Arm hurts after a fracture: what to do and how to get rid of it

A bone fracture is a complete violation of integrity with a divergence of the lower and upper parts. Fractures can be open and closed, comminuted, intra-articular, without displacement and with displacement, compression, tear. Also, these types of tissue integrity violations are divided into pathological and traumatic. The first type occurs in people suffering from osteomalacia and osteoporosis. In them, a fracture can occur without traumatic impact.

Pain after bone fractures is a natural process, but only in the first three days, when capillary blood accumulates inside the resulting cavity. This provokes an inflammatory reaction, swelling of surrounding tissues and impaired blood microcirculation. Compression of small nerve endings leads to the development of pain. After about a week, in the cavity of the destroyed bone tissue, blood clots gradually transform into the form of fibrous fibers. The process of restoring bone integrity begins. At this stage, pain after a fracture may indicate a violation of the microcirculation of blood and lymphatic fluid. The second stage lasts from the 10th to the 30th day from the moment of injury.

If at this time pain persists after bone fractures, then a repeat X-ray examination and correction of the prescribed treatment are required. The plaster cast may have been applied incorrectly or subsequent displacement of bone fragments may have occurred.

From the 31st to the 50th day the third stage of fusion occurs. A dense bone callus is formed, which is formed by osteoblasts and osteoclasts. If a person has a compromised blood supply or orthopedic problems, this process may be disrupted. Pain after a broken leg may be a consequence of violation of the physical rest recommended by the doctor. If the patient tries to stand on his leg, then displacement of bone fragments or destruction of the still soft bone callus may occur. Due to the fact that it is based on fibrinogen, it is easily deformed and displaced.

Persistent pain after a broken arm is most often a consequence of impaired innervation. When a fracture occurs, the integrity of the brachial, median, radial, cutaneous and other large nerves may be disrupted. They are damaged by fragments, hematomas, and improperly formed callus. If pain occurs during the period of immobilization of the injured limb with a plaster cast, you should consult a traumatologist. The doctor must take a repeat X-ray, monitor the process of callus formation and make the necessary adjustments to the treatment.

If pain persists after removing the plaster cast, you should contact an orthopedist or chiropractor. These doctors will be able to develop an individual course of therapy that will allow for effective rehabilitation using physiotherapy, osteopathy and therapeutic exercises.

In Moscow, you can make an appointment with these doctors at our manual therapy clinic. Our initial appointment is free for all patients. The doctor will make a diagnosis and identify the potential cause of the pain syndrome. Will develop an individual rehabilitation course.

How to recognize a broken arm: symptoms of injury

First, you should make sure whether your arm really hurts after a fracture, and not because of a bruise, dislocation, sprain/rupture of ligaments or tendons.

Of course, it is difficult to make a mistake and mistake a fracture for a minor injury. However, sometimes this happens, especially if the victim has a high pain threshold, when sensitivity to pain is reduced. For example, such a person may classify a crack in a bone, which is a type of fracture, as a bruise and not even see a doctor. Therefore, you should know the characteristic symptoms of a broken arm:

acute, cutting pain , which intensifies with movement, especially if there are displacements of bone fragments that damage surrounding vessels, nerve endings, and muscles;
deformation and unnatural position of the limb, its pathological mobility due to displacement of the bone relative to its own axis;
crepitus - a crackling, grinding sound produced by the friction of bone fragments against each other;
impairment of motor activity : for example, with a fracture of the radius, the fingers do not obey, so it is even impossible to clench a fist, and if the injury is localized in other places, the arm will either not bend at the elbow, or you will not be able to lift it up, point the hand forward and etc.;
partial loss of sensitivity in the hand and fingers due to damage to nerve endings by bone fragments;
circulatory disorders , possible when the blood vessels are pinched, it is expressed by the fact that the limb below the injury becomes cold, sometimes some parts of the arm, on the contrary, become hot; when blood vessels rupture, hematomas are formed;
swelling of the hand;
skin damage and bleeding with exposure of bone fragments in an open fracture.

Of course, some of these symptoms are common to other types of injuries. However, if several of them are present at once, a fracture is likely. This means that you need to competently provide first aid to the victim (or yourself) and urgently go to the emergency room or call an ambulance.

