I have zero knowledge of elbows, but I can offer one observation that may or may not be of help.
People often assume that if x-rays show degenerative changes in joints that surgery is the only option. Someone in this thread made the point that physical therapy can’t help because it’s a hard, physical, bone restriction.
I would dispute this. In the case of shoulders and hips (where I’ve had impingement problems - so bone jamming against bone) it can be down to soft tissue. Simple muscle imbalances. Some of the muscles acting on and around the joint get too tight - others weak and lazy. The end result is that the joint is pulled out of it’s correct position and the bones jam against each other. Tight, over-active muscles can very easily cause pain and prevent full ROM. The degenerative changes in the joint could in theory be a result of the real problem - muscle imbalance.
Fix the muscle imbalance and the symptoms go away. You’ll still have worn joints, but does that matter? I know in the case of hips, shoulders it’s known that there is zero correlation between degenerative changes on mri and xray and symptoms. Some people have wrecked joints and no symptoms. Others have perfect joints and extreme pain!!
It makes sense to me to rule out the possible soft tissue causes of a problem prior to even thinking about surgery. The trouble is, the ‘experts’ in these matters are the surgeons. That’s who you’ll get referred to. They no nothing about soft tissue problems so it’s hardly a surprise that all that’s ever offered is surgery. A physio would probably send you to the expert - the surgeon!
If I were you I’d be learning a little more about the function of the muscles acting on and around the elbow joint. Looking into trigger point massage. Testing for weaknesses in these muscles. Stretching out the tight muscles. It can’t do any harm and there’s always a chance that this is all that’s needed.
[I was diagnosed with hip OA and according to the pros my active life was over. I also had bad shoulder impingement. Both down to muscle imbalance. 9 years on I’m doing great - no symptoms from the joints]