What is the treatment for an elbow contusion?

Treatment for Elbow Contusion

First-line treatment for an elbow contusion should include rest, ice application for 10-minute periods through a wet towel, activity modification, and NSAIDs for pain and inflammation. 1

Initial Assessment and Diagnosis

• Radiography is recommended as the first imaging study for acute elbow pain to rule out fractures and compare with the contralateral elbow to look for asymmetry 1
• Ultrasound can be useful for evaluating soft tissue injuries if there is concern for associated tendon pathology 1
• Advanced imaging with MRI should be considered for persistent symptoms or when complications are suspected 1

Treatment Protocol

Acute Phase (0-6 weeks)

• Rest and activity modification: Avoid activities that aggravate symptoms
• Ice application: Apply ice for 10-minute periods through a wet towel several times daily 1
• Pain management: Use acetaminophen or NSAIDs for pain control and inflammation reduction 1
  • Topical NSAIDs may cause fewer gastrointestinal side effects than oral NSAIDs 1
• Protection: Consider using protective padding or elbow sleeve to prevent recurrent injury 1

Persistent Symptoms (6-12 weeks)

• Continue activity modification
• Begin physical therapy with focus on eccentric strengthening exercises 1
• Consider corticosteroid injection (limited to 1-2 injections) if pain persists 1
• Continue eccentric exercises for at least 12 weeks 1

Chronic Phase (>12 weeks)

• Reassessment of diagnosis with imaging if symptoms persist
• Consider referral to orthopedic specialist if symptoms continue beyond 3 months 1

Special Considerations

• Range of motion: The goal of treatment should be to restore functional range of elbow motion (≥30° to 130°) 1
• Prevention of recurrence:
  • Use elbow pads during activities that put pressure on the elbow
  • Avoid leaning on elbows for prolonged periods
  • Maintain proper ergonomics at workstations 1
  • Implement technique modifications for athletes and manual laborers to minimize repetitive stress 1

Complications to Monitor

• Elbow stiffness and limited mobility of the joint 2
• Development of chronic conditions like lateral or medial epicondylalgia
• Persistent pain or functional limitation requiring further evaluation

Caution

• Avoid complete immobilization as this may lead to joint stiffness; relative rest is preferred 1
• Limit corticosteroid injections to 1-2 as excessive use can lead to tissue weakening 1
• Monitor for signs of more serious injury such as fracture or dislocation, which would require different management approaches 2

The primary goal of management is to control pain and inflammation while allowing for early range of motion to minimize future morbidity, particularly elbow stiffness and limited joint mobility 2.