Rheumatoid arthritis (RA) is a chronic, progressive disease caused by an overactive immune system.

The immune system protects the body against foreign invaders. But with RA, it stimulates the production of antibodies that attack the lining of healthy joints.

RA affects smaller joints in the body as well as larger ones. When there’s involvement of smaller joints, it commonly develops in the elbow.

Elbow involvement is often symmetrical, affecting both the right and left arms in about 20 percent to 65 percent of people living with RA.

Elbow pain can start in the early stages of the disease. As RA progresses, other parts of the body become affected, too. This includes the joint lining in the hips, knees, and hands.

Rheumatoid arthritis can gradually damage or destroy soft tissue. It primarily causes inflammation and swelling in the joint lining of the elbow. Some people even develop a noticeable bulge near their elbow where the inflamed joint lining has pushed out

Pain and swelling aren’t the only complications of RA in the elbow. Severe swelling can also lead to nerve compression. If so, you may have a pins and needles sensation in your elbow. Or, you might have complete or partial numbness in your elbow and distal arm.

Uncontrolled inflammation in the elbow may also cause cartilage and bone destruction.

Pain from rheumatoid arthritis in the elbow is often symmetrical and best described as a dull ache or throbbing pain.

In the beginning stages, you may have intermittent pain that comes and goes, or you may only feel pain with certain movements like bending your elbow.

As your disease progresses, elbow pain can become persistent, or the slightest movement can trigger discomfort.

Pain from RA in the elbow differs from pain caused by an injury. With an injury, pain can be short-term and gradually improve. RA pain does not improve on its own. Instead, pain can become progressively worse if left untreated.

RA in the elbow may also feel worse at certain times of the day, such as in the morning.

Along with pain, you may also develop rheumatoid nodules. These are firm, tender lumps that form under the skin. They’re typically associated with rheumatoid arthritis in the hands, feet, and elbows.

Nodules can occur as RA progresses. They vary in size and typically take a circular shape. These lumps form during a flare-up. They’re also associated with a more severe disease type.

Up to 20 percent of people with RA develop nodules. The exact cause of these lumps is unknown, but they tend to occur in people who smoke, those who have a severe form of the disease, and in people who have other inflammatory conditions.

RA in the elbow can affect mobility, making it difficult to extend or bend your arm. Your elbow joints may also lock in place or you may have periods of instability. This is when the elbow joint gives out and it becomes difficult to complete activities.

Elbow pain may occur mostly on the outer side of the joint. As your disease worsens, you may have pain that interferes with sleep.

Joint stiffness is another symptom of rheumatoid arthritis in the elbow. Interestingly, the risk of stiffness is greater when arthritis develops after an elbow injury.

If you have symmetrical elbow pain, your doctor may test for RA. Elbow pain is an early symptom of this disease.

Your doctor will likely perform a physical exam. This involves checking your elbow for signs of swelling and tenderness. Your doctor will also move your elbow in different directions to gauge range of motion.

There isn’t a single medical test to diagnose RA. A blood test to check for auto-antibodies, however, can help confirm or rule out this disease. Imaging tests like an MRI, ultrasound, and X-ray can also look for joint damage in your elbow.

Treatment doesn’t cure RA in the elbow, but it can reduce inflammation, stiffness, and swelling. The goal of treatment is to slow the progression of the disease and bring about remission.

Your medical treatment depends on the severity of your condition, but might include nonsurgical or surgical options.

Nonsurgical treatments are the first line of the defense for rheumatoid arthritis in the elbow.

Medication

Medication options include:

  • OTC pain medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) can block inflammation and reduce swelling. These medications provide short-term relief and include naproxen sodium (Aleve) or ibuprofen (Motrin). Topicals containing this type of medication are also available.
  • Corticosteroids. Steroids can be taken orally or by injection into the elbow, and effectively reduces pain and inflammation. Oral steroids are used sparingly due to potential side effects.
  • DMARDs. Disease-modifying anti-rheumatic drugs (DMARDs) work to block inflammation of the joints.
  • Biologics. These medications target specific parts of the immune system that lead to inflammation.

Other remedies

Other remedies to help relieve joint pressure and stop pain include:

  • applying cold or heat therapy for pain and swelling, respectively
  • wearing an elbow splint
  • avoiding activities or sports that aggravate symptoms
  • physical therapy
  • occupational therapy
  • resting and avoiding overuse of the elbow joint

Surgery

Persistent or uncontrolled inflammation can cause permanent joint damage in the elbows. If this happens, your doctor may recommend surgery to repair this damage. Surgical procedures include:

  • removing inflamed tissue lining in the elbow
  • removing bone spurs or loose fragments around the elbow
  • removing part of the bone to ease joint pressure
  • a total joint replacement

RA can lead to joint destruction in the elbow. See a doctor for unexplained elbow pain that doesn’t improve, especially when pain affects both elbows.

If you have a diagnosis of RA in the elbow, yet pain continues, schedule a doctor’s appointment. Your doctor may need to adjust your current therapy to better control inflammation.

Pain in the elbow is typical with RA. There’s no cure, but with treatment it’s possible to block inflammation and reduce symptoms like swelling, stiffness, and loss of movement.

Pain may not improve on its own. So speak with your doctor to discuss an effective treatment plan. The sooner you treat the condition, the sooner you can achieve remission.