Understanding how your elbow works

Your elbow is a hinge joint consisting of three bones. The upper portion of the hinge is at the end of the upper arm bone (humerus), and the lower portion is the top of the two forearm bones (radius and ulna) which are side by side. All three of these bones are in contact with each other. The joint is surrounded and lined by cartilage, muscles, and tendons that provide support and stability, and make it easy for you to move.

It's your elbow joint that lets you bend, extend, and rotate your arm. Your range of motion is dependent upon the proper articulation of this joint.

In a healthy elbow joint, the surfaces of these bones are very smooth and covered with a tough protective tissue called cartilage. Arthritis causes damage to the bone surfaces and cartilage where the three bones rub together. These damaged surfaces eventually become painful. Ligaments (another type of soft tissue) lie along the sides and back of the elbow, holding the bones of the elbow joint in place. These ligaments work with the muscles that control the bones and the tendons that connect the muscles to the bones so you can bend and straighten your elbow. Fluid-filled sacs (bursae) cushion the area where skin or tendons glide across bone. The elbow also has a lining (synovium) that secretes a clear liquid called synovial fluid. This fluid lubricates the joint, further reducing friction and making movement easier. 

As you might expect, there are many different reasons why you could be feeling elbow pain, including injury, infection, and arthritis.

Post-traumatic arthritis

Periodically, traumatic events to the elbow region result in bone fractures and severe dislocation of the joint structures. This typically can result in surgery that attempts to heal bone fragments in their proper orientation. Periodically, this attempt is not completely successful in either addressing damage to the cartilage from the injury or in precisely rebuilding your elbow as it was prior to the injury. As a result, the cartilage in your elbow may see forces differently than before the injury occurred. This can result in premature wear of the cartilage in the area of the injury and is called post-traumatic arthritis.

Rheumatoid arthritis

In rheumatoid arthritis, the synovium (lining of the joint) becomes inflamed. The inflammation causes chemicals to be released that thicken the synovium and damage the cartilage and bone of the affected joint. This inflammation of the synovium causes pain and swelling.

The good news about arthritis in the elbow is that it can be treated. Arthritis is a disease that typically worsens over the years, so it is common for treatment to involve more than one approach and to change over time. For some people, nonsurgical treatments such as lifestyle changes, medications, and physical therapy help alleviate the pain. For others, elbow replacement surgery may be a long-term solution. Together, you and your doctor can determine the best treatment options for you.