Stiffness affects various joints in the body. Arthritis may also affect the elbow joint and the symptoms include swelling, pain, stiffness, and malformation all of which interfere with use of the elbow.
Who develops stiffness?
Stiffness may affect people of all ages. The most common cause is wear-and-tear, as you age you are more prone to develop arthritis. Also, traumatic injuries, fractures and joint dislocation make you more susceptible to develop stiffness. What are the types of arthritis?
There are over several causes of stiffness. The most common are:
Osteoarthritis: Osteoarthritis is also called degenerative joint disease; this is the most common type of arthritis, which occurs often in older people. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint, and this is called a bone spur.
Osteoarthritis causes joint pain and can limit a person’s normal range of motion (the ability to freely move and bend a joint). When severe, the joint may lose a lot of movement, causing a person to become disabled. Elbow osteoarthritis can be very disabling.
Post-traumatic stiffness/ contracture: Stiffness developing following an injury to the elbow is called as post-traumatic stiffness. The condition may develop months or years after the trauma such as a fracture, severe sprain, or ligament tear.
Myositis Ossificans: Stiffness developing following ossification around the front or back of the elbow following an injury or surgery to the elbow is called as post-traumatic stiffness. The condition may develop months or years after the trauma such as a fracture, severe sprain, or ligament tear.
Chronic Regional Pain Syndrome (CRPS) : Stiffness developing following an injury to the elbow with pain out of proportion without any identifiable cause on the Xray and MRI is called as chronic regional pain syndrome or CRPS. The condition may develop months after the trauma such as a fracture, severe sprain, or ligament tear.
How is stiffness diagnosed?
Diagnosis of elbow stiffness is made by examining the elbow. X-rays of the joint may be taken to identify any bony causes for the stiffness such as arthritis. What are the treatments available for stiffness of the elbow?
Nonsurgical treatment methods for relieving pain in a stiff arthritic joint include activity modification, pain medications, physiotherapy, and use of splints, and steroid injections.
Surgery is usually considered if nonsurgical treatment fails to give relief. There are different surgical procedures that can be used and may include:
Synovectomy, joint lavage and capsular release: This surgery is usually indicated for early cases of inflammatory arthritis where there is significant swelling (synovitis) that is causing pain or is limiting the range of motion of digits and thumb. Synovectomy is a surgical removal of the inflamed synovium (tissue lining the joint). The procedure is often performed using keyhole surgery (elbow arthroscopy). It may also be performed open where the joint is washed out and the capsule is released both in the front and at the back to improve movement. Loose bodies in the front and back of the joint may be removed and bony spurs obstructing movement can be removed as well.
Dr Bala will discuss the options with you and help you decide which type of surgery is the most appropriate for you. In the event you may have a tattoo on the forearm Dr Bala is well versed in suturing tattoos back accurately with absorbable sutures.
Rehabilitation
Following surgery, a rehabilitation program, often involving a physiotherapist may help to regain elbow strength and movement. You may need to use a post-operative splint for a while after surgery that helps to protect the elbow while it heals. You may need to restrict activities for 12 weeks to let the joint reconstruction heal properly. Although recovery is slow, you should be able to resume your normal activities within a few months of surgery.
