Stiffness

What is it?

The elbow is made up of three joints which may become  stiff as a result of trauma, surgery or some degenerative change. Stiffness can be a result of a change in any of the surrounding structures that affect how the elbow flexes, extends, pronates or supinates with the forearm. Any restriction in movement can make day to day activities, such as washing, dressing and cooking, extremely difficult.

Why does it occur?

Elbow stiffness can be caused by changes to the bone, such as arthritis or the formation of osteophytes (tiny pointed outgrowths of bone), or damage to any of the soft tissue structures such as the joint capsule. Tears or injury to the joint capsule leads to scarring and tightening of the joint.

What are the symptoms?

Typical symptoms include pain and reduced range of motion in the forearm which may make carrying out simple tasks  increasingly difficult. 

How is it diagnosed?

This will be based on a thorough medical history, a clinical examination and the use of imaging such as x-rays and ultrasound scans.

How is it treated?

Non-surgical
The aim of any treatment will be to increase your elbow’s range of movement and reduce any pain. Physiotherapy, with targeted regular exercise, is crucial in achieving this. Occasionally splinting is recommended.

Surgical
Surgery may be considered if less invasive forms of treatment are deemed ineffective. Depending on what is impairing your elbow, it can often be rectified using keyhole surgery. The removal of scar tissue or lose bone may be necessary, for example, or it may be that a scarred, constricted joint capsule requires release. In some circumstances scar tissue can constrict the nearby ulnar nerve, causing pain. Recovery is often faster in those who have arthroscopic (keyhole)  surgery, and physiotherapy afterwards is crucial in maintaining the improved range of movement and minimising the build up of  scar tissue which can cause symptoms to recur.

Treatment options

The One Orthopaedics team specialists

Anthony Hearnden

Consultant Orthopaedic Specialist FRCS (Tr & Orth)