Contents
What is elbow arthritis?
Inflammatory processes can occur in different parts of the body. Perhaps the most unpleasant of them are those that affect the articulation of bones – the joints. Arthritis is accompanied by acute pain syndrome and significantly limits the mobility of the limbs.
Elbow arthritis is an inflammation of the elbow joint.
Elbow arthritis is a complex articulation and consists of three bones:
elbow;
ray;
brachial.
Accordingly, there are the same number of simple joints:
brachioradialis (lat. articulatio humeroradialis);
shoulder-elbow (lat. articulatio humeroulnaris);
radioulnar (lat. articulatio radioulnaris proximalis).
Arthritis occurs in about 10% of all cases of elbow pain. They tend to quickly spread to other joints. So monoarthritis turns into polyarthritis. To diagnose the disease, the doctor conducts a conversation with the patient to clarify all the details of the clinical picture. Examination with palpation is performed. To clarify the localization of inflammation, an x-ray is taken in two projections: direct and lateral. To determine the degree of inflammation, take a blood test.
If radiography is not enough, then an ultrasound examination is performed, computed or magnetic resonance imaging is performed. Additionally, atro- and thermography are used (examination with a thermal imager). It is also possible to puncture the contents of the synovial bag, tissue biopsy to identify the etiology of the disease. Analyzing the chemical composition of the extracted contents, it is possible to establish the causative agents of the inflammatory process.
Forms of arthritis of the elbow joint:
acute;
chronic.
The course of the disease and the methods of treatment used are different for adults and children. The statistics of the incidence of arthritis is as follows: they suffer from 80% of people 65 years of age and older. Every sixth of them becomes disabled. Tuberculous arthritis of the elbow usually occurs in children and accounts for approximately 3% of all specific diseases of the musculoskeletal system. Risk factors for getting sick are divided into genetic – due to heredity (only in women) and acquired. In females, the disease is provoked by the HLA-B27 gene.
In most cases, the disease is rheumatoid in nature, i.e. develops gradually. Over time, a very serious complication may appear – articular contracture (“tightening, narrowing”). This is a forced fixation of the hand in one position, which occurs due to scarring of the surrounding soft tissues. They treat contracture with traction, with the help of plaster casts and even operations. Recovery procedures are very painful.
Another unpleasant consequence of elbow arthritis is phlegmon. Often a complication develops in the form of bursitis – inflammation of the periarticular bag. The consequence of elbow arthritis can also be ankylosis – immobility of the joint due to the complete fusion of the articular surfaces. The disease sometimes leads to damage to the cardiovascular system, skin and mucous membranes.
Why do so many patients keep postponing a visit to the doctor? This is due to the peculiarity of arthritis pain. They are aggravated in the morning or after a long immobility of the hand. Having developed a sick elbow a little, the sick one significantly reduces discomfort. Most often, people seek medical help when the disease enters an acute phase, and it becomes impossible to endure pain.
The duration of the treatment course depends on at what stage of the disease the relief of the inflammatory process began. The sooner you seek help, the sooner you can recover. A mild form of elbow arthritis is cured within a week, a severe form – a few months.
After treatment, the patient should not neglect preventive measures. Staying in specialized sanatoriums is welcome. If the pain is neglected, treatment is postponed indefinitely, then elbow arthritis will not only become chronic, but will also cause severe complications. Some of them can be fatal.
Symptoms of Arthritis of the Elbow
Elbow arthritis is accompanied by the following symptoms:
pain syndrome due to compression of the nerve roots during swelling – arthralgia (joint pain);
general weakness;
muscle aches;
malaise;
hyperthermia (fever);
nausea;
vomiting;
swelling due to excess synovial fluid in the joint capsule;
redness of the skin;
local temperature increase (elbow hot to the touch);
increased ESR – erythrocyte sedimentation rate – and the number of leukocytes, c-reactive protein in the blood;
joint stiffness.
These symptoms are more common in women. Symptom complexes for different types of arthritis practically do not differ. In addition to the listed symptoms, the patient is also concerned about the manifestations of concomitant diseases.
It is important to remember! The symptoms of elbow arthritis worsen if left untreated. The patient loses his ability to work more and more, and the pain becomes unbearable. A variety of elbow arthritis at an early stage of the disease is quite difficult to determine. But after receiving the results of the studies, the attending physician will be able to choose the most effective therapeutic technique.
Causes of elbow arthritis
The causes of elbow arthritis are as follows:
infections – bacteria, viruses, fungi (infectious arthritis);
diseases of the digestive system;
dysbiosis;
food poisoning (eteroarthritis);
chronic pathologies of the upper respiratory tract (sinusitis, pharyngitis, tonsillitis and others);
autoimmune disorders after stress or a large psycho-emotional load;
allergic reactions;
metabolic disorder;
avitaminosis;
collagenosis – connective tissue diseases: rheumatism, lupus erythematosus and others;
gout – a metabolic disease with excessive deposition of salts in the joints;
psoriasis – a type of skin disease (psoriatic arthritis);
viral hepatitis;
urethritis;
enterocolitis;
diabetes;
pyelonephritis;
cystitis;
sepsis – general infection with microbes;
tuberculosis (tuberculous arthritis);
measles;
brucellosis transmitted from domestic animals;
gonorrhea – purulent inflammation of the genitourinary system;
syphilis;
excessive physical activity – movements that exceed the physiological limits of the joint;
injuries: fractures, bruises, dislocations, sprains, tendon ruptures, burns, frostbite (traumatic arthritis);
malignant tumors;
unfavorable living conditions (unsanitary conditions, high humidity, poor ventilation, etc.).
