Trauma & Sports

Nursemaid's Elbow: Pulled Elbow in Toddlers

Name: Child Won't Move Arm: Nursemaid's Elbow, What to Do | Milan
Creator: Daniele Priano
Published: 2026-01-15

A pulled arm the child stops moving: nursemaid's elbow is common under age 5; the diagnosis is clinical and treatment is a medical reduction manoeuvre.

Medically reviewed: September 2026·Dott. Daniele Priano

In short

A pulled elbow may explain a young child's sudden refusal to use an arm. Prompt assessment is needed to confirm the diagnosis and treat it when indicated. Do not perform manoeuvres at home. Recovery should be checked after reduction; persistent pain or reluctance to use the arm requires reassessment.

When an evaluation can be useful

questions about prevention after a fully resolved episode
discussion of recurrent episodes between incidents, while the child is using the arm normally.

The aim of the visit is not always to start a treatment: often it is to understand whether the situation can be observed calmly or whether further investigation is needed.

Check availability and book

Visits in Milan at Pini and CTO, subject to availability.

When not to wait

a child who continues not to use the arm
persistent pain or reluctance to use the arm after reduction
swelling, bruising, deformity or an injury suggesting another diagnosis
fever, a child who is unwell or changes affecting the hand.

For an acute episode, seek prompt assessment at a service able to examine and treat your child. After treatment, contact the treating service if recovery is not proceeding as expected. Significant or worsening warning signs require urgent care without waiting for a routine appointment.

This information does not replace a medical visit and does not allow a diagnosis at a distance.

A toddler keeping an unused arm close to the body, observed by the mother and doctor. — The child protects an arm
Pulled elbow is one possibility, even without a remembered pull. Not every unused arm has this diagnosis.
Read all the illustrated explanations →

A pulled elbow, also called nursemaid's elbow, is a subluxation of the radial head that mainly affects young children. It often follows a pull on the hand or wrist, although the incident is not always noticed. The child stops using the arm: prompt assessment is needed to confirm the diagnosis and exclude fractures or other causes.

When the presentation is typical, the diagnosis is clinical and an X-ray is not always needed. Treatment is a reduction performed by an experienced healthcare professional. Movement often returns within a few minutes, but recovery must be checked; if pain or reluctance to use the arm persists, promptly contact the service that treated your child.

Do not attempt manoeuvres at home or wait for a routine appointment if the child continues not to use the arm. Swelling, bruising, deformity, significant pain, fever or a hand that is cold, pale or has altered sensation require urgent assessment. Any observation at home should be advised after examination, with clear follow-up instructions.

💪Check that comfortable arm movement returns

After a successful reduction, a child often starts using the arm within a few minutes. If pain or reluctance to move persists, the response needs reassessment: performing the manoeuvre alone is not enough. Avoid attempts at home and promptly contact the treating service if recovery is not proceeding as expected.

Assessment and treatment

When to seek evaluation

The child stops using the arm: prompt assessment
Pain or reluctance to use the arm after reduction: contact the treating service
Swelling, bruising, deformity, fever or changes affecting the hand: urgent assessment
Questions about prevention or recurrence between fully resolved episodes

What is evaluated

History, examination and alternative diagnoses
Findings that may require X-rays or other investigations
Return of movement and comfort after reduction

Treatment options

Reduction by an experienced healthcare professional after assessment
Confirmation of recovery and discharge instructions
After successful reduction and full recovery, immobilisation is usually unnecessary
No manoeuvres at home; reassessment if pain or reluctance to use the arm persists

Frequently Asked Questions

What is a pulled elbow?▼

Is an X-ray always needed?▼

No: in a typical presentation, the clinician can make a clinical diagnosis. X-rays or other investigations are considered according to the injury, examination, diagnostic uncertainty or recovery after treatment. The absence of a remembered pulling incident alone does not exclude a pulled elbow.

What should I do at home before assessment?▼

Let the arm rest in its most comfortable position without forcing movement or attempting a manoeuvre. If the child continues not to use it, seek prompt assessment. Do not wait for spontaneous recovery; even an episode that appears identical to a previous one may have a different cause.

Are a cast or follow-up checks needed after reduction?▼

With a confirmed diagnosis, successful reduction and full recovery, a cast or physiotherapy is usually unnecessary. Follow the discharge instructions. Persistent pain or reluctance to use the arm requires prompt contact with the treating service; follow-up may be needed if the findings remain uncertain or recovery is incomplete.

How can the risk of recurrence be reduced?▼

To reduce recurrence, lift your child by supporting them under the armpits and avoid pulling or swinging them by the hands or wrists. Share this advice with other caregivers. Some children are nevertheless prone to further episodes: a new episode needs assessment rather than an assumption that it is identical to the previous one. [3, 4]

Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.