Rheumatoid arthritis can affect the joints in the body that have a lining of synovial tissue, including the elbow joint. Rheumatoid arthritis in the elbows can cause synovial thickening, which leads to inflammation, stiffness, and pain around the affected joints.

Rheumatoid arthritis (RA) in the elbow can be very uncomfortable and 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.

This article takes a close look at how arthritis can affect the elbow. It also covers treatment options, including exercise, surgery, and steroid injections.

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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 supports the movement of the hand and forearm, so people rely on its mobility to carry out many everyday tasks. It has a lining of synovial tissue, which lubricates the joint.

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

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. People may also experience bone erosion.

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 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, the bones in the elbow can suffer damage and change shape. In addition to a decreased range of motion, this can result in ankylosis, where the bones of a joint fuse together.

Damaged or deformed elbow joints may also press on the nerves that lead to the hands, which can cause a numb or tingling sensation in the fourth and fifth 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 painless but can indicate a higher risk of further health problems, such as vasculitis. These occur in up to 2 in 10 people with RA.

RA can cause several other symptoms, including:

Sometimes, people living with RA may develop interstitial lung disease, which can cause shortness of breath.

In addition, in about 3 in 10 cases, people living with RA may develop Sjögren’s disease, which can decrease tears and saliva. This can lead to mouth and eye dryness, which may cause vision and dental damage.

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 duration and frequency.

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

A doctor 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 may be very beneficial for the treatment and outlook of RA.

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

Clinical remissions are sometimes possible with effective treatment. Doctors will reduce medication to the minimal dosage necessary to prevent inflammation in these cases.

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.

Learn about exercises for arthritis pain here.

Medications

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

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

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

Learn more about medications for RA here.

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 may 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.

The following are answers to additional questions about RA in the elbow.

How common is RA in the elbow?

According to a 2020 study, the prevalence of impact on the elbow visible in an ultrasound image is about 35% of people with RA.

What can be mistaken for rheumatoid arthritis?

Other conditions can mimic the symptoms of RA. These include lupus, Lyme disease, sarcoidosis, and other types of arthritis.

What triggers rheumatoid arthritis?

RA can have different triggers. For example, research shows that in some people, eating an unhealthy diet or being at an unhealthy weight may be a factor in the development of RA. However, in at least 4 in 10 cases of RA, the person has likely inherited the condition.

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

RA is a chronic health condition. While it is impossible to cure the disease, people can manage their symptoms and prevent joint damage using different treatments.