Dear Ask The Doctor: My husband is a skateboarder and he fell terribly on his right arm while it was extended. His elbow is totally swollen and he can't straighten his arm out completely. It just won't straighten out. Yesterday there was quite a bit of pain so we iced and heated for about 2 hours. The swelling went down last night but it's pretty bad again today. Should we keep icing it? Also is heat and ice good to do the first day?
Dear Patient: If your husband is capable of actively move his elbow: flexion and extension, he does not have any remarkable deformity, and the swelling is improving then you do not need to go to the hospital but if this is not the case and on the contrary your husband’s elbow swelling worsens, also there is significant deformity and limitation in the movements along with severe pain, then it is strongly recommended to go to the Emergency Room so your husband can be assessed by a physician and get X rays taken to rule out a fracture or dislocation, that might need other form or treatment.
The suggested strategy in the case that your husband can actively move the elbow and he has no significant swelling or deformity would be: applying 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, take anti-inflammatory medication (i.e.: “Aleve”) 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, start applying on the elbow warm and wet compresses for periods no more than 15 minutes each time, 2-3 times a day, also he can do series of active movements of flexion and extension of the elbow. The pain after the fall could persist for about 2-4 weeks but eventually will disappear.