Pulled Elbow: Causes, Symptoms & Treatment

Nursemaid's Elbow
Nursemaid’s Elbow

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Referred to as nursemaid’s elbow or radial head subluxation, pulled elbow is a prevalent injury, especially among young children. Although generally not considered severe, it can induce discomfort and restrict movement. This article aims to explore the origins, symptoms, and available treatments for pulled elbow, providing valuable insights for parents, caregivers, and individuals seeking a comprehensive understanding of this condition.


Pulled elbow often occurs in young children, typically between the ages of one and four. The injury is caused by a sudden pulling or tugging on the child’s arm, especially when the arm is extended and the forearm is pronated (palm facing down). Common scenarios leading to pulled elbow include:

  1. Childhood Play: Children’s natural curiosity and playfulness may lead them to grasp onto objects, attempt to pull away from a caregiver, or engage in activities that involve swinging or lifting.
  2. Lifting by the Arm: Lifting a child by their arms, particularly when their arm is outstretched, can result in pulled elbow. It is crucial to lift children properly, supporting their underarms rather than pulling on their hands or wrists.
  3. Falls: A child may experience a pulled elbow if they fall on their outstretched hand or if their arm is twisted during a fall.


The symptoms of pulled elbow are often immediate and may include:

  1. Pain: The child may experience pain in the affected arm, particularly around the elbow area.
  2. Refusal to Use Arm: Due to the discomfort, the child may avoid using the affected arm altogether and keep it close to their body.
  3. Crying or Irritability: The pain associated with pulled elbow can lead to increased crying or irritability in the affected child.
  4. Limited Range of Motion: The child might face difficulty in completely extending or rotating the impacted arm, and any attempt to do so could result in heightened pain.


If you suspect that a child has pulled elbow, it is important to seek medical attention. However, there are a few simple maneuvers that healthcare professionals may use to correct the condition. These include:

  1. Reduction Maneuver: A healthcare provider will typically perform a gentle maneuver to reposition the dislocated radial head back into place. This is a quick and usually painless procedure.
  2. Pain Management: Over-the-counter pain medications like acetaminophen or ibuprofen may be suggested to ease any lingering discomfort.
  3. Rest and Ice: Allowing the affected arm to rest and applying a cold compress to the elbow can aid in reducing swelling and fostering the healing process.


Preventing pulled elbow involves being mindful of activities and movements that may put stress on a child’s arm. Here are some tips:

  1. Proper Lifting Techniques: When lifting a child, support them under the arms rather than pulling on their hands or wrists.
  2. Educate Caregivers: Parents, caregivers, and teachers should be aware of the risk factors and avoid activities that may lead to pulled elbow.
  3. Teach Safe Play: Educate children about safe play habits, including how to navigate climbing structures and avoid putting excessive force on their arms.


While pulled elbow is a common and usually minor injury, prompt recognition and appropriate intervention are essential for a quick and complete recovery. Parents, caregivers, and those working with young children should be aware of the causes and symptoms, practicing safe lifting and play techniques to reduce the risk of this injury. If pulled elbow is suspected, seeking medical attention promptly will ensure proper diagnosis and treatment, allowing the child to return to normal activities with minimal discomfort.

Pulled Elbow FAQ

The hyperpronation maneuver, involving holding the elbow at 90° and firmly pronating the wrist, is more effective in reducing pulled elbow than the supination-flexion maneuver. It is recommended to perform the hyperpronation maneuver initially.
Symptoms may include instant pain in the injured arm and elbow, as well as pain in the wrist and/or shoulder. The unwillingness or inability to move the damaged arm.
Symptoms may manifest as pain, tenderness, or swelling around the elbow, whether in motion or at rest. Difficulty in bending or extending the elbow, along with potential signs like bruising, redness, or warmth in the area, can be observed.
If you suspect your child has a pulled elbow, promptly seek medical attention from a general practitioner or visit a hospital emergency department. The longer the elbow remains dislocated, the more challenging and painful the repositioning process becomes, potentially prolonging the recovery period.


If you would like an appointment / review with our pulled elbow specialist in Singapore, the best way is to call +65 3135 1327 or click here to book an appointment at the clinic. If you would like to speak to one of our clinicians first, then please contact contact@orthopaedicclinic.com.sg or SMS/WhatsApp to +65 3135 1327.

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