Elbow arthritis
Content reviewed by✓Mr Andrew Davies, PhD FRCS (Tr & Orth)· Reviewed June 2026Elbow arthritis is wear and damage to the smooth cartilage lining the elbow joint, causing pain, stiffness, and reduced movement. It can follow a previous injury, be part of an inflammatory condition such as rheumatoid arthritis, or, less often, develop as ordinary wear-and-tear osteoarthritis. Treatment ranges from medication and physiotherapy through to surgery, including total elbow replacement in advanced cases.
📊 Elbow arthritis is less common than arthritis of the hip or knee, as the elbow is not a major weight-bearing joint. It most often develops after a previous fracture or dislocation, or as part of rheumatoid arthritis. Ordinary osteoarthritis of the elbow is relatively uncommon and tends to affect people who have placed heavy demands on the arm over many years.
What is elbow arthritis?
Arthritis means loss of the smooth cartilage that normally lets the joint surfaces glide over each other. As the cartilage wears away, the bones begin to rub together, causing pain, stiffness, a grating sensation, and a gradual loss of the range through which the elbow can bend and straighten. Bony spurs and small loose fragments can form and may cause catching or locking.
Three main types affect the elbow. Post-traumatic arthritis develops months or years after a fracture or dislocation and is the most common form needing treatment. Rheumatoid and other inflammatory arthritis cause the joint lining to become inflamed and progressively damage the cartilage and bone, often affecting both elbows. Ordinary osteoarthritis, the wear-and-tear type, is comparatively rare in the elbow.
Symptoms usually build up slowly over years, and many people manage well for a long time with simple measures. Surgery is only considered once pain and stiffness significantly affect daily life and non-surgical treatment is no longer helping. Where the joint is severely worn, total elbow replacement can give reliable pain relief, but it carries a permanent restriction on lifting (no more than about 1kg with the operated arm), so it is reserved mainly for older or lower-demand patients.
Common causes
- Previous elbow fracture or dislocation (post-traumatic arthritis)
- Rheumatoid and other inflammatory arthritis
- Ordinary osteoarthritis (wear and tear, less common in the elbow)
- Heavy manual or repetitive loading of the arm over many years
- Previous joint infection or earlier elbow surgery
Who is at risk? A previous elbow injury and inflammatory arthritis such as rheumatoid disease are the main risk factors. Heavy manual work and older age also contribute.
Symptoms
Symptoms vary depending on the severity and duration of the condition. Common symptoms include:
- Deep elbow pain, at first with use and later also at rest
- Stiffness and gradual loss of full bending or straightening
- Grating or grinding (crepitus) on movement
- Catching or locking if there are loose bony fragments
- Tingling or numbness in the ring and little fingers if the ulnar nerve is irritated
- In rheumatoid arthritis: swelling, warmth, and involvement of both elbows
When to seek help: See your GP or an elbow specialist if elbow pain and stiffness are persistent, disturbing your sleep, or limiting everyday activities, or if you notice locking, catching, or numbness in the hand. Early assessment helps guide treatment and, in inflammatory arthritis, protect the joint.
How is it diagnosed?
Your surgeon will take a detailed history and examine the joint. The following investigations may be arranged to confirm the diagnosis:
- X-ray - shows loss of joint space, bony spurs, and joint damage
- CT scan - gives detailed bone images and helps plan surgery
- MRI - assesses the cartilage and soft tissues around the joint
- Blood tests - help diagnose rheumatoid or other inflammatory arthritis
- Nerve tests - if there is numbness or tingling suggesting ulnar nerve involvement
The ulnar nerve runs close to the inner side of the elbow and is often affected by elbow arthritis, so it is checked carefully - any nerve symptoms are assessed before surgery is planned.
Treatment pathway
Treatment is tailored to the severity of the condition, your age, activity level, and overall health. Most conditions are treated in a stepwise fashion, starting with the least invasive options.
Medication, physiotherapy and activity changes
Pain relief, anti-inflammatory medication, physiotherapy to maintain movement and strength, and adapting activities that aggravate the joint. In rheumatoid arthritis, getting the disease-modifying medication right with the rheumatology team is an important part of protecting the joint.
Keyhole clean-up (arthroscopic debridement)
For earlier arthritis, particularly the post-traumatic type, keyhole surgery to remove loose fragments and bony spurs and to release tight tissue can improve movement and reduce pain. It is a useful option in younger or more active patients before joint replacement is considered.
Total elbow replacement
For a severely worn joint, the damaged surfaces are replaced with an artificial joint, giving reliable pain relief. A permanent 1kg lifting limit applies afterwards to protect the implant, so it is generally reserved for older or lower-demand patients. The ulnar nerve is protected or moved during the operation.
