bone erosion.

In up to 20% of people with RA, small, firm bumps called nodules will also appear around the elbow.

Symptoms of RA in the elbow

RA primarily causes pain, swelling, and tenderness in the joints, which can also become stiff. When the condition affects the elbow joint, this will restrict the mobility of the arm.

Over time, the bones in the elbow can become damaged and change shape. In addition to a decreased range of motion, this can result in ankylosis, in which the bones of a joint fuse together.

Damaged or deformed elbow joints can sometimes press on the nerves that lead to the hands, which can cause a numb or tingling sensation in the fingers.

In more advanced forms of RA, rheumatoid nodules can form on the elbow. These are small lumps that appear just below the surface of the skin. They are generally painless, but they can indicate a higher risk of further health problems, such as vasculitis.

RA can cause several other symptoms, including:

• fatigue
• weight loss
• fever
• weakness

The symptoms of RA tend to come and go, so people often have periods of remission that alternate with flares. Everyone with RA will have a different experience of flares, which can vary in their duration and frequency.

Diagnosis

Doctors usually diagnose RA based on a person's symptoms, although medical tests can be helpful.

Doctors will begin by performing a physical examination, and they may also order imaging tests, including X-rays, ultrasounds, MRI scans, and blood tests.

MRI scans are less common, but they can be useful for detecting early signs of RA and assessing the damage in the joints. An early diagnosis can be very beneficial for the treatment and outlook of RA.

Treatment

RA is a chronic health condition, but people can use various treatments to manage their symptoms, improve their overall quality of life, and slow down the progression of the condition.

Clinical remissions are sometimes possible with effective treatment. In these cases, doctors will reduce medication down to the minimal dosage necessary to block inflammation.

Treatments for RA in the elbow include:

Physical therapy: It is vital to keep the elbow joints mobile during the day to improve flexibility and range of motion and keep the muscles around the elbow joint strong.

Exercises that stretch and strengthen the elbow joint can reduce the symptoms of RA in the elbow. Strengthening the arm muscles will relieve some of the pressure on the joint, while stretches can help minimize stiffness in the tissue surrounding it.

A physical therapist with experience in the field of rheumatic conditions can help a person design an exercise plan to keep their elbows active without causing injury.

Where possible, a good exercise regimen will usually combine cardiovascular and resistance exercises to keep the heart and other body systems healthy.

Medication: Doctors often recommend medications to reduce inflammation, manage pain, and slow down RA damage. These include:

• pain relievers
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• disease-modifying antirheumatic drugs (DMARDs)
• biologics
• steroids

Doctors may recommend a combination of these medications to increase their effectiveness.

It is worth noting that these drugs can have side effects. For example, DMARDs and biologics can suppress the immune system, increasing a person's likelihood of infection.

Steroid injections: Steroid injections into the joint can help in certain situations and may be very effective. Steroids can immediately reduce acute inflammation. A doctor will be able to provide advice on when this might be an appropriate treatment.

Surgery: Long-term inflammation can cause permanent damage to joints and the surrounding tendons, ligaments, and other tissues.

In some cases, people may need surgery to repair the damage. This ranges from straightforward surgical procedures to major ones, such as elbow replacement surgery.

Outlook

The symptoms of RA are mild initially, but they tend to get worse over time.

RA is a chronic health condition. While it is not possible to cure the disease, people can manage their symptoms and prevent joint damage using different combinations of treatments.