Elbow Osteoarthritis: Causes, Symptoms, and How We Can Help
- staystrongtherapy
- Jun 30
- 4 min read
All information in this blog is supported by NICE guidance and peer-reviewed research. Reference numbers appear throughout, with the full list at the bottom of the page.
What Is Elbow Osteoarthritis?
Elbow osteoarthritis is far less common than osteoarthritis of the hip or knee, but it is a genuine cause of elbow pain and stiffness worth understanding properly. NICE Guideline NG226, Osteoarthritis in over 16s: diagnosis and management, sets out the general principles of osteoarthritis care that apply here, even though the elbow is not one of the most commonly affected joints. ¹
Unlike the knee or hip, where osteoarthritis is most often described as primary, age-related wear, the elbow tells a slightly different story. The condition may be primary or secondary to repeated use, as well as trauma, with pain, discomfort, and progressive loss of functionality being the common features. ² Around 60% of people with primary elbow osteoarthritis have a clear history of repetitive upper limb use, particularly seen in manual labourers, weightlifters, throwing athletes, and wheelchair users. ³
How Does It Develop in the Elbow Specifically?
This is genuinely interesting and elbow-specific. Elbow osteoarthritis is widely understood to begin at the radiocapitellar joint, the smaller of the two main joints making up the elbow, which supports around 55% of the load passing through the elbow when the forearm is in a neutral position. Because cartilage wear tends to be more pronounced here first, the arthritic process typically progresses from the radiocapitellar joint into the larger ulnohumeral joint over time. ³
Secondary changes are common as the condition progresses, including bone spurs (osteophytes) forming around the olecranon, loose bodies of cartilage or bone floating within the joint, and softening of the cartilage surface. These changes can occur at a relatively young age in athletes involved in repetitive throwing activities, such as javelin or shot put. ²
Common Signs and Symptoms
Pain and progressive loss of elbow movement, particularly with full extension
Stiffness, often worse after periods of rest or first thing in the morning
Occasional catching, locking, or grinding sensations within the joint
Swelling around the elbow
In more advanced cases, irritation of the ulnar nerve as it passes close to the joint, causing tingling or numbness into the ring and little fingers
It is worth knowing that there is often a genuine mismatch between how a joint looks on an X-ray and how much pain someone actually experiences, a mismatch that is common across osteoarthritis generally and not unique to the elbow. ²
What to Look Out For
Please seek medical assessment if you experience:
Sudden, significant swelling, redness, or warmth around the elbow (possible infection)
Elbow pain following significant trauma, with deformity or inability to move the arm
Progressive numbness or weakness spreading into the hand
Fever or feeling generally unwell alongside joint pain
Locking of the joint that prevents normal movement
How We Can Help
NICE guidance for osteoarthritis emphasises education, advice on weight management where relevant, and staying physically active as the foundation of management, alongside non-drug approaches such as exercise and joint protection strategies being prioritised over medication wherever possible. ⁴ The treatment goal for elbow osteoarthritis specifically is to reduce pain while maintaining the best possible range of motion and joint function, with conservative treatment providing genuine symptomatic relief for most people in the earlier stages of the condition. ²
Osteopathic manual techniques and manual therapy: used to maintain and gently improve joint mobility, reduce compensatory muscle tension around the elbow, and support overall upper limb function.
Deep tissue and sports massage: targeted soft tissue work to ease tension in the surrounding forearm and upper arm muscles that often develops as the body adapts to a stiffer, less mobile joint.
Medical acupuncture and cupping: used alongside exercise-based treatment to support pain management.
Joint protection advice: practical guidance on modifying repetitive loading activities, particularly relevant given how strongly elbow osteoarthritis is linked to repetitive upper limb use.
Exercise and Rehabilitation
In line with NICE's emphasis on staying active and non-drug management, gentle, consistent exercise plays a genuinely important role.
Range of motion exercises: gentle, regular elbow flexion and extension within a comfortable range helps maintain joint mobility and reduce stiffness.
Forearm and grip strengthening: supports the muscles surrounding the joint, helping to share load more effectively.
Activity modification: reducing or adapting repetitive loading activities where these are clearly driving symptoms, particularly relevant for manual workers and athletes.
Pacing: balancing activity and rest to avoid flare-ups while still maintaining overall joint movement and strength.
Your practitioner will guide an appropriate, progressive programme based on the stage and severity of your symptoms.
What to Expect at Your First Appointment
We will take a thorough history, including any relevant occupational, sporting, or previous injury factors, and carry out a hands-on assessment of your elbow's range of movement, strength, and any signs of nerve involvement. We will explain clearly what we find and build a treatment plan focused on maintaining function and reducing pain, in line with current osteoarthritis management principles.
Frequently Asked Questions
Do I need a scan? Not always. Diagnosis is often based on history and examination, though imaging can be useful to confirm the extent of joint changes, particularly if symptoms are significant or surgery is being considered.
Will I need surgery? Most people do not, particularly in the earlier stages. Surgery is generally considered based on the underlying cause, severity, age, and functional demands, and only once conservative treatment options have been explored. ²
Can exercise make it worse? Generally not, when appropriately guided. Staying active and maintaining movement is a core part of recommended osteoarthritis management, though activity should be adapted around significant flare-ups.
Why do I have this in my elbow when it's much more common in the knee or hip? Elbow osteoarthritis is genuinely less common, and is far more strongly linked to repetitive use and previous injury than the more typical age-related wear seen in weight-bearing joints like the knee and hip. ³
Recognise these symptoms? Get in touch using the contact form and we will assess and build the right treatment plan for you.
References
National Institute for Health and Care Excellence (NICE). Osteoarthritis in over 16s: diagnosis and management. NICE Guideline [NG226]. 2022. Available at: https://www.nice.org.uk/guidance/ng226
An Overview of the Pathogenesis and Treatment of Elbow Osteoarthritis. PMC. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7739329/
Primary Elbow Osteoarthritis: Evaluation and Management. PMC. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC8165431/
Current and future advances in practice: practical management of hand osteoarthritis. PMC, citing NICE NG226. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12536898/
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