Elbow osteoarthritis in Vienna
The first grip after a rest hurts, something rubs when you turn the forearm, and straightening stops short of the end. Behind these signs there is often wear of the joint cartilage: elbow osteoarthritis. I assess how far it has progressed and discuss with you which treatment fits these findings.
In short
Elbow osteoarthritis is wear of the joint cartilage between humerus, ulna and radius. It is usually a consequence: of earlier fractures, a dislocation, untreated instability or heavy work with the arm and hand. Typical signs are start-up pain after rest, rubbing on rotation, swelling after loading and an extension that meets a hard stop. Examination, ultrasound and X-ray show how far the wear extends. Treatment is conservative first; where something interferes mechanically, an arthroscopy helps. A joint replacement only comes into question with far advanced wear.
What is elbow osteoarthritis (joint wear)?
The elbow combines three partial joints in one shared capsule: humerus and ulna form the hinge, humerus and radial head a ball-and-socket joint, ulna and radius the pivot joint for turning the hand over. All joint surfaces are covered with cartilage — a smooth, elastic layer without blood vessels and without nerves.
In osteoarthritis this cartilage grows thinner and rough. The bone beneath it becomes denser and responds at the joint margins with bony growths, the osteophytes. The joint lining becomes irritated, the capsule thickens. Because cartilage has no nerves, the wear itself does not hurt: the pain comes from bone, capsule and irritated joint lining.
At the elbow, osteoarthritis is rarer than at other joints, because the elbow carries no body weight. All the more often there is a history behind it — a radial head fracture, an elbow dislocation or elbow instability that loads the joint unevenly. Heavy work with the arm and hand, weight training and throwing sports add to this. If pieces of cartilage or bone come loose, they move around the joint as loose bodies.
Typical symptoms
- Start-up pain — the first movements after a rest hurt, then it gets better
- Pain under load — when carrying, leaning on the arm and gripping firmly
- Rubbing and grinding — felt when the forearm is turned
- A hard stop — extension stops short of the end
- Swelling — the joint fills up after loading
- Sudden locking — loose bodies catch between the joint surfaces
- Tingling in the ring and little finger — growths irritate the ulnar nerve, see cubital tunnel syndrome
How I make the diagnosis
It begins with your history: earlier fractures and dislocations, operations, work and sport. I then measure the range of motion in comparison with the other side, feel the joint line and the marginal growths, and test ligament stability and the ulnar nerve; when the forearm is turned, I pay attention to rubbing. In the practice I use ultrasound to assess effusion, capsule thickness and the growths at the joint margin. The X-ray in two planes is decisive: it shows the narrowed joint space, the marginal growths and loose bodies. If there is a bony block, I arrange a CT scan; for cartilage and soft tissues, an MRI.
Treatment: conservative first
The aim of treatment is to relieve the pain and preserve movement. The wear itself cannot be reversed — I say this at the outset, because everything else builds on it. Adjusted loading achieves the most: leaning on the arm, carrying and abrupt gripping can be organised differently.
Physiotherapy and exercise therapy at the Orthozentrum Döbling maintain movement and strengthen the muscles that guide the joint. I treat irritation in the practice myself: with ultrasound-guided injection, with magnetic field therapy and with PRP therapy. If a tendon attachment is irritated as well, shockwave therapy is added.
When an operation comes into question
Two routes are open, and they answer different questions. Elbow arthroscopy helps where something interferes mechanically: I remove loose bodies, take down the marginal growths on the olecranon and the coronoid process, smooth unstable cartilage edges and release the thickened capsule. This takes away locking and the hard stop at the end of movement.
What it cannot do needs saying just as clearly: arthroscopy does not bring back lost cartilage, and where the cartilage is evenly worn away, little can be expected from it. A joint replacement only becomes an option when the pain persists even at rest and the joint surfaces are destroyed. An artificial elbow joint has a clear limit: heavy lifting and leaning on the arm remain permanently ruled out. If this step comes into question, I discuss its benefits and limits in detail.
If restricted movement rather than pain is in the foreground, the issue is less the cartilage than the capsule and scarring; the page on the stiff elbow and arthrolysis covers this in full. I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare.
My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. The page on private practice and billing explains more; elbow surgery in Vienna gives an overview.
How far the wear extends and what it means in everyday life are two questions. I answer both together with you once the examination and images are available.
Frequently asked
Common questions about elbow osteoarthritis
Wear is the everyday word for osteoarthritis. The joint cartilage grows thinner and rough, the bone beneath it becomes denser, and growths form at the joint margins. The cartilage itself has no nerves; the pain comes from bone, capsule and irritated joint lining.
Usually as a consequence. After a radial head fracture, after a dislocation, with untreated instability or after cartilage damage, the joint runs unevenly. Heavy work with the arm and hand, weight training and throwing sports add to this. Without such a history, osteoarthritis is rarer at the elbow than at other joints, because the elbow carries no body weight.
By the start-up pain: the first movements after a rest hurt, and then it gets better. Added to that are pain under load when carrying, rubbing when the forearm is turned, an extension that meets a hard stop, and swelling after loading. Sudden locking points to loose bodies.
Adjusted loading, physiotherapy and exercise therapy maintain movement and strengthen the muscles that guide the joint. I treat irritation in the practice with ultrasound-guided injection, magnetic field therapy and PRP therapy. The aim is to relieve the pain and preserve movement; none of these treatments brings back the lost cartilage.
When something interferes mechanically: with loose bodies that cause locking, with marginal growths that put a hard limit on the end of movement, with unstable cartilage edges and a thickened capsule. Where the cartilage is evenly worn away, little can be expected from it. Whether your findings fit this is shown by examination and X-ray.
Only with far advanced wear: when the pain persists even at rest, the joint surfaces are destroyed and conservative treatment has been exhausted. An artificial elbow joint has a clear limit, because heavy lifting and leaning on the arm remain permanently ruled out. If this step comes into question, I discuss its benefits and limits in detail.
The point of view. Osteoarthritis is the diagnosis: wear of the cartilage with marginal growths and irritation. The stiff elbow describes the symptoms: an arm that can no longer be fully straightened or bent, often because of a scarred capsule after an injury. Osteoarthritis can lead to stiffness, and stiffness can also exist without osteoarthritis.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.