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Rheumatoid Arthritis in the Elbow: Symptoms and Treatment

Posted on February 25, 2021
Medically reviewed by
Diane M. Horowitz, M.D.
Article written by
Victoria Menard

Rheumatoid arthritis (RA) is a chronic autoimmune disease that occurs when the immune system mistakenly attacks the body’s healthy tissues. The resulting inflammation can cause pain, swelling, and stiffness in the affected joints. Although RA tends to affect the joints in the hands, wrists, and knees, between 20 percent and 65 percent of people with RA experience involvement in the elbow. In fact, rheumatoid arthritis is the most common cause of arthritis in the elbow.

What Does RA in the Elbow Feel Like?

Rheumatoid arthritis tends to affect similar joints on both sides of the body — if one elbow joint is affected by RA, the other one will likely be affected, as well. The symptoms you experience may change over time as the disease progresses.

Pain is a common symptom of rheumatoid arthritis in the elbow. In RA’s early stages, elbow pain may be focused only on the outer side of the joint and worsen as you rotate your forearm. One myRAteam member wrote, “The only time [my elbow] really hurts, though, is when I straighten my arm out or use my elbow to prop myself up while I’m watching TV.”

Some myRAteam members describe RA elbow pain as causing many different sensations. As one member wrote, “I have pain in my elbows. It feels like a bell ringing, but the pain starts in the middle of my elbow and ‘rings’ out. This seems to attack my big joints instead of my smaller ones.” Another member described their elbow pain like “nails on a chalkboard,” writing, “When I get it, I want to crawl out of my skin.”

As another member pointed out that RA-related elbow pain is often accompanied by swelling. They wrote that their right elbow “is swollen, red, and warm to the touch.” Swelling is more common in rheumatoid arthritis than in osteoarthritis.

RA symptoms in the elbow can also cause difficulties during everyday tasks. Limited mobility and instability may cause the elbow to lock up or give out, whereas stiffness may prevent you from moving your elbow as fully as you used to.

Pain and stiffness in the elbows can also lead to difficulties sleeping. Many myRAteam members have shared that they have sleeping problems alongside their arthritis symptoms: “My elbows have been interrupting my sleep,” wrote one member. “I wake up, and whatever side I’m sleeping on, the elbow is stiff and painful. I roll over, only to wake up with the same problem on that side.”

Another member shared a similar experience: “I woke up again with a stiff and sore right elbow and a sore neck. … If only I could sleep on my back, so my elbows and neck wouldn’t hurt.”

One member even shared that getting up in the morning posed a challenge: “When my RA is flaring, using my elbows to get up out of bed in the morning is very painful.” They added that their elbow pain is usually accompanied by pain in other joints, as well. “I have to kind of roll out of bed, because if my elbows are bad, then my hands and wrist are, too,” they said.

Pain Management and Treatment Options for RA in the Elbow

If you’re experiencing RA symptoms in your elbow, talk to your doctor about finding the right combination of treatments to alleviate pain and reduce swelling. Your rheumatologist may prescribe or recommend the following choices.

Medications

There are several options for treating rheumatoid arthritis and managing elbow pain with medication. Your doctor may recommend a combination of systemic drugs, which treat the underlying disease, and over-the-counter or prescription pain relievers.

Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help relieve pain and reduce inflammation caused by RA. NSAIDs include over-the-counter medications, like Advil (ibuprofen), as well as other options available by prescription.

Systemic Arthritis Medications

Systemic medications, which include disease-modifying antirheumatic drugs (DMARDs) and biologics, work to treat rheumatoid arthritis by slowing disease progression and preventing joint deformities. These medications treat the underlying inflammatory response that causes RA, helping to alleviate symptoms.

Steroid Injections

If you’re experiencing a flare-up of RA symptoms in your elbow, your doctor may prescribe corticosteroid injections. Corticosteroids (or steroids) are mainly used in the short term to control RA symptoms during disease flares.

Surgery

Surgery for elbow arthritis in RA is generally recommended when:

  • Nonsurgical treatments do not provide enough pain relief
  • Joint stiffness interferes with daily activities
  • The affected joint is severely unstable, causing notable dysfunction
  • The disease has progressed to the point that bone loss compromises potential future surgeries or is leading to fracture (breakage)

Depending on your disease progression and symptoms, your doctor may recommend one of several surgical procedures for elbow arthritis, including:

  • Synovectomy (removal of the synovial tissue surrounding the joint)
  • Joint replacement surgery
  • Interposition arthroplasty (placing soft tissue between the damaged surfaces of the joint)

Physical and Occupational Therapy

Your rheumatologist may recommend physical therapy to help improve flexibility, strength, and range of motion. An occupational therapist can help you make adjustments in your environment and everyday tasks to reduce pain and discomfort during activities.

Heat and Cold Therapy

Both heat and cold can help alleviate the symptoms of arthritis. Heat helps to loosen the muscles around the joint and increase flexibility and circulation. Cold, on the other hand, helps reduce inflammation and dull pain.

For hot therapy, the Cleveland Clinic recommends showering or soaking in a warm bath for 20 minutes or using a heating pad. Applying a moist dishcloth warmed in the microwave for 20 seconds can work in the same way.

Cold therapy can be applied for 20 minutes at a time using a gel-filled ice pack, frozen peas, or a baggie filled with ice.

Compression Sleeves

Compression and support garments can help provide relief. One myRAteam member said, “I have a lot of trouble with my elbows. I have a compression sleeve that I wear when they really act up, and it helps. At times, I will put pain cream on and the compression sleeve over it.”

Find Your Community

On myRAteam, the social network for people living with rheumatoid arthritis and their loved ones, more than 143,000 members come together to offer support, give advice, and share stories of everyday life with rheumatoid arthritis.

Have you experienced RA symptoms in your elbow? What have you used to alleviate pain, swelling, or stiffness? Share your tips in the comments below or by posting on myRAteam.

All updates must be accompanied by text or a picture.
Diane M. Horowitz, M.D. is an internal medicine and rheumatology specialist. Review provided by VeriMed Healthcare Network. Learn more about her here.
Victoria Menard is a writer at MyHealthTeam. Learn more about her here.

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