Post-Traumatic Elbow Pain After Fall

Dear Ask The Doctor:  This morning I fell on ice while walking my dog. I landed squarely on my ulna jamming my shoulder upwards. The pain is centered in my elbow. The pain has gone away when I touch it but it still hurts when I leave it in one position for too long. Sometimes the pain moves all the way down my arm to my hand. The pain was enough to make me cry until I took Advil. Should I go to the emergency room? Or give it a while to see if the pain worsens?
 
Dear Patient:  If you can actively move your elbow: flexion and extension, and you do not have any remarkable swelling or deformity, then you do not need to go to the hospital but if this is not the case and on the contrary you develop significant swelling or deformity and you can not move actively the elbow, then you should go to the Emergency Room to be assessed by a physician and get X rays taken to rule out a fracture or dislocation.
The suggested strategy in the case that you can actively move the elbow and you have no significant swelling or deformity would be: you must apply ice to the elbow 4 to 6 times during this first 24 hours for periods no more than 15 minutes each time to avoid swelling, and also ease the pain, continue taking Advil every 8 hours for the first 3 days and then 1 or 2 times a day as needed. After the first 24 hours from the fall, you will start applying on your elbow warm and wet compresses for periods of no more than 15 minutes each time, 2-3 times a day, also you can do series of active movements of flexion and extension of the elbow. You feel the pain moving down your arm because the nerve of the elbow might be involved in the traumatism and swelling.
The pain after the fall could persist for about 2 weeks but eventually will disappear.

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