If the arm at the elbow cannot be fully extended, which doctor should you contact?

In everyday life, when people use the word “elbow,” they mean the elbow joint, which connects the shoulder to the forearm. But not everyone knows that this is a complex joint, consisting of three joints (humeral-ulnar, humeroradial and proximal radioulnar) enclosed in one articular capsule. They are formed by three bones: the humerus, ulna and radius.

Due to its complex structure, the elbow is a movable joint that allows the arm to bend and extend. At this joint, you can rotate the forearm and rotate it outward and inward. However, due to a number of reasons, his mobility is limited. For example, a phenomenon may occur when the arm at the elbow does not fully extend. In this case we are talking about joint contracture.

The structure of the elbow joint

What does this term mean?

Contracture should not be understood as a situation where the elbow does not straighten exclusively. Sometimes the arm straightens, but there are problems moving in other directions.

Contracture is any limitation in the mobility of a joint. It is often accompanied by joint deformation, swelling and pain.

If we classify pathology by type of movement restriction, we can distinguish several types:

• flexion;
• extensor;
• pronation;
• supination, etc.

The first type is the most common. It manifests itself as difficulties when trying to straighten the arm or complete inability to make this movement.

Flexion contracture is diagnosed when the arm does not fully extend

There are four degrees of joint damage:

1. In the first degree, the limitation is insignificant, since a person is able to extend the arm no less than 170°.
2. If it extends in the range of 130°–170°, the second degree of contracture is diagnosed.
3. At the next degree, extension is possible within 90°–130°.
4. With the most severe degree of pathology, the extension angle does not exceed 90°.

Next, let's look at the possible causes of the disease.

Causes of contracture

There are many reasons causing this pathological condition. They can be divided into two large groups: injuries and diseases (congenital and acquired).

Injuries

Damage leading to pathology:

• Bruise is the most common injury. Usually it affects the olecranon, periarticular tissues, humeral condyle, and ulnar nerve.
• Partial or complete ligament ruptures.
• Various dislocations of the bones that form the joint.

Injuries also include fractures, which most often affect the internal joint of the ulna.

Fractured elbow as a result of falling on it

Signs of damage

The first sign of injury is acute, severe pain at the time of injury to the elbow. Then the injured area begins to swell and the color of the skin changes. Any attempts to move the injured limb are extremely painful. Pathological mobility cannot be ruled out. There may be numbness in the forearm, hand and fingers. When a fracture occurs, bone fragments may clearly protrude under the skin.

Consequences of fractures and bruises

After an injury, immobilization contracture may develop:

1. Due to mechanical obstacles, if reposition was not carried out (comparison of bone fragments for their optimal fusion) or it was not done in the best way. In both cases, the bones do not heal properly, and mobility in the joint is limited.
2. If scars have formed after ruptures of the ligaments or periarticular bursa.
3. When a person, after a fracture, is forced to wear a plaster cast for a long time.
4. If the brain has been damaged.

Less commonly, mobility suffers after puncture and cutting injuries to the periarticular muscles.

Diseases

The cause of impaired mobility may lie in congenital:

1. Clubbing. There are two types of pathology (ulnar and radial). In the first case, the ulna bone is absent or underdeveloped, in the second - the radius. The latter type of pathology is most often observed.
2. Dislocation of the radial head.
3. Synostosis, which is a fusion of the ulna and radius bones.

Congenital bone abnormalities are accompanied by disturbances in the development of muscles, tendons and ligaments that serve the corresponding bones.

Two types of epicondylitis

Acquired diseases

Often the factors causing the development of styloiditis are:

• Excessive physical activity. One of the diseases of this nature is epicondylitis - “tennis elbow”. Due to constant overload of the forearm muscles, an inflammatory process begins in the places where the muscles attach to the bones.
• Long monotonous movements that a person is forced to perform in the course of one or another production activity. The tendons that attach to the styloid or olecranon process become inflamed.
• Bursitis or inflammation of the joint capsule, which negatively affects the range of motion in the joint.
• Various forms of arthritis. With this disease, which can be caused by many reasons, almost all joint structures (synovium, capsule, cartilage and others) suffer from inflammation.

