Limited Range of Motion

What range of motion means

Range of motion (ROM) is how far a joint can move, measured in degrees with a goniometer (a hinged ruler). For example, a normal elbow straightens to 0 degrees and bends to about 140 to 150 degrees. Doctors test:

• Active range: how far you can move the joint yourself.
• Passive range: how far the examiner can move it while you relax.

The difference is a useful clue. If both are limited, the problem is usually in the joint itself, such as arthritis or a frozen capsule. If active movement is limited but passive is normal, the problem is more likely weak muscles, a torn tendon, a nerve problem, or pain.

Causes of limited range of motion

Arthritis

• Osteoarthritis: wear of cartilage and bone spurs cause gradual stiffness, especially in knees, hips, hands and the spine. Stiffness usually eases within 30 minutes of getting up.
• Rheumatoid arthritis and other inflammatory arthritis: swollen, warm joints and morning stiffness lasting more than 30 minutes, often in hands and feet on both sides.
• Gout and pseudogout: sudden, hot, very painful swelling that limits movement.
• Ankylosing spondylitis: inflammatory back pain and progressive loss of spinal movement in young adults.

Frozen shoulder

Frozen shoulder, or adhesive capsulitis, is thickening and tightening of the shoulder capsule. It causes pain then marked stiffness, especially when rotating the arm outward. It is more common between 40 and 60 and in people with diabetes, and usually resolves over 1 to 3 years.

Injuries

• Fractures and dislocations, during healing and after immobilization in a cast
• Torn cartilage (meniscus) causing locking of the knee
• Ligament injuries with swelling
• Muscle strains and tendon tears, such as a rotator cuff tear

Soft tissue inflammation

Tendinitis and bursitis cause pain that limits certain movements, such as lifting the arm overhead with shoulder impingement.

Contractures

A joint contracture is a permanent shortening of muscles, tendons or the joint capsule. It develops after long immobilization, burns, stroke, cerebral palsy, spinal cord injury, or conditions such as Dupuytren's contracture of the hand.

Other causes

• Swelling from fluid in the joint (effusion)
• Joint infection (septic arthritis), an emergency
• Nerve and brain conditions causing spasticity, such as stroke, MS and Parkinson's disease
• Hypermobility conditions, paradoxically, after injuries
• Bone tumors (rare)

Limited range of motion by joint

How doctors assess it

A doctor will ask when stiffness started, whether there was an injury, whether it is worse in the morning, and about swelling, fever, other joints, and other diseases. They compare active and passive movement with the other side, feel for warmth, swelling and crepitus (grating), and test strength and nerves. Depending on findings:

• X-ray: arthritis, fractures, bone spurs
• Ultrasound or MRI: tendons, cartilage, ligaments, fluid
• Blood tests: inflammatory markers, rheumatoid factor and anti-CCP, uric acid
• Joint aspiration: draining fluid to test for infection or crystals

Treatment to restore movement

• Physical therapy: stretching, joint mobilization and strengthening are the main treatment for most causes.
• Range-of-motion exercises at home: gentle, regular movement through the available range several times a day, within comfort.
• Heat before exercise, ice afterward if sore.
• Pain relief: acetaminophen (paracetamol) or NSAIDs at the label dose, so you can exercise. Avoid NSAIDs if you have kidney disease, stomach ulcers or heart failure.
• Steroid injections for frozen shoulder, bursitis or arthritis flares.
• Disease-modifying treatment for inflammatory arthritis.
• Splints and serial casting for contractures.
• Surgery: joint replacement, arthroscopic release of a frozen capsule, repair of torn cartilage or tendons.

Early movement after injuries and surgery, within the limits your surgeon or therapist sets, prevents stiffness from becoming permanent.

Frequently asked questions

What does limited range of motion mean?

It means a joint cannot move through its full normal arc, such as fully bending, straightening or rotating. It can be caused by pain, swelling, stiff tissues, damaged cartilage, bone spurs, or weak muscles.

What causes decreased range of motion in the shoulder?

The most common causes are frozen shoulder, rotator cuff tendinitis or tears, shoulder impingement and osteoarthritis. Frozen shoulder typically limits both active and passive movement, especially rotating the arm outward.

Can limited range of motion be restored?

Often yes. Physical therapy, regular stretching and treatment of the underlying cause restore movement for many people. Long-standing contractures and advanced arthritis may only partly improve, and sometimes need surgery.

Is limited range of motion a sign of arthritis?

It can be. Osteoarthritis and inflammatory arthritis both reduce movement, often with pain, stiffness and swelling. Injuries, tendon problems and frozen shoulder are other common causes, so an examination is needed to tell them apart.