Arthritis is one of the most common degenerative illnesses in the United States and around the world. Osteoarthritis occurs when joint tissue experiences degradation over time, causing bones to rub against one another. This causes damage to the bones, resulting in pain and other symptoms.
Degeneration of tissues in the body occurs to everyone as we age, but in some cases, it develops into arthritis. The pain caused by this ailment can significantly impact day-to-day activities but often comes on slowly.
People experiencing joint pain must maintain communication with their doctor. Elbow pain specifically can impair many daily activities. It is important to be well informed when potentially facing a diagnosis.
Elbow Anatomy and Osteoarthritis
The elbow consists of 3 bones, the ulna, radius (in the forearm), and humerus (in the upper arm). Connecting these bones is an intricate network of joints and ligaments. The elbow joint has a fleshy sac called a bursa, which is used to cushion the bones to prevent them from rubbing against one another.
Tendons and ligaments work together to stabilize the joint and provide structure during motion. Damage to joints can happen over time, as the body goes through a natural process of gradual degeneration.
Osteoarthritis occurs when cushions such as the bursa become so damaged that the bones rub against one another. This can cause pain and discomfort in affected individuals.
Osteoarthritis is generally caused by several factors. These include:
- Injury: Tendons, ligaments, and other soft tissues can become damaged. Dislocation or fractures can contribute to degeneration and abnormal reformation of the joint.
- Natural degeneration: Most cases of osteoarthritis are simply a culmination of structural changes that occur due to degeneration.
People who are at a greater risk of osteoarthritis include seniors, athletes, and people who have jobs that require repetitive motions such as movers or construction workers. Though certain people are at a greater risk of developing it, the symptoms can come on at any time in anyone.
Signs and Symptoms of Osteoarthritis in the Elbow
Elbow pain is not a cause for concern alone but should be closely monitored for changes as pain progresses. Some causes of elbow pain will heal by themselves over a few months.
When the pain persists, it is recommended that a doctor visit occurs to diagnose the cause of the symptoms. Some common symptoms of osteoarthritis are:
- Pain
- Numbness in the arm or hand
- Tingling sensation
- Loss of range of motion or stiffness
- Clicking or locking sensation
Some pain can be manageable, but doctors recommend that individuals open up a discussion about their pain when it begins to impact daily life. The progression of osteoarthritis can take months, years, or even decades. It may not be immediately noticeable as problematic. Generally, patients begin to notice when they can no longer extend their arms fully.
Patients who are experiencing chronic pain of any kind must provide as much information as possible to their doctors so that they can diagnose the cause of pain properly.
Diagnosis of Osteoarthritis in the Elbow
Proper diagnosis of an ailment is the first step on the road to recovery. Due to the complex and intricate nature of the elbow, the cause of pain is not often apparent without further testing. There are many soft tissues, tendons, and ligaments that could be contributing to pain. Diagnoses can typically be reached with information about the symptoms, and X-ray imaging.
Osteoarthritis is a condition that affects bones, so X-ray technology is most commonly used by doctors to reach a diagnosis. Other imaging techniques that are commonly used for other forms of pain, such as CT scans or MRIs, are not often used to diagnose osteoarthritis.
If there are overlapping conditions, it may be more useful for doctors to have a complete picture of the joint including bone and soft tissue.
Treatment
If osteoarthritis is diagnosed in its early stages, with minimal degeneration, the first steps of treatment are mostly focused on pain management. This includes:
- Pain medication: Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) can help to alleviate pain. They work by delivering anti-inflammatory properties in small doses to the source of pain. Some doctors may recommend that a patient apply ice to the injured area for similar anti-inflammatory properties.
- Activity adjustment: Making slight adjustments to activity, especially for people who are experiencing symptoms due to overactive joints (such as athletes or people with jobs that require a lot of repetitive motion), could alter the progression of osteoarthritis and prevent further damage from occurring.
- Physical therapy: Some doctors will recommend that patients undergo physical therapy of the elbow, arm, or hand. The goals of physical therapy are generally to improve the range of motion, which may be greatly affected by osteoarthritis, as well as strengthen the muscles which provide support to the elbow. Providing more support to the joint could result in a slower progression of the degeneration.
