Pain is usually the first sign of elbow osteoarthritis. At first, the pain gets worse when using the elbow. Once it gets warmed up, though, the pain usually eases. Pain and stiffness commonly occur after resting the joint, such as when waking up after a night's sleep. Again, these symptoms usually subside as you get moving. Eventually, you may have pain when resting the joint, and the pain may interfere with sleep.

Swelling around the elbow may cause the joint to feel tight, especially after using it. When the surfaces of the joint have worn off, moving the elbow may cause you to hear and feel a squeak or creak in the joint. This is called crepitus.

Osteoarthritis eventually affects the elbow's motion. The elbow joint is one of the most sensitive to injury. It quickly becomes stiff and loses motion. The first thing most people notice is that it becomes hard to completely straighten the arm. Later it may also become hard to bend it.