Stability of the elbow joint is provided by three elements: the bones, ligaments and muscles. Instability causes the elbow joint to become loose, causing the joint to slide out of alignment or catch. When supporting bones and ligaments surrounding the elbow are placed under additional stress in order to stabilise the elbow joint, they can become damaged, especially if left undiagnosed or treated.
Causes of Elbow Instability
Elbow instability is most commonly caused by the outside ligament of the elbow being detached or thinned, usually through a traumatic injury or recurrent dislocation of the elbow. It can also be associated with soft tissue and collagen disorders. Common causes include:
- Overuse of the elbow
- Impact from a fall
- Elbow deformity
Symptoms of Elbow Instability
The individual will usually feel as though their elbow is slipping out of place, particularly when the arm is almost completely straight with the palm turned upwards. This is usually accompanied by pain when weight is placed onto the elbow. Other typical symptoms include:
- A catching, clicking or locking sensation
- An unstable sensation
- Pain with movement or throwing
- Sliding or shifting of the elbow joint
Diagnosing Elbow Instability
A simple clinical examination can sometimes diagnose elbow instability, along with diagnostic investigations, however, more often than not; the diagnosis is made at the time of surgery. When the patient is awake, the muscles around the elbow automatically contract to help stabilise it, which makes it difficult to provide an accurate diagnosis. When the patient is under anaesthetic, the muscles become relaxed enough for the surgeon to provide a precise diagnosis.
Treatment for Elbow Instability
Most doctors prefer to start treatment for elbow instability using conservative measures rather than opting for a surgical intervention, unless the symptoms are severe enough to warrant it.
Resting from, or reducing activities that aggravate the problem are usually recommended. Athletes may be required to limit sporting activities, particularly if it involves repetitive arm use such as throwing or overhead movement. Bracing the elbow may also provide relief and help keep the elbow stabilised.
Physical therapy can be effective, as it will focus on strengthening the muscles around the joint to relieve pain and stabilise the elbow.
Surgery for Elbow Instability
If the condition does not improve, surgery may be the recommended course of treatment for you. Surgery is designed to restore stability to the elbow; this involves either reattaching the ligament or reconstructing the ligament with a tendon graft, similar to an anterior cruciate ligament reconstruction of the knee.
If a fracture is involved, the procedure will require additional repair or replacement of the fractured bone. In severe injuries, a cast or external fixator will be used to protect the injury and repair until the bone and tissues have a chance to start healing.
Once the surgeon has finished operating and the wound is closed, the elbow is placed in a splint with the hand facing downwards. The results of surgery are very reliable with recovery taking approximately six weeks. During this time, the amount of movement allowed is increased whilst the arm is kept in a protective brace. Some patients do experience ongoing pain, loss of motion or subtle symptoms of instability post-surgery, but most see a noticeable improvement compared to before surgery.
At One Healthcare we can book you in to see a specialist Orthopaedic surgeon for an initial consultation, usually within 48 hours. Treatment for elbow instability is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.
You can use your private medical insurance or pay for your Elbow Instability treatment. We offer competitive, fixed price packages as well as the ability to spread your cost with the option of 0% finance. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.
Why One Healthcare
- Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
- Fast access to diagnostics including MRI, Xray and Ultrasound
- Private, spacious, en-suite rooms
- Specialist Physiotherapy and nursing teams
- Little or no waiting time
- ‘Ultra clean air’ theatres
- Freshly prepared food
- Calm, dignified experience
Mr Rajeev Sharma
Consultant Orthopaedic Surgeon - Upper Limb Surgery (Shoulder, Elbow, Wrist and Hand)
One Hatfield Hospital