Twisted elbow downstairs (5)
I believe the answer is:
below
'downstairs' is the definition.
('below' can be a synonym of 'downstairs')
'twisted elbow' is the wordplay.
'twisted' is an anagram indicator.
'elbow' anagrammed gives 'BELOW'.
(Other definitions for below that I've seen before include "as mentioned later" , "Subordinate to" , "in one's cabin" , "second-rate" , "Beneath" .)