- Corticosteroid injections: This form of treatment is also anti-inflammatory, but unlike NSAIDs, corticosteroid injections involve placing a very high dose of anti-inflammatory cortisol into the area of pain. This can reduce pain symptoms temporarily but has been proven to damage soft tissue over time. Osteoarthritis symptoms can be exacerbated over time with corticosteroid injections, so they must be closely monitored by a doctor.
A doctor’s decision to recommend any treatment plan will be affected by several factors, including:
- Patient’s activity level
- Family history
- Willingness to undergo treatment
- Severity of pain
- Location of pain
Each treatment plan is tailored specifically to each patient with their needs in mind. When these forms of nonsurgical treatments fail to stop the pain, doctors will open up a discussion about surgical treatments.
Surgery for Osteoarthritis of the Elbow
Surgical treatment for osteoarthritis can vary depending on a patient’s specific condition. There are several different forms of surgery that a doctor may recommend. The two most common treatments include:
- Arthroscopy: This form of surgery uses tiny instruments, typically with a camera involved. These tiny instruments can then remove degenerative tissues, bone spurs, and other causes of pain. There are many uses for arthroscopy, and the type that is used depends on the patient’s condition. This procedure is considered minimally invasive, as it employs a small number of tiny incisions. The recovery time for arthroscopy is typically shorter than other forms of surgery.
- Joint replacement: This form of surgery is one of the most invasive forms of surgery that is performed on the elbow. It is essentially removing the damaged joint, and sometimes damaged parts of bone, and replacing them with plastic and/or metal pieces. These pieces allow the joint to glide more smoothly once in place, but it may take a long time for the bones to grow into prosthetic parts.
Any surgery will come with a list of risks and potential side effects. Depending on the nature of the surgery, these may change, but generally, include:
- Infection
- Heart attack
- Stroke
- Blood clots
- Complications with anesthesia
In addition to the list of risks, the recovery process for surgery can be long and arduous. Many doctors will recommend a regimen of physical therapy alongside surgery, typically starting even small therapeutic exercises within hours after surgery.
The amount of recovery time needed will vary depending on the patient’s commitment to healing, the severity of the operation, and many other factors.
These surgeries are almost always elective, meaning that it is ultimately up to the patient to decide whether or not it is right for them. When facing the potentially life-altering option of surgery, patients must be aware of all the potential treatments on the market which could benefit them.
Regenerative Medicine to Repair Joint Damage
Most of the conventional treatment options involve treating and managing the pain but do not seek to fix the cause of pain. Orthobiologic methods are a part of regenerative medicine that offers an option that gets to the root cause of the problem and fix it.
These forms of regenerative medicine are known to help repair and rebuild soft tissue in the body. It has also been shown to aid in bone growth. The nature of osteoarthritis means that these types of therapy could be particularly beneficial.
There are two main forms of orthobiologic treatments offered at CELLAXYS:
Cell-Based Therapies
Many people know cell-based therapies as stem-cell therapies. These procedures involve using a patient’s own stem cells (autologous tissues), processing them, and then reinjecting them into the affected area to promote healing.
Your doctor may recommend one of two types of cell-based therapies:
- Minimally Manipulated Adipose Tissue Transplant (MMAT). This method focuses on harvesting the cells of your adipose tissues and injecting them into the affected areas, such as the elbow. Your doctor can perform MMAT in multiple areas of your elbow to promote the healing of osteoarthritis.
- Bone Marrow Concentrate (BMAC). This procedure harvests the highly concentrated cells from your bone marrow and injects them into the injury site.
For both cell-based procedures, the doctor will put you under anesthesia to minimize the pain. They take about 1.5-2 hours to complete. The doctor uses a live X-ray and ultrasound to spot the exact transplant location. These are outpatient procedures, so you can go home right after.
Platelet-Rich Plasma (PRP) Therapy
PRP therapy starts with taking the patient’s blood sample and isolating platelets from the plasma. Platelets are the healing component in your blood that release 10 Growth Factors to stimulate tissue growth. They also send chemical signals to attract healing cells from your blood and produce fibrin.
Fibrin is a sticky web-like structure that provides support to the development of new tissues. Platelets are then injected into your injury sites to speed up the healing process.
Like cell-based therapies, PRP is also an outpatient procedure completed within 45 minutes. Regenerative medicine can also be used alongside surgical treatments.
