Elbow Stiffness

Elbow Stiffness result in loss of motion and difficulty performing activities of daily living. That may occur as a result of trauma, osteoarthritis, elbow surgery, or a congenital condition.

The elbow is a joint that is easily complicated by stiffness after injury or disease. This is because the elbow actually comprises three separate joints that fit extremely well together. And it is in close proximity to a host of soft tissue structures.

Causes of Elbow Stiffness

• Post-injury stiffness: The most common cause in our population is post-injury stiffness of the elbow.
• Other diseases: A stiff elbow joint can also arise due to other diseases like infection and auto-inflammatory conditions (e.g, rheumatoid arthritis).
• Congenital problems: Certain congenital problems may also present with elbow stiffness.

Risk Factors

• Prolonged immobilisation: Patients with prolonged immobilisation of the elbow joint due to injury or illness are at highest risk of developing elbow stiffness.
• Damage to joint: Diseases like infection that lead to damage of the joint surface (also known as the articular cartilage) also predispose to elbow stiffness.

Symptoms

You will experience limited range of motion in the elbow when bending the elbow, and sometimes in forearm rotation as well. Pain may or may not be an associated symptom depending on the underlying problem.

Treatment of Elbow Stiffness

The exact treatment for elbow stiffness depends on the underlying cause, and the extent to which the elbow joint itself and its surrounding soft tissue structures are affected. Orthopedic Surgeon at Shreya Hospital generally suggest, the treatment of elbow stiffness hinges on the use of splints, exercises, and judicious surgery. Surgical release of the stiff elbow may sometimes be used if conservative methods fail, or if these measures are unsuitable.

Currently, both conservative and surgical treatment can be considered valid. Obviously, the choice will be conditioned by many factors, such as timing, mode of presentation, severity, comorbidities and patient’s compliance. Conservative treatment is used when elbow stiffness has been present for less than six months. While surgical treatment is more appropriate in those patients who have not benefited from conservative treatment, due to the persistence of pain and inadequate recovery of ROM and function.

Conservative treatment

It consists of the use of serial casts, static or dynamic splints, CPM (continuous passive motion), home and assisted physical therapy, manipulations and subsequent functional re-education. Static immobilization of the elbow is usually used for short periods as a preventive measure after an injury or surgery. While long-term immobilization is not recommended and is therefore rarely indicated.

The use of the CPM is strongly indicated in maintaining a satisfactory articulation. Before mobilization, the elbow should be kept raised and extended with a circular bandage. And in the case of surgery, drainage should also be placed to avoid the formation of a hemarthrosis. Once the patient has passed the phase in which he cannot independently reach the complete ROM. Then the CPM can be suspended; this phase varies greatly from patient to patient and ranges from several days to a month.