Elbow stiffness
What is Elbow stiffness?
Elbow stiffness is loss of motion that interferes with daily function. It commonly develops after fracture, dislocation, surgery, arthritis, prolonged immobilisation or heterotopic ossification, where extra bone forms in the soft tissues.
Common symptoms
Patients may be unable to fully straighten or bend the elbow, bring the hand to the mouth, wash the face, reach the head or perform work and gym tasks. Pain, locking and nerve symptoms may coexist.
Diagnosis and imaging
Examination measures flexion, extension and forearm rotation. X-rays assess joint congruity, arthritis, spurs and previous implants. CT is often useful to map bony blocks, deformity or heterotopic ossification before surgery.
Non-surgical treatment
Treatment includes supervised physiotherapy, dynamic or static-progressive splinting, oedema control and management of pain. Early stiffness may improve significantly when addressed before scar and bone blocks mature.
Surgical treatment
Surgery is considered when stiffness remains functionally limiting despite appropriate therapy. Arthroscopic or open capsular release, removal of bone blocks, hardware removal and ulnar nerve decompression may be required depending on the cause.
Recovery and follow-up
After release, early motion is essential. Therapy usually begins quickly and may include splinting to maintain gains. Recovery requires discipline because the elbow has a strong tendency to stiffen again.
Elbow stiffness FAQs
How much elbow motion is needed for daily life?
Many daily tasks require roughly 30 to 130 degrees of flexion and good forearm rotation. Smaller losses can still matter for sport, work and personal care.
How is elbow stiffness diagnosed?
Diagnosis starts with a focused history and examination, then uses imaging selectively to confirm the pattern of injury, exclude related problems and plan treatment accurately.
Can physiotherapy alone improve stiffness?
Yes, especially early or moderate stiffness. Long-standing stiffness caused by bone blocks or severe capsular contracture may need surgical release.
Will I need surgery for elbow stiffness?
Many patients improve without surgery. Surgery is considered when symptoms remain limiting despite appropriate non-surgical care, when there is significant structural damage, or when delay may compromise function.
Why is early rehabilitation so important after elbow surgery?
The elbow forms scar tissue quickly. Early, controlled movement helps preserve the range gained at surgery while tissues heal.
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