Elbow pain is no laughing matter

Chronic elbow pain can be really debilitating, but there are ways to treat it, including elbow joint replacement, as consultant orthopaedic surgeon Lisa Leonard, explains.

Despite having a funny bone, elbow problems are no fun at all and can be really debilitating. The pain can make you struggle with lifting and carrying and everyday tasks such as shopping, driving or even cleaning your teeth can become difficult.

What causes elbow pain?

Much elbow pain can be attributed to muscular problems or an injury, which usually heal of their own accord. Painkillers, anti-inflammatory drugs or just a few days of rest can help.  However, there are some chronic conditions, such as arthritis, that cause longer-term problems.

Elbow arthritis occurs when the cartilage that helps your joint move smoothly becomes damaged or worn, either as the result of an injury or through wear and tear.

Although there is no cure for arthritis, there are many treatments that can ease the pain or slow down its progression. Painkillers and anti-inflammatory medication are often very effective, especially when combined with physiotherapy.  If your elbow pain can’t be improved by non-surgical treatments, you may need surgery. This may involve cleaning out the joint, removing loose fragments, removing parts of the worn joint or, in severe cases, replacing the elbow joint with metal and plastic implants. A replacement might be considered in patients with persistent, unremitting elbow pain that is functionally limiting.

Elbow replacement surgery

While elbow replacement surgery isn’t as common as hip or knee replacement, it is a well-established surgical procedure and reliably provides pain relief for the majority of patients. The operation is carried out under general anaesthetic and involves making an incision at the back of the elbow. The damaged parts of the bones are removed and two metal stems are attached to the humerus (the bone in your upper arm) and the ulna bone in your forearm. The implants are kept in place with bone cement and connected with a hinge to recreate the elbow joint.

Recovering from elbow replacement surgery

After the operation, you normally stay in hospital overnight and the elbow is often protected in a plaster until the wound is healed after 10-14 days. After that elbow exercises are commenced to regain full flexibility and then strength. Often a physiotherapist will help you with this. You can get back to light activities with the arm once the plaster is removed but it will take a few weeks to maximise the function of your elbow. Very heavy lifting is not encouraged after an elbow replacement operation.

A replaced joint is never as good as a natural joint and few patients regain a full range of elbow movements after such surgery. In addition, a life-time restriction on lifting very heavy objects is wise to avoid the replaced joint working loose in the bone. Nonetheless, you will be able to accomplish everyday tasks and maintain your independence. The majority of patients find they have much less pain and a better quality of life after elbow replacement surgery.

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