Version July 2025
Please read the Disclaimer at the end of this page.
What is pulled elbow? —
This is an injury that causes elbow pain. It is common and happens most often in children ages 1 to 4 years. It is also called a "radial head subluxation" or a "nursemaid's elbow."
Pulled elbow can happen when:
●Someone pulls hard on a child's arm by the hand, wrist, or forearm when the child is not expecting it
●Someone grabs a child's arm suddenly, for instance, when the child is about to fall
When this happens, a ligament can get caught between 2 of the bones in the elbow joint, causing pain (figure 1). Ligaments are bands of tissue that connect bones together.
Pulled elbow is common in young children. The ligaments in the elbow joint are looser in children younger than 5 years. Because of this, they can get caught between the bones more easily.
What are the symptoms of pulled elbow? —
Pulled elbow is painful. When the injury happens, children usually cry and are upset. They usually hold their injured arm straight or slightly bent and close to their body (figure 2). They avoid using the injured arm.
Should I try to move or straighten the child's arm? —
No. Bring the child to the doctor or nurse right away.
Will the child need tests? —
Probably not. The doctor or nurse should be able to tell if a child has pulled elbow by asking about the injury and doing an exam.
Some children need X-rays. The doctor or nurse will order an X-ray if:
●The injury might have caused a broken bone.
●The procedure to fix the injury (described below) does not work.
How is pulled elbow treated? —
It is treated with a procedure called "reduction" to move the ligament and bones back into place. It is very quick. The doctor or nurse usually does this in the office or emergency department.
Children do not usually need pain medicine for the procedure. Although it can hurt, the child will feel much better in 5 to 10 minutes. After, the child will probably not need any further treatment. They can go back to their normal activities.
Sometimes, the procedure does not work, and the child continues to have pain. In this case, the doctor will probably recommend that you:
●Have the child use a sling for a few days.
●Apply a cold gel pack, bag of ice, or bag of frozen vegetables on the elbow every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the child's skin.
●Use a medicine like acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) to help ease pain. Check the package directions carefully to make sure that you give the child the right dose. Never give aspirin to a child younger than 18 years old.
●See the doctor again after a few days if the child still cannot move their arm normally.
How can I help prevent pulled elbow? —
Do not pull hard on a child's arm or lift them up by the hand, wrist, or forearm. Instead, to lift the child up, hold them by the upper arms or under the arms.
When should I call the doctor? —
Call for advice if:
●The child stops moving their arm.
●Their hand feels cold or numb.
●They have more pain or swelling in the elbow.
