What is the treatment for swelling on the elbow?

Treatment of Elbow Swelling

For acute elbow swelling from soft tissue injury, apply ice (in a bag with water surrounded by a damp cloth) for 20-30 minutes per session, 3-4 times daily, combined with rest, activity modification, and consideration of compression wrapping for pain relief. 1

Initial Management Approach

Ice Application (Cryotherapy)

• Apply cold therapy using ice and water in a bag surrounded by a damp cloth - this method achieves the greatest tissue cooling compared to gel packs or ice alone 1
• Duration: 20-30 minutes per application, 3-4 times daily 1
• Never place ice directly on skin to prevent cold injury 1
• Ice effectively decreases pain and swelling in acute soft tissue injuries, with evidence showing improved pain scores at weeks 1,2, and 4 after injury 1
• Repeated 10-minute applications through a wet towel are most effective for achieving target temperature reduction of 10-15°C 2

Rest and Activity Modification

• Avoid activities that cause pain and limit use of the injured extremity 1
• Rest prevents ongoing damage and promotes healing, though complete immobilization should be avoided to prevent muscle atrophy 3
• This is critical because uncertainty often exists about whether the injury is a sprain, strain, or fracture 1

Compression

• Consider applying a compression wrap to promote comfort after acute injury 1
• Apply compression without compromising circulation - avoid overtightening 1
• While compression wraps provide comfort and pain relief acutely, evidence shows they do not significantly reduce swelling or improve recovery time 1

When to Seek Medical Attention

Red Flags Requiring Immediate Evaluation

• Obvious deformity, severe pain with movement, or inability to move the extremity - these may indicate fracture 1
• Persistent swelling beyond one week requires expeditious evaluation to exclude major outflow obstruction, hematoma, infection, or venous hypertension 1
• Visible protruding bone suggests open fracture requiring emergency care 1

Evaluation Timeline

• Minor "physiological" swelling should disappear within the first week 1
• If swelling persists, seek medical evaluation to rule out underlying pathology requiring correction 1

Additional Supportive Measures

Elevation

• Elevate the affected arm to reduce swelling 1
• Hand elevation combined with patient reassurance is appropriate for early postoperative or post-injury swelling 1

Pain Management

• NSAIDs (oral or topical) can provide short-term pain relief 3
• While effective for pain, NSAIDs do not affect long-term outcomes 3
• Topical NSAIDs avoid gastrointestinal risks associated with oral formulations 3

Important Caveats

Limitations of Ice Therapy

• Ice has not been shown to improve overall outcome or stop bleeding/swelling from hemarthrosis in certain conditions 4
• Reflex activity and motor function may be impaired for up to 30 minutes following ice treatment, potentially increasing susceptibility to reinjury 2
• Ice primarily provides pain relief but does not necessarily improve function or time to recovery 1

Progressive Rehabilitation

• Once acute pain subsides (typically after first week), consider progressive therapeutic exercises including stretching and eccentric strengthening 3, 5
• Early therapeutic exercise combined with ice (cryokinetics) may improve ankle function faster than standard rest protocols, though this evidence is primarily from ankle sprains 5