Rheumatoid arthritis (RA) is a chronic, progressive disease caused by an overactive immune system. RA affects smaller joints in the body as well as larger ones. When there’s the involvement of smaller joints, it commonly develops in the elbow.
The immune system protects the body against foreign invaders. In RA, this immune system malfunctions by cases of stimulating the production of antibodies that attack the lining of healthy joints.
There are two types of RA: Seropositive and seronegative. About 60% to 80% of people have seropositive RA, which means their blood will show unusually high levels of antibodies called anti-cyclic citrullinated peptides (anti-CCPs).
You won’t have these antibodies in your blood if you have seronegative RA. Some people living with RA may have another marker called rheumatoid factor (RF) in their blood, but not all.
If RA is affecting your elbow, this will usually be symmetrical. This means it affects both the right and left arms in about
Rheumatoid arthritis can gradually damage or destroy tissue. It primarily causes inflammation and swelling in the joint lining of the elbow. Some people even develop a noticeable bulge near their elbow where the inflamed joint lining has pushed out.
Elbow pain can start in the early stages of the disease. As RA progresses, other parts of the body become affected, too. This includes the joint lining in the hips, knees, and hands.
Uncontrolled inflammation in the elbow may also cause cartilage and bone destruction, as well as bursitis, which is the inflammation of the small, fluid-filled sacs that cushion the bone. Severe swelling in the elbow
RA in the elbow can affect mobility, making it difficult to extend or bend your arm. Your elbow joints may also lock in place, or you may have periods of instability. This is when the elbow joint gives out, making completing activities difficult.
Elbow pain may occur mostly on the outer side of the joint. As your disease worsens, you may have pain that interferes with sleep.
Joint stiffness is another symptom of rheumatoid arthritis in the elbow. The risk of stiffness is greater when arthritis develops after an elbow injury.
What does rheumatoid arthritis in the elbow feel like?
Pain from rheumatoid arthritis in the elbow is often symmetrical and best described as a dull ache or throbbing pain.
In the beginning stages, you may have intermittent pain that comes and goes, or you may only feel pain with certain movements like bending your elbow.
As your disease progresses, elbow pain can become persistent, or the slightest movement can trigger discomfort.
Pain from RA in the elbow differs from pain caused by an injury. With an injury, pain can be short term and gradually improve. RA pain does not improve on its own. Instead, pain can become progressively worse if left untreated.
RA in the elbow may also feel worse at certain times of the day, such as in the morning.
If you nerve compression, you may get a pins and needles sensation in your elbow. Or, you might have complete or partial numbness in your elbow and distal arm.
What are elbow nodules?
Along with pain, you may also develop rheumatoid nodules. These are firm, tender lumps that form under the skin that are not bound to any tissue or bone. They’re typically associated with rheumatoid arthritis in the hands, feet, and elbows.
When first forming, they are considered a type of small-vessel vasculitis. Over time, inflammatory cells will accumulate around the area. More nodules can occur as RA progresses, primarily on the surface where the elbow typically rests on a chair.
Nodules vary in size and typically take a circular shape. These lumps form during a flare-up. They’re also associated with a more severe disease type. They can make it hard to flex the arm.
Up to 20% of people with RA develop nodules. The exact cause of these lumps is unknown, but they tend to occur in smokers, people with a severe form of the disease, and those with other inflammatory conditions.
If you have symmetrical elbow pain, your doctor may test for RA. Elbow pain is an early symptom of this disease.
Your doctor will likely perform a physical exam. This involves checking your elbow for signs of swelling and tenderness. Your doctor will also move your elbow in different directions to gauge your range of motion.
There isn’t a single medical test to diagnose RA. But a blood test to check for autoantibodies can help confirm or rule out this disease. Imaging tests like MRI, ultrasound, and X-ray can also look for joint damage in your elbow.
Your medical treatment depends on the severity of your condition but might include nonsurgical or surgical options.
Nonsurgical treatments are the first line of defense for rheumatoid arthritis in the elbow.
Medication
Medication options
- Over-the-counter (OTC) pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can block inflammation and reduce swelling. These medications provide short-term relief and include naproxen sodium (Aleve) or ibuprofen (Motrin). Topicals containing this type of medication are also available.
- Corticosteroids: Steroids can be taken orally or by injection into the elbow, effectively reducing pain and inflammation. A doctor needs to prescribe oral steroids. These are used sparingly due to potential side effects. The doctor may use a pulsed ultrasound to help the steroids penetrate deeper into the tissue around the joint.
- DMARDs: Disease-modifying anti-rheumatic drugs (DMARDs) block inflammation of the joints.
- Biologics: These medications target specific parts of the immune system that lead to inflammation.
A doctor may use Iontophoresis, in which an electrically charged liquid helps get medication through the person’s skin into the joint.
Other remedies
Other remedies to help relieve joint pressure and stop pain include:
- applying cold or heat therapy for pain and swelling, respectively
- wearing an elbow splint for periods
- avoiding activities or sports that aggravate symptoms
- physical therapy
- occupational therapy
- resting and avoiding overuse of the elbow joint
Surgery
Persistent or uncontrolled inflammation can cause permanent joint damage in the elbows. If this happens, your doctor may recommend surgery to repair this damage. Surgical procedures include:
- removing inflamed tissue lining in the elbow
- removing bone spurs or loose fragments around the elbow
- removing part of the bone to ease joint pressure
- a total joint replacement
Here you will find additional answers to common questions about arthritis in the elbow:
What are some rheumatoid arthritis elbow exercises?
There are different exercises a person can do to help manage RA symptoms in the elbow. Examples include elbow bends, flexes, turns, and lifts. Depending on the severity of symptoms, a person may be able to use weights.
Learn more about exercises for the elbow.
How do I know my elbow pain is serious?
RA can lead to joint destruction in the elbow. See a doctor if you have unexplained elbow pain that doesn’t improve, especially when the pain affects both elbows. If you have a diagnosis of RA in the elbow, yet the pain continues, schedule a doctor’s appointment. Your doctor may need to adjust your current therapy to better control inflammation.
Can you reverse arthritis in your elbow?
Treatment cannot cure RA in the elbow but can reduce inflammation, stiffness, and swelling and preserve the arm’s range of motion and function. The goal of treatment is to slow the progression of the disease and bring about remission.
Pain in the elbow is typical with RA. There’s no cure, but with treatment, it’s possible to block inflammation and reduce symptoms like swelling, stiffness, and loss of movement.
Pain may not improve on its own. So speak with your doctor to discuss an effective treatment plan. The sooner you treat the condition, the sooner you can achieve remission.