Huw David

Stiffness / arthritis in the elbow joint

Stiffness in the elbow jointStiffness of a joint is often the result of arthritis and mild arthritis leading to some loss of movement is common in the elbow.  It is estimated that 1:50 of the population has a degree of elbow arthritis and is most commonly seen in middle aged men engaged in heavy physical work. The degree of stiffness is often mild and does not cause problems with function. Individuals will seek advice once the level of restriction begins to interfere with day to day activities, particularly bending or flexion movements leading to an inability to get ones hand to ones mouth.

The elbow appears unusually sensitive to trauma and stiffness, often quite marked, can develop following an injury that causes little or no damage to the joint (fracture). Stiffness in these circumstances is not usually painful, but the restriction in movement can impact significantly on day to day use of the arm. Currently, there is much interest in the use of splints and braces in addition to physiotherapy in the treatment of elbow stiffness. Surgery is indicated if the level of stiffness impacts on function and has failed to respond to physiotherapy. The type of procedure most appropriate will to a large extent depend on the underlying problem and degree of stiffness. An open or arthroscopic procedure aimed at releasing the contracted  tissue within the joint may be indicated. Physiotherapy following surgery is essential in order to prevent  further stiffness.

Elbow StiffnessArthritis leading to significant discomfort in addition to stiffness is less common, but when it does occur a total elbow replacement may be indicated and an elbow replacement is a well-recognised and proven treatment option for those suffering with severe arthritis. It is more suited to those suffering rheumatoid arthritis (inflammatory) rather than osteoarthritis (wear and tear). A total elbow replacement may also benefit older patients who suffer certain complex fractures of the joint.

Loose bodies are common in the elbow. The elbow is in essence a hinge and entrapment of one or more small loose bodies can give rise to intermittent locking of the joint. They can usually be removed using keyhole techniques although a small incision will occasionally be needed. Both procedures are normally performed on a day case basis.