How to diagnose elbow stiffness and 3 ways to treat it

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How to diagnose elbow stiffness and 3 ways to treat it

A lot of different things can cause a stiff elbow. It could be the result of a direct trauma such as an injury from a fall, or it can also be caused by an existing condition such as arthritis. When you have a stiff elbow, you will probably be unable to move the elbow as you normally would, making it difficult for you to perform simple, everyday tasks. You also may not be able to bend or straighten the elbow to pick up objects or rotate your palms to do things like wash your hands.

The elbow is made of three separate joints that fit extremely well together, and it is in close proximity to a host of soft tissue structures. The elbow allows us to bend (flexion), straighten (extension) and rotate our arms. The normal range of flexion and extension is from 0 to 145 degrees, although the range of motion that we work within for daily activities is only from 30 to 130 degrees. This means that for most people a bit of loss of motion does not cause problems with function. However, with a reduction of extension greater than 30 degrees or flexion of less than 130 degrees, most people will complain of loss of function. Loss of extension is usually less disabling than loss of the same degree of flexion.

Our arms and their capabilities to do various movements and carry stuff around are highly dependent on the elbow. Because of this, the elbow can be easily complicated by stiffness after injury or disease. 

Causes of stiff elbow

The most common cause of stiffness is after trauma and injury. The amount of stiffness of the elbow depends on the degree of initial trauma to the joints. Prolonged immobilisation after injury can also lead to an increased long-term stiffness. Stiffness in the elbow usually improves, but sometimes it may not. 

A stiff elbow joint can also arise due to other diseases like infection and auto-inflammatory conditions such as rheumatoid arthritis, post-traumatic osteoarthritis, primary osteoarthritis, joint infections and malunions. 

Certain congenital problems may also present with elbow stiffness. Examples are arthrogryposis or congenital dislocation of the radial head.

Stiff elbow symptoms

When experiencing elbow stiffness, the elbow’s range of motion becomes limited. Bending the elbow and, sometimes, rotating the forearm become difficult. These symptoms may or may not be accompanied by pain depending on the underlying problem.

Stiff elbow diagnosis

Once you sustain injuries to the elbow that result in severe pain and swelling, you should seek medical treatment immediately. Do not attempt to do traditional forms of treatment without prior evaluation. You may be recommended to undergo an X-ray examination to exclude fractures. Fractures can lead to long-term damage of the elbow joint, pain and stiffness.

If you suddenly feel elbow pain and stiffness without any prior history of trauma, you should seek medical advice to examine any underlying elbow disease, as delays in treatment may lead to a worsening of condition.

Stiff elbow treatment

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. General treatment on stiff elbows involves the use of splints and some exercises. Surgery may be done on the stiff elbow if conservative methods fail or if these measures are unsuitable.

Here are different methods that your surgeon may recommend for treating a stiff elbow:

Exercises and stretching

Physiotherapy involves passive motion exercises, light stretching and active exercises. Ideally, these should be done with a physiotherapist who specialises in upper limb rehabilitation.


In many cases, splinting of the elbow may be required. Splinting is effective when performed in a static progressive fashion.

Often, your specialist will have you begin by seeing a hand or upper extremity therapist who will guide you through exercises and stretching methods while wearing a splint. 


At least three or six months should be allowed for the inflammatory phase of soft tissue healing to resolve. If there are no improvements and if therapy does not work, your doctor may recommend having surgery. 

Surgery is often recommended when patients are no longer improving in their original post-traumatic rehabilitation program. 

This may be performed via keyhole (arthroscopy) or open surgery. The decision depends on the surgeon’s experience and the type of stiffness.

Arthroscopic release is ideal for stiffness due to arthritis and when there has been no previous surgery. However, if there has been a previous internal fixation and there are extrinsic causes for the stiffness, open surgery is required.

In surgery, the tight structures that are stopping the elbow from moving are removed. This surgery could be performed through a cut (incision) or with elbow arthroscopy, which is a procedure during which a tiny camera is used to look inside the elbow. 

After undergoing surgery, you will still need to undergo physical therapy afterwards to rehabilitate your elbow. This ensures that your elbow properly works again once healed. Most patients return to normal after surgery.

It is important to note that all surgeries come with risks. This includes potential damage to nerves or blood vessels. It could also mean that your stiffness returns.

Stiff elbow p​revention tips

In patients with elbow injury, early detection and treatment of fractures, as well as early mobilisation, are the best forms of prevention of elbow stiffness. In diseases that can result in articular cartilage damage, early and effective treatment to control the disease and limit articular cartilage is needed to minimise long term elbow stiffness.

Got a question or anything I can help with? My name is Steve Stretton, and I’m the owner and manager at You can drop me a line here. Good luck!

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