Depending on the cause, arthritis can be primary (developing on its own) or secondary (accompanied by other ailments). Purulent elbow arthritis is also divided into primary and secondary. The first type occurs due to the ingress of infectious pathogens directly into the joint through broken skin. This may be due to injury.
Secondary purulent arthritis develops due to the “attack” of pathogens from adjacent tissues (viruses, streptococci, etc.). There are more than 100 factors that provoke the development of arthritis. It is still unknown what causes many types of this disease.
Success in the treatment of any disease is largely determined by the correct diagnosis and identification of the cause that triggered the pathological process. If elbow arthritis is a consequence of another disease, then treatment should primarily be directed to it.
Treatment of arthritis of the elbow joint
The attending physician (orthopedist, rheumatologist or arthrologist) usually prescribes conservative treatment.
Surgery is used only in very severe cases. The following therapeutic methods are used:
drug therapy;
physiotherapy procedures: magnetotherapy, amplipulse, electrophoresis, laser, ultrasound – phonophoresis, treatment with paraffin and ozocerite;
massage and physiotherapy exercises to activate the blood supply and metabolic processes in the diseased limb;
surgery.
Of the drugs, painkillers and anti-inflammatory drugs are primarily prescribed. To reduce pain, the arm is immobilized. Usually it is enough to keep it in a sling for some time (kerchief bandage). Sometimes special orthopedic aids are used, for example, bandages or elbow pads.
Analgesics are prescribed a variety of:
Acetaminophen;
Paracetamol;
Analgin;
Capsaicin;
Tylenol;
Oxycodone;
Methadone;
Tramadol;
Ibuprofen.
Inflammation is removed with the help of non-steroidal drugs:
Acetylsalicylic acid;
Nimesulide;
Movalis or Meloxicam;
Piroxicam;
Celebrex;
Nimesil;
Indomethacin.
Steroid hormones also reduce the inflammatory process:
Hydrocortisone;
Prednisolone;
Triamcinolone;
Kenalog;
Detralex
If the inflammation proceeds with the formation of pus, then an autopsy and removal of the contents are performed. In this case, the inflamed area is treated with strong anti-inflammatory drugs and antibiotics.
Cartilage tissue is restored using chondroprotectors:
Chondroitin sulfate;
Glucosamine;
Hondrolon;
Structure;
Arthritis.
Chondroprotectors are taken in long courses even after the end of the main treatment. They significantly accelerate cell regeneration. If arthritis is provoked by an infectious agent, then antibiotic therapy (etiotropic) is performed. Additionally, immunostimulants and antitoxic agents are administered.
Forms of medications prescribed for arthritis of the elbow joint:
tablets (for example, Diclofenac);
solutions for intramuscular and intraarticular injections (for example, corticosteroids);
gels (for example, Diklak);
cream;
ointments (for example, Bishofit, Nikoflex, Menovazin);
solutions for lotions (for example, Dimexide).
These drugs have many side effects, overload the gastrointestinal tract, so at the same time as they are taken, it is necessary to follow a diet and prescribe drugs that support the digestive process. Carrying out physiotherapy, massage or physiotherapy exercises is possible only after the removal of the pain syndrome. These treatments are necessary to prevent muscle fiber atrophy.
A rehabilitation medical and physical culture complex usually includes aerobic, strength and motor exercises for specific muscle groups. Swimming and hiking are shown. You can also visit the gym, but exercise only under the supervision of an instructor. The modern methods of treatment of arthritis of the elbow joint include the use of stem cells. This technology is under development and testing.
Surgical methods of treatment:
arthroscopy – removal of processes from the bone and other manipulations through a micro incision;
endoprosthetics – replacement of joint components with implants;
arthrodesis – complete immobilization of the joint;
arthrolysis or Wolff’s operation – excision of fibrous adhesions;
synovectomy – removal of the affected synovial membrane;
osteotomy – removal of part of the bone in order to reduce pressure on the joint;
resection – removal of a joint or part of it;
arthroplasty — joint replacement.
The main goal of therapy is to stop the process of dystrophy of the affected joint. The role of restoration of normal blood supply and metabolic processes is great in this. In cases where arthritis is a secondary disease, i.e. complication of another disease, therapy must be comprehensive. Without getting rid of the root cause, all efforts to stop inflammation will be fruitless. If there is no treatment for arthritis of the elbow joint, then pathological changes in the hand become irreversible.
With persistent pain in the elbow area, you should contact a specialist as soon as possible. The inflammatory process, which has not yet passed into the acute stage, is stopped much easier and faster. Only timely treatment can avoid unpleasant complications and disability.