Rheumatoid Arthritis in the Elbow: What to Know

Rheumatoid arthritis (RA) is an autoimmune condition that targets joints throughout the body. This condition occurs when your immune system destroys your body's own cells as if they were a foreign invader. RA can cause elbow pain, as well as swelling, stiffness, and limited movement.

This article discusses rheumatoid arthritis of the elbow—what the symptoms are, how it's diagnosed, and treatments for this condition.

Symptoms of RA in the Elbow

One of the earliest symptoms of RA in the elbows is pain that affects both arms at the same time. Other elbow injuries or conditions, such as osteoarthritis, typically only affect one side of the body. RA causes inflammation in the joints, which can also lead to warmth, redness, and swelling.

Nodules, or lumps under the skin, often develop with RA in joints that are frequently under pressure. While rheumatoid nodules most commonly affect the fingers, they can also develop on the tips of your elbows. These nodules are firm and aren't usually painful to the touch.

RA frequently causes stiffness first thing in the morning. You might notice difficulty bending or straightening your elbow, or rotating your forearm. This often improves throughout the day.

Joints are supported by ligaments that attach bone to bone, and a joint capsule that surrounds the entire joint. RA attacks these structures, which can lead to elbow instability—"locking" during movement, pain with activity, and difficulty with tasks that involve your arms, such as pushing up from a chair.

Diagnosis of RA in the Elbow

Rheumatoid arthritis is a systemic disease. Although it often attacks your joints, it affects your whole body. Diagnosis of RA is based on several things: review of your symptoms, blood work, and imaging of the affected joints.

Medical Review of Signs and Symptoms

Early on, RA often begins with specific signs and symptoms that can lead your healthcare provider to suspect you might have this condition—especially if you've had them for six weeks or more. These include:

• Stiffness throughout your body, first thing in the morning
• Symptoms affecting both sides of your body at the same time
• Inflammation in four or more joints, including your fingers and hands
• Swollen joints (not related to other injury or activity)

Blood Work

Blood tests are performed to help diagnose rheumatoid arthritis. General blood work can show high levels of inflammation in your body. Other blood tests include:

• Rheumatoid factor
• C-reactive protein
• Antinuclear antibody (ANA)
• Cyclic citrullinated peptide (CCP)
• Erythrocyte sedimentation rate (ESR)
  

Imaging

A variety of imaging techniques are used to assess RA in your elbows. X-rays provide a picture of your bones and swelling in the affected area. Magnetic resonance imaging (MRI) is used to look at the supporting structures in your elbows, such as your ligaments and tendons.

Ultrasound uses sound waves to produce pictures of the soft tissues around your elbow joints and inflammation. Computed tomography (CT) scans can also be used to assess the amount of bone damage that has occurred.

Treating RA in the Elbow

Elbow pain from RA can be treated with medications and home remedies.

Medications

Rheumatoid arthritis is treated with medications that target your overactive immune system to decrease inflammation in the body. These medications, called disease-modifying anti-rheumatic drugs (DMARDs), are most effective when they are started soon after your diagnosis, but can take between six weeks to three months to kick in.

RA symptoms tend to fluctuate. When your symptoms are worse, it's often referred to as a "flare-up." Anti-inflammatory medications can help treat your elbow pain during a flare-up.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are available over-the-counter. Common NSAIDs include Aleve (naproxen) and Advil (ibuprofen). If these aren't effective, your healthcare provider might prescribe oral steroids, such as prednisone.

Home Remedies

At-home remedies for managing pain and inflammation in the elbow due to rheumatoid arthritis include:

• Heat it up: Apply moist heat to your elbows for 15 to 20 minutes, several times per day. This will increase blood flow and help decrease stiffness and pain. To combat morning stiffness, take a hot shower.
• Keep it moving: Elbow stiffness is common with RA, and it can get worse if you don't keep your joints moving. Gently bend and straighten your elbow, and rotate your forearm as far as you can without pain. Pushing past your pain can increase inflammation.
• Rest: Avoid activities that make your elbow pain worse until your flare-up is over. If you have to use your elbow, take frequent breaks.
• Unload your joints: Carry bags on your shoulder rather than in the bend of your elbow. Make multiple trips when carrying groceries into the house to limit pressure on your hands and elbows.

Surgery

In severe cases of RA in the elbow, surgery might be required. Synovectomy is a procedure that involves removing damaged tissues in the joint. However, symptoms often return within five years of this surgery.

Elbow joint replacement, or total elbow arthroplasty, is another surgical option for severe RA. Damaged joint structures are removed and replaced with an artificial joint during this procedure.

Physical therapy is usually required after total elbow arthroplasty to help you regain movement and strength while protecting your healing joint. Full recovery takes about three months.

Summary

Rheumatoid arthritis (RA) is an inflammatory condition that affects the whole body. RA often attacks the joints, including your elbows. RA in the elbow causes pain, stiffness, swelling, warmth, and difficulty with daily tasks. Treatment includes medication, home remedies, and in severe cases, surgery.

A Word From Verywell

Rheumatoid arthritis (RA) can take a toll, both physically and emotionally. Elbow pain can interfere with even the most basic daily tasks. Be proactive and talk to your healthcare provider about treatment options. See a physical therapist for education for joint protection tips and ways to make daily activities less stressful for your joints.