Stiff elbow in Vienna
The arm can no longer be straightened fully, the hand no longer reaches the shoulder, turning the forearm stops halfway. I clarify what is blocking the movement and discuss with you whether exercise therapy is enough or whether an arthrolysis (releasing the scarring) is sensible.
In short
A stiff elbow can no longer be fully straightened, bent or rotated. The cause is usually a scarred joint capsule after a fracture, a dislocation or long immobilisation, wear of the cartilage with bone spurs, or loose bodies. Typical are a loss of extension, pain at the end of the movement and sudden locking. I measure the range of motion in comparison with the other side, examine with ultrasound and arrange an X-ray or MRI where needed. Treatment is conservative first, with guided exercise therapy; if the arm stays restricted, I release the scarring arthroscopically and take down the bone spurs.
What is a stiff elbow?
The elbow bends and straightens the arm and, with the radius, turns the hand inwards and outwards. The bony guidance is tight, the joint capsule is thin. After an injury, bleeding into the joint or an operation, this capsule thickens, shrinks and scars. The elbow therefore reacts sensitively to long immobilisation: it stiffens, and usually loses extension first.
The first group of causes is injury. After an elbow dislocation, a radial head fracture or a ligament injury, capsule and scar tissue heal in a shortened position; at times new bone forms in the soft tissue (heterotopic ossification). Stiffness and residual instability are not rare in combination, see elbow instability.
The second group is wear. Bone spurs (osteophytes) at the joint margins and a thickened capsule make the arm come up against a barrier; loosened pieces of cartilage or bone block it as loose bodies. How the cartilage wears down and how that is treated is explained on the page about elbow osteoarthritis; an overview can be found under elbow surgery in Vienna.
Typical symptoms
- Loss of extension — the arm stops in slight flexion
- Loss of flexion — the hand no longer reaches the mouth or the shoulder
- Restricted rotation — the palm can no longer be turned fully upwards
- Hard pain at the end of the movement — only at the barrier, not during the movement
- Sudden locking — the joint jams briefly, typical of loose bodies
- Tingling in the ring and little finger — with a compressed ulnar nerve, see cubital tunnel syndrome
How I make the diagnosis
At the beginning there is a detailed conversation: was there an accident or an operation, which everyday movements no longer work? I then measure the range of motion actively and passively in comparison with the other side and pay attention to the end feel — a soft one points to capsule and scarring, a hard one to a bony block. In addition I check forearm rotation, ligament stability and the ulnar nerve. Ultrasound is available in the practice: for joint effusion and the thickness of the capsule. Where needed I arrange an X-ray for bone spurs and ossification, a CT scan for a bony block or an MRI for cartilage and soft tissue.
Treatment: conservative first
The aim is to relieve the pain and to regain movement. Movement comes first: I prescribe physiotherapy and exercise therapy — both in the same building at the Orthozentrum Döbling — with guided exercises and a programme of your own for home. What matters is the kind of exercise: calm, repeated movement up to the limit takes the elbow further, while forceful stretching irritates the tissue and can increase the stiffness.
I calm painful irritation in the practice myself: an ultrasound-guided injection when pain blocks every exercise, magnetic field therapy in addition, shockwave therapy when a tendon attachment is irritated as well, and PRP therapy for symptoms arising from the cartilage. These methods change nothing about a bony barrier or a loose body — I say that openly.
When an operation is necessary
If the arm stays restricted despite exercise therapy, or if the joint locks repeatedly, an arthrolysis is sensible — the release of the scarring. Usually I carry it out as part of an elbow arthroscopy: through small entry points I release the thickened capsule, remove scar tissue and loose bodies and take down the bone spurs at the olecranon and the coronoid process until the arm moves through without a barrier again. With extensive ossification or after previous operations I choose the open route; if the ulnar nerve is compressed, I free it in the same procedure.
I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. After that, early movement is what counts: the range of motion that has been gained has to be held, which is why physiotherapy starts quickly. Whether an arthrolysis is an option for you depends on the findings; the decision is made together, once examination and imaging have been evaluated.
Frequently asked
Common questions about the stiff elbow
Arthrolysis means releasing the scarring. I remove the thickened, shrunken capsule and scar tissue, take down bone spurs that act as a hard barrier, and take out loose bodies. The aim is an elbow that can move again without hitting a barrier. How much movement comes back depends on the state of the cartilage and on the cause.
When the arm can no longer be fully straightened or bent after a fracture, a dislocation or an operation and the movement no longer increases despite physiotherapy. Likewise when the joint suddenly locks, when the ring and little finger tingle, or when the stiffness hinders you in everyday life.
Often yes, above all when the restriction comes from capsule, scarring and muscles. What matters are regular, calmly guided exercises without force — forceful stretching irritates the tissue and can increase the stiffness. If, on the other hand, a bony barrier or a loose body is in the way, exercises alone are not enough.
They are detached pieces of cartilage or bone lying free in the joint — colloquially known as joint mice. They arise with osteoarthritis or after injuries. If they settle between the joint surfaces, the arm locks suddenly. I usually remove such bodies arthroscopically through small entry points.
No, but the two are connected. Osteoarthritis is the wear of the joint cartilage; it leads to growths at the bone margins, to a thickened capsule and therefore often to stiffness. An elbow can, however, also stiffen without osteoarthritis, for instance after a fracture. The examination and the X-ray show which cause predominates. Everything about the wear itself is covered on the page about elbow osteoarthritis.
Arthroscopically, if the findings allow it: through small entry points I release the capsule under direct view, remove scar tissue and take down bone spurs that are in the way. With extensive ossification or after previous operations, the open approach is the safer route. After examination and imaging, I decide together with you which method is suitable.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Please bring previous reports and images with you; a referral is not needed. My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. More on the page about billing in a private practice.
Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.