The elbow is often left unnoticed until something goes wrong. We use it throughout the day in nearly every activity, from writing to cooking to driving.
When the elbow is affected by contracture, the range of motion is reduced. This can happen progressively or abruptly, depending on the cause. Contracture can be painful, and in severe cases, it may make it difficult to move the affected limb.
Elbow contracture is a relatively common condition, so it’s essential to be aware of it. This blog post will cover elbow contracture, its symptoms and causes, and how it’s treated.
What Does “Contracture of Elbow” Mean?
Elbow contracture is a debilitating condition that results in the loss of range of motion in the elbow. It can be caused by several things, including repetitive motions, prolonged immobilization, disease, burns, or other injuries. It can also result for prior injury which we call posttraumatic elbow stiffness or post traumatic flexion contracture. In some cases, the exact cause is unknown.
The elbow joint’s typical functional arc of motion is 30 to 130 degrees. Elbow contracture occurs when the tissues around the joint become shortened or tightened, resulting in a stiff elbow. This limits the range of motion of the joint. A limited elbow range can make everyday activities difficult — or even impossible — to do.
Elbow contracture disrupts normal functional elbow motion, including:
- Elbow flexion: This is the movement of the forearm towards the upper arm. It occurs when you bend your elbow, like when you bring your hand to your face.
- Elbow extension: This is the opposite of flexion. It’s the movement of the forearm away from the upper arm. It occurs when you straighten your elbow, like when you push something away from you.
- Supination: This is the forearm movement where the palm faces upwards. It occurs when you turn your palm up, like when you unscrew a lid.
- Pronation: This is the opposite of supination. It is the movement of the forearm where the palm is turned downwards. It occurs when you turn your palm down, like when you pour a liquid from a container.
Contracture can occur in any or all of these motions and can happen gradually or suddenly. It also can affect any joint in the body, but the elbow joint is one of the most common sites.
What Does Elbow Contracture Cause?
Elbow contracture can be painful. The loss of range of motion in the elbow can cause difficulty with daily activities such as writing, cooking, and driving. In severe cases, it may be challenging to move the arm.
The most common symptom of elbow contracture is a reduced or limited range of motion in the affected joint. Stiff elbows can make it difficult to straighten or bend the arm fully. In severe cases, the arm may be permanently immovable.
Other signs and symptoms of elbow contracture may include:
- Elbow pain: Elbow contracture can be painful, especially when the arm is moved.
- Stiffness of the elbow: The elbow may feel stiff and difficult to move.
- Swelling: There may be swelling around the elbow.
- Muscle weakness: The muscles surrounding the elbow may become weak.
- Numbness or tingling: Numbness or tingling may occur in hand or fingers if the ulnar nerve is affected. The ulnar nerve can cause numbness to the small and ring fingers.
- Deformity: The affected elbow may look bent or distorted and differ from the other elbow.
If you have experienced any symptoms of elbow contracture, it’s essential to see a doctor. Early diagnosis and treatment can help prevent the condition from getting worse.
What Causes a Contracted or Stiff Elbow?
There are many possible causes of elbow contracture. The most common cause is after trauma. This results in a posttraumatic elbow flexion contracture. Another common cause is repetitive motions of the elbow. This can happen with activities where the elbow is used repeatedly, such as painting, construction, or cleaning. It’s also prevalent in sports or activities that put constant pressure on your elbows, such as tennis, golf, or weightlifting. This can result in elbow arthritis.
Other possible causes include the following:
- Prolonged immobilization: If the elbow is in one position for too long — like when it’s in a cast — it can lead to elbow stiffness or contracture.
- Elbow trauma or injury: A broken arm or other injuries to the elbow can cause contracture or a posttraumatic stiff elbow.
- Elbow surgery: Elbow surgery — such as after an elbow fracture repair — can lead to contracture.
- Inflammatory Disease: Diseases like rheumatoid arthritis, osteoarthritis, or diabetes can lead to contracture.
- Burns: Severe burns can damage the skin and muscles around the elbow, leading to contracture.
In some cases, the exact cause of contracture is unknown.
It’s vital to be aware of the causes and symptoms of elbow contracture, especially if you have a daily activity that puts stress on the elbow. While prevention is the best treatment method, there are many ways to treat elbow contracture once it has occurred.