Acquired pathologies also include arthrosis, a chronic disease leading to degenerative changes in the joint.

Diseases that cause elbow pain and their treatment

Lateral (external) epicondylitis

This is an inflammatory disease of the tendons of the forearm muscles.

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Medial (internal) epicondylitis

This is an inflammatory lesion of the internal tendons of the muscles connected to the medial epicondyle of the elbow joint.

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Bursitis

Bursitis is an inflammation of the joint capsule accompanied by infection.

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Arthritis

Arthritis is inflammation of joint tissues. Its main types are: reactive, post-traumatic and systemic (for example, rheumatoid - when the disease affects the entire body).

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Arthrosis

Arthrosis is damage (destruction) of cartilage due to wear and tear.

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Osteochondrosis of the cervical spine

Osteochondrosis is the destruction of intervertebral discs. Pain in this pathology is of a reflected nature (i.e., the nerves responsible for pain in the elbow and arm are pinched, leaving them at the level of the spinal column - without damaging the joint itself - but the person feels discomfort precisely in the elbow). Often such pain is combined with numbness and pain in the neck, under the shoulder blade.

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Diagnostics

If it is difficult or impossible to straighten your arm at the elbow, you should not treat with folk remedies at home. You can find a great variety of similar remedies and recipes on the Internet. However, not all of them are correct from a medical point of view. In addition, motor abnormalities in the elbow occur as a result of various factors. Therefore, each individual case requires its own approach to treatment.

A specialist must decide how to treat. Which doctors should I contact? A traumatologist, orthopedist, neurologist and rheumatologist will make the correct diagnosis and prescribe adequate treatment:

1. Diagnosis begins with listening to the patient's complaints, examining the sore elbow and examining it with the fingers. The doctor finds out whether the person has suffered injuries or illnesses, how long it takes for the pathology to develop, what sensations it is accompanied by, etc.
2. At the next stage, the patient is sent for general and biochemical blood tests. A general analysis of the level of leukocytes in the blood and the erythrocyte sedimentation rate allows us to determine the strength of the inflammatory process in the body. The second type of analysis provides information about the presence of arthritis, damage to internal organs, and metabolic disorders.
3. If necessary, synovial fluid from the joint cavity can be taken for analysis.
4. An x-ray of the damaged joint is required to identify its anomalies.

X-ray of the elbow joint
To clarify the diagnosis, instrumental examination methods such as magnetic resonance imaging, computed tomography and ultrasound can be used.

Therapy

Treatment methods depend on the diagnosis:

1. If necessary, elbow immobilization can be performed.
2. In case of severe pain, a joint block is performed.
3. Non-steroidal anti-inflammatory drugs are prescribed to relieve inflammation and relieve pain.
4. Physiotherapeutic procedures are actively used (massage, various methods of traction, mechanotherapy, etc.).
5. Surgical intervention is practiced when bone fragments have not healed properly or rough scars have formed that impede free movement. The nature of the operation is determined by the type and severity of the pathology. In especially severe cases, joint replacement is practiced.

During the recovery period, regular exercise of the joint will be useful. A set of exercises will be selected by a specialist in physical therapy.

Even if you have minor problems with elbow movements, you should not hesitate to visit a medical facility. Delay can result in joint degradation with a concomitant deterioration in quality of life.

More information about the anatomy of the elbow can be obtained from the video:

You can learn about exercises for elbow epicondylitis by watching the following video:

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Types of pain in the elbow during flexion and extension

Pain syndrome, depending on the disease that caused it, has its own characteristics. When examining a patient, the doctor always pays attention not only to what movement causes discomfort, but also what its nature is:

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