Pulled Elbow
What is a Pulled Elbow?
A pulled elbow, also known as radial head subluxation, is a common childhood injury that usually affects children under five years of age. It occurs when one of the forearm bones (the radius) partially slips out from the ligament that normally holds it securely in place at the elbow.
Although it can be painful, it is considered a minor injury and usually resolves quickly once treated.
What Causes a Pulled Elbow?
Young children’s joints and ligaments are still developing, making the elbow more prone to this type of injury.
A pulled elbow is commonly caused by:
- Pulling a child suddenly by the hand or wrist.
- Lifting a child by one hand.
- Swinging a child by their arms.
- Pulling an arm through a sleeve while dressing.
- A sudden jerk or stretch to the arm.
- Occasionally following a minor fall or rolling onto the arm.
Symptoms
Children with a pulled elbow may:
- Suddenly cry after the injury.
- Hold their arm by their side.
- Refuse to use the affected arm.
- Be unable to fully bend or straighten the elbow.
- Experience pain when the arm is moved.
Sometimes a small “click” or “pop” may be heard when the injury occurs.
Diagnosis
A healthcare professional will usually diagnose a pulled elbow by:
- Asking how the injury happened.
- Examining your child’s arm.
An X-ray is not normally required, as the injury affects the ligament rather than the bone. However, imaging may be considered if there is concern about a fracture or another injury.
Treatment
Treatment involves gently moving the elbow in a specific way to guide the radius back into its normal position.
This procedure:
- Takes only a few seconds.
- May cause brief discomfort.
- Often produces a small click as the joint returns to place.
Many children begin using their arm again within minutes, although some may take a few hours depending on how long the elbow was out of position.
Pain Relief
If your child remains uncomfortable after treatment, simple pain relief may help.
Suitable options include:
- Paracetamol
- Ibuprofen
Always follow the dosing instructions appropriate for your child’s age and weight.
If the elbow remains sore or swollen after treatment, continue regular pain relief until your child is using their arm normally.
Recovery
Most children recover completely within a few days following successful treatment.
If the elbow does not improve as expected, further assessment may be required.
Occasionally:
- An X-ray may be arranged.
- A sling may be recommended for 2–3 days if no fracture is found but symptoms persist.
Possible Complications
Long-term problems following a pulled elbow are extremely rare.
Most children regain full movement without any lasting effects.
Preventing Another Pulled Elbow
To reduce the risk of the injury happening again:
- Avoid swinging your child by the arms.
- Do not lift your child by one hand or wrist.
- Lift your child under the arms or around the upper arms instead.
- Encourage family members, grandparents and childcare providers to follow the same advice.
When to Seek Medical Advice
Seek further medical assessment if:
- Your child is still not using their arm after 2–3 days.
- Pain becomes worse.
- Swelling develops.
- There is obvious deformity.
- You are concerned about another injury.
If your child has severe pain, significant swelling or a serious injury, seek urgent medical attention.
Frequently Asked Questions
What is a pulled elbow?
A pulled elbow is a common injury in young children where one of the forearm bones slips partially out of its supporting ligament at the elbow.
How is a pulled elbow treated?
A healthcare professional gently manipulates the elbow to return the bone to its normal position. The procedure is quick and usually provides rapid relief.
Does my child need an X-ray?
Not usually. Most cases can be diagnosed by examining the arm and discussing how the injury happened.
How long does recovery take?
Most children begin using their arm within a few hours and make a full recovery within a few days.
Can a pulled elbow happen again?
Yes. Children who have experienced one pulled elbow may be more likely to have another until the ligaments strengthen as they grow, so avoiding pulling or swinging by the arms is recommended.