Recovery
Many people manage elbow arthritis for years with medication, physiotherapy, and activity changes. If surgery is needed, recovery depends on the procedure: a keyhole clean-up recovers over a few weeks, while total elbow replacement takes 6-12 months to reach maximum benefit and carries a permanent 1kg lifting limit that must be respected for life.
- Non-surgical treatment: ongoing
- Keyhole surgery recovery: 6-12 weeks
- Elbow replacement hospital stay: 2-4 days
- Elbow replacement full recovery: 6-12 months
What results can I expect?
The outlook depends on the type and severity of arthritis and the treatment chosen. Non-surgical measures control symptoms well for many people. Where total elbow replacement is needed, over 85-90% report significant pain relief, with around 80-85% of implants still working at 10 years - a little lower than for hip or knee replacement because the elbow is a complex, highly loaded joint.
Elbow arthritis - causes and treatment options
Common activity questions for this condition. Timelines are approximate, always follow the specific guidance given by your surgeon and physiotherapist.
| Activity | Typical timeline | Notes |
|---|---|---|
| Drive | Weeks 6–8 | When you have adequate elbow control and strength and are off strong painkillers. |
| Sleep in bed | Week 1–2 | Arm elevated on pillows. Most patients manage lying flat within 1–2 weeks. |
| Shower | Week 2 | Once wound is healed. Avoid submerging until fully healed. |
| Return to desk work | Weeks 4–6 | Light keyboard use and writing when elbow movement allows. |
| Lift more than 1kg | NEVER | The 1kg weight limit is permanent and lifelong. This is the most important restriction. |
| Manual work | NOT recommended | Heavy manual work permanently excluded after total elbow replacement. |
| Swimming | Months 2–3 | Gentle swimming when wound healed and movement allows. No heavy strokes. |
Common concerns during recovery, and whether they are expected.
Your questions, answered
Plain-English answers to the things people most often ask, drawn from real patient questions and grounded in published guidance. Tap a question to open it.
About thisWhat is an elbow replacement?
Worn or badly damaged elbow joint surfaces, from arthritis or after a fracture, are replaced with an artificial joint to reduce pain and improve function.
Your choiceShould I have one?
It is considered when pain and stiffness are not controlled by medicines, injections and physiotherapy and your quality of life is affected. It reliably reduces pain, but comes with lasting activity limits, so a specialist discussion weighs the benefits and risks for you.
Implant lifeHow long does it last, and are there limits?
An important point: a replaced elbow has a permanent lifting limit, often only a few kilograms repeatedly, to protect the implant. Over time it can loosen or wear, and revision surgery is more complex. This is why elbow replacement is usually reserved for lower-demand use.
InjectionsDo injections help before considering replacement?
A steroid injection can give temporary relief and is sometimes used to manage symptoms or delay surgery, but the effect is usually short-lived.
Getting backWhat is recovery like?
Expect a period in a sling or splint, then guided movement and gradual strengthening within the lifting limits, with improvement continuing over months.
UrgentWhen should I seek urgent help after surgery?
Fever, spreading redness, wound discharge, severe or increasing pain, or new hand numbness all need prompt review. Infection is a particular concern with elbow replacements.
PreparingHow do I prepare?
You will have a pre-assessment to optimise your health, and you should arrange help and any equipment at home. Your team will explain the lifting restrictions you will follow for life.
WellbeingAdjusting to the lifting limits sounds hard.
It does take adjustment, but most people value the pain relief it brings. An occupational therapist can suggest practical ways to adapt everyday tasks within the limits.
- Versus Arthritis: Osteoarthritis of the elbow and shoulder
- Versus Arthritis: Elbow pain
- British Elbow & Shoulder Society: Exercises for elbow stiffness
- British Elbow & Shoulder Society: Patient information
These links are to UK clinical guidance and patient information from recognised organisations. This page is for general information and does not replace personalised advice from your own clinical team.
Preparing for surgery?
Read our step-by-step guide - what to expect before, during, and after your procedure.
How is it diagnosed?
- ✓X-ray - shows loss of joint space, bony spurs, and joint damage
- ✓CT scan - gives detailed bone images and helps plan surgery
- ✓MRI - assesses the cartilage and soft tissues around the joint
- ✓Blood tests - help diagnose rheumatoid or other inflammatory arthritis
- ✓Nerve tests - if there is numbness or tingling suggesting ulnar nerve involvement
Recovery milestones
- ●Non-surgical treatment: ongoing
- ●Keyhole surgery recovery: 6-12 weeks
- ●Elbow replacement hospital stay: 2-4 days
- ●Elbow replacement full recovery: 6-12 months