First aid after a broken arm

So, in a situation where the arm hurts severely, sometimes unbearably, even to the point of shock, after a fracture, and dangerous circulatory disorders are possible, it is necessary:

take painkillers;
if there is external bleeding (typical of an open fracture), first stop it by applying a tourniquet or tight bandage above the fracture, and treat the wound with an antiseptic; however, clamping the bloodstream for more than 30–40 minutes carries the risk of tissue necrosis, so you should monitor the time;
if the forearm is fractured, place two splints on it (planks, plywood, thick cardboard, etc.) on the palm and outer side of the hand, while the hand should not dangle freely; do the same for a shoulder injury;
fix the broken limb using a bandage (scarf, scarf) attached to the neck, while the arm should be bent at the elbow at a right angle and threaded into the loop of the sling;
immediately go to the hospital or call an ambulance;
While waiting for professional help, apply ice wrapped in a cloth to the site of injury, which will ease pain, reduce swelling and inflammation, while raising the injured limb above the level of the heart.

Under no circumstances should you try to straighten bone fragments or a joint yourself. You also cannot move your injured arm. Since there is a possibility that anesthesia will be used during surgery, the victim is not recommended to eat or drink before going to the hospital.

Diagnosis of an arm fracture

The final verdict on whether the arm hurts after a fracture or another, less serious injury is made by a traumatologist. When making a diagnosis, it takes into account the nature of the traumatic impact itself and the symptoms listed above, but instrumental studies are of decisive importance.

An x-ray is usually done . In most cases, it is quite informative and allows one to judge the violation of the integrity of bone tissue and determine the location and type of fracture.

In addition, computed tomography, ultrasound, magnetic resonance imaging, and nuclear magnetic tomography .

Why do bones hurt a lot after a fracture?

In fact, it only seems that the bone hurts a lot after a fracture; in fact, the pain syndrome is provoked by compression of the radicular nerves located in the periosteum and surrounding soft tissues.

The real reason why bones hurt after a fracture is that a cavity forms at the site where the integrity of the bone tissue is broken. Capillary blood flowing from ruptured blood vessels in the periosteum accumulates in it. Inflammatory factors are drawn to the site of blood accumulation. They cause swelling of the soft tissues and increased local blood circulation.

Other causes of pain:

mixing of bone fragments;
impaired blood supply due to vascular diseases (varicose veins of the lower extremities, diabetic angiopathy, endocrine pathologies, atherosclerosis, etc.);
osteomalacia and disruption of bone tissue formation;
vitamin D deficiency;
insufficient amounts of calcium and phosphorus salts in the body, associated with improper absorption or dietary errors;
deficiency of B vitamins.

Pain during the rehabilitation period may be associated with the destruction of callus and its deformation. An incorrectly carried out rehabilitation course can provoke a re-violation of the integrity of the bone. Therefore, you need to strictly follow the recommendations of first the traumatologist, and then the chiropractor conducting the rehabilitation course.

Therapy and rehabilitation after a broken arm

The answer to the question of how much and how much the arm hurts after a fracture directly depends on the correctness of therapy and rehabilitation.

Therapy can be conservative (for closed fractures and no displacement of bone fragments) or surgery. The first includes:

plaster application for 3–5 weeks;
painkillers , or analgesics: analgin, baralgin, pentalgin, paracetamol ;
nonsteroidal anti-inflammatory drugs (NSAIDs): ibuprofen, nurofen, indomethacin, ketorol, etc., their use is preferable if the arm after a fracture swells and hurts at the same time, and an inflammatory process develops;
diuretics , or diuretics: furosemide, diacarb, etc., which help relieve swelling after a fracture;
vitamin and mineral complexes with calcium and vitamin D to restore and strengthen bone tissue. They serve only as a supplement to a balanced diet. A nutritious diet can, in principle, provide the body with both of these substances. But what is much more important during a fracture is the activation of the birth of new bone cells. Only when there is a sufficient amount of them will bone mineral be directed from the bloodstream into the bones, strengthening them.

Important! A new Russian development makes it possible to speed up the healing of a fracture, as it not only supplies the bones with minerals and vitamins, but also stimulates bone formation at the cellular level. This effect was possible due to the presence of a natural anabolic component in the drug.

In case of open fractures and/or displacement, before applying a plaster cast, reposition - combining bone fragments surgically. This procedure is necessary so that the bone heals correctly, and the soft tissues, nerves and blood vessels have the opportunity to recover. The period of immobilization with plaster is extended to 1.5–2 months. Drug therapy is the same as without surgery.

Rehabilitation after plaster removal takes on average from 2 weeks to a month, and restoration of working capacity - from one and a half to two months. During this period, measures are relevant to return the hand to normal motor activity, restore soft tissues, strengthen bone tissue at the site of injury and in general. Exercise therapy, physiotherapeutic procedures, and massage are provided.

Vitamin and mineral supplements may be prescribed for a year or more if low bone mineral density—osteoporosis or osteopenia—is detected.

