Elbow Arthritis and Stiffness
Elbow arthritis and elbow stiffness often occur together, but they are not the same problem.
Causes and symptoms
Primary osteoarthritis often affects active adults with years of heavy use. Post-traumatic arthritis can follow fracture, dislocation, instability, or surgery. Inflammatory or rheumatoid arthritis, cartilage injury, infection, and chronic deformity are other causes. Symptoms include pain at the limits of motion, progressive loss of extension or flexion, grinding, locking, loose-body symptoms, reduced forearm rotation, swelling, and numbness in the ring and small fingers. Even modest motion loss can impair eating, grooming, typing, exercise, and work.
Evaluation
The examination distinguishes active from passive motion loss, pain from a firm mechanical block, instability, and ulnar nerve symptoms. X-rays show joint-space loss, bone spurs, loose bodies, deformity, and prior fracture healing. CT is useful for mapping bone spurs, loose bodies, heterotopic bone, malunion, nonunion, and complex anatomy before surgery. MRI is used selectively for soft-tissue or cartilage questions. EMG or nerve-conduction testing may be obtained when ulnar neuropathy is present.
Patient Experience
“I saw Dr. Knudsen for a really bothersome pain in my elbow. He was very thorough with his exam and patiently explained his diagnosis and recommended treatment. I really appreciate his expertise and patient-friendly approach.”
Elbow consultation patient | Google review
Nonsurgical care
Treatment may include activity modification, appropriate medication, physical or occupational therapy, a directed home-motion program, and static-progressive or dynamic splinting. Corticosteroid injection can provide temporary relief for selected arthritic joints. Forceful stretching is not appropriate for every stiff elbow. The program should reflect stability, bone quality, nerve symptoms, and whether a structural block is present.
Arthroscopic or open surgery
Arthroscopy can remove loose bodies and selected bone spurs, release scar tissue, and improve motion in appropriate anatomy. Open surgery may be safer or more effective when stiffness is severe, heterotopic bone is extensive, prior trauma has altered the anatomy, the ulnar nerve requires direct treatment, or bone reconstruction is needed. The objective is meaningful functional improvement. A severely damaged elbow may not regain normal motion even after a technically successful release.
When replacement is considered
Total elbow replacement may be considered for selected patients with end-stage joint destruction, severe pain, major functional limitation, or an unreconstructible fracture. It can improve daily function but usually requires lifelong restrictions on repetitive and heavy loading. Younger patients and heavy laborers require careful consideration of joint-preserving alternatives.
This information is educational and is not a substitute for an individualized medical evaluation. Written and medically reviewed by Michael L. Knudsen, MD | Last reviewed: July 2026
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