How Can Elbow Contracture Be Treated and Fixed?
When diagnosing elbow contractures, doctors will ask about your medical history, underlying medical conditions, and previous injuries or surgeries.
They will then perform a physical examination to check your range of motion and look for any signs of elbow stiffness, swelling, deformity, or pain. They may also order X-rays or other imaging tests to better look at the elbow.
There are many different ways to treat elbow contracture, depending on the severity of the condition. The treatment’s goals are to relieve pain, improve the range of motion, and prevent further damage.
For mild elbow contractures or post traumatic, a doctor may recommend non-surgical treatments. These include:
- Rest: Avoiding activities that cause stress to the stiff elbow can help prevent further damage and allow the elbow to heal.
- Ice/Heat: Applying ice and heat to the stiff or contracted elbow can help reduce pain and swelling.
- Anti-inflammatory medication: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation.
- Stretching exercises: Doing exercises that stretch and strengthen the muscles around the elbow can help prevent contracture from getting worse.
- Physical therapy: Physical therapy can help improve the range of elbow range, motion, and function under a supervised setting.
- Occupational therapy: Activities that help you learn how to complete daily tasks with and without using the affected elbow can be helpful.
- Splinting or bracing: Wearing a splint or brace can help stretch the elbow contracture.
For more severe elbow contractures, surgery may be necessary. Surgery is typically only recommended when non-surgical treatments have failed to improve the range of motion, relieve pain, or restore elbow flexion.
Many different types of surgical procedures can be used to treat elbow contracture. The type of surgery will depend on the severity of the condition and the underlying cause.
Some of the most common surgical procedures used to treat elbow contracture include:
- Elbow Arthroscopy: A small camera is inserted into the elbow through a small incision. This surgical technique can remove scar tissue or loosen tight muscles and tendons.
- Capsular release: This surgical release helps to ease the elbow capsule due to elbow stiffness. It involves making an incision in the capsule and cutting some of the surrounding ligaments. If there is ulnar nerve entrapment a release can also be preformed at the same time.
- Arthroscopic release: Arthroscopic elbow capsular release — a type of capsular release — is a minimally invasive surgery performed under regional or general anesthesia. It involves making a small incision to release the tight tissue around the joint.
- Total Elbow Replacement: This surgical procedure involves replacing the entire elbow joint with an artificial joint. This is typically only used as a last resort for severe elbow arthritis.
Recovery following elbow contracture release includes a period of rest, ice, compression, and elevation (RICE). You will likely need to wear a sling for the first few weeks following surgery. A doctor may also likely recommend physical therapy or occupational therapy with both active and passive motion to help improve your elbow flexion contracture and post-traumatic elbow stiffness.
Many people after elbow contracture release experience an improvement in range of motion and relief from pain. However, it can take several months for the full effects of surgery to be seen, and it can also take a while for full elbow flexion and extension to be restored. It’s important to follow your doctor’s instructions carefully during recovery to prevent further damage to the elbow.
Is There Any At-home Temporary/Short-term Pain Relief?
Suppose that you’re experiencing pain due to an elbow flexion contractures. In that case, there are some things you can do at home for short-term relief, such as resting, applying ice/heat to the affected area, taking anti-inflammatory medication, and stretching. Cortisone injections can also provide excellent short term relief of your elbow flexion contractures.
However, seeing a doctor is helpful, especially if you are experiencing pain and home remedies aren’t providing relief. Pain, swelling, and loss of range are all signs that the condition is getting worse and may require medical intervention.
Your doctor can help devise a treatment plan to relieve your pain and prevent further damage. They may recommend surgery if your elbow contracture is severe, especially if post traumatic.
Contact Academy Orthopedics
Elbow contracture is a condition that can significantly affect your quality of life. It can cause pain and difficulty performing everyday tasks, worsen over time, and lead to loss of function if left untreated. Early diagnosis and treatment are critical to prevent further damage and restore function.
You must consult a doctor if you frequently have a stiff elbow or pain that limits your range. At Academy Orthopedics, our team of orthopedic specialists is experienced in diagnosing and treating all types of elbow conditions, including contracture. We will work with you to develop a treatment plan that is best for you.
Contact us today to schedule an appointment.