Pain after removing plaster for a fracture: what to do

The first thing to do if you have pain after a fracture is to see a specialist as soon as possible. The doctor must exclude the possibility of repeated violation of the integrity of the tissue; for this it is necessary to take a control x-ray. If there is no re-injury, and the pain after removing the cast for a fracture persists and intensifies with any physical activity, then it is necessary to begin a course of rehabilitation. It will allow you to quickly restore all physiological processes, improve the condition of soft tissues, strengthen muscles and ensure the conduction of nerve impulses.

You can relieve pain after a fracture without pharmacological drugs. To do this, you can use manual influence. It is not recommended to independently develop a limb after a fracture. Callus is a very soft and pliable tissue. It is easily deformed. Complete ossification of the callus in the fracture area is observed 80–90 days after the injury. But if the swelling is immobilized for three months, ankylosis will develop, which can completely disrupt the function of the joints.

Pain when walking after a fracture of the tibia or femur can be eliminated with the help of physical therapy and kinesiotherapy. But before starting therapy, it is necessary to exclude the possibility of compression of large nerves.

Why does my arm hurt after a fracture, and how long will I have to endure it?

It is clear that immediately after an injury the pain is very intense, up to the development of pain shock. It is caused by damage not so much to the bone itself as to the tissues surrounding it: nerves, blood vessels, muscles, tendons and ligaments.

Particularly severe outbreaks of pain occur when moving or incorrectly positioning the broken limb. Therefore, it is important to immobilize the arm as soon as possible and secure it at chest level with a sling.

Patients often ask the question: how long does the arm hurt after a fracture?

Usually, after applying plaster, injury to soft tissues from bone fragments stops and the acute pain is replaced by aching pain, which also declines over the next two weeks to finally disappear after 2-3 months .

If your arm in a cast hurts severely after a fracture, and the pain remains at the same level or increases, this is a bad symptom. The fact is that the broken arm, fixed with a splint (hardening tape made of several layers of plaster bandage like a splint), continues to swell over the next three days.

Severe swelling can last up to a week, compressing soft tissues. And if their trophism, that is, nutrition, is disrupted, local foci of necrosis - skin necrosis - . It’s worse if large vessels are pinched. Disruption of the blood supply to large areas of the limb can lead to ischemic contracture - deformation of the arm with loss of the ability to flex and extend the hand and fingers. Even more dangerous is gangrene followed by amputation.

In this negative scenario, the patient experiences unbearable pain that is not relieved by analgesics or NSAIDs. The limb below the cast becomes cold, looks swollen and pale, the fingers turn blue and lose sensitivity. It is urgent to free your hand.

Treatment of an improperly healed finger fracture

Home > Cases from practice

Fractures of the phalanges of the fingers are a common injury. In the case of undisplaced “simple” fractures, conservative treatment works well - immobilization in a cast or an individual orthosis for 4 weeks and the patient is healthy.

The situation is much more complicated in the case of damage to the articular surface, a combination of fractures and dislocations, as well as significant displacement of fragments. The difficulty in treating phalangeal fractures is that the concentration of significant anatomical formations (vessels, nerves, tendons, ligaments, bones, cartilage) is very large per unit volume. Any inaccurate or excessive incision leads to the formation of scar tissue, which will subsequently prevent full movement of the finger. And even a slight displacement of the fragments can significantly complicate the function of the finger.

I want to talk about an interesting case of treatment of an improperly healed fracture of the base of the middle phalanx of the finger.

We previously communicated with the patient by email, so to describe the situation I will use a quote from the correspondence:

The injury occurred in November 2021 (with a sharp jerk of the finger to the left by a hooked leash), they applied cold and went to the emergency room, where they took a picture

They put a cast on (three fingers together, broken in the middle), recommended taking a control x-ray on the seventh day and sent me to a surgeon. The surgeon was concerned, so to speak, about the appearance of the finger joint, prescribed Nimulid gel and referred me to an orthopedist at a regional hospital. I used Nimulid only a few times, since the skin came off immediately (maybe after the plaster) and, as it turned out, there were contraindications. While I was waiting for the appointment date with the orthopedist, the swelling of the finger in the joint area decreased (I only shone the bioptron). The orthopedist looked, listened and said: “What you wanted, now it will happen. If you climb there you can make it even worse. Develop, but don’t overdo it.” Of course, no one wants things to get worse. I developed it, convincing myself that aesthetics, in this case, is not the most important thing, but since some aspects of the condition of my finger bothered me, I looked through information on the topic on the Internet, where I found handclinic.pro.

And this is what worries me: Of course, the finger does not bend into a fist, but, as I understood the doctor, that is why it is necessary to develop the finger, and some pain when developing after a fracture is natural, but: - the axis of direction of the finger is very clearly changed - when bending inside a slight click is often felt on the finger - the finger hurts at rest (tolerable, but constant); - the finger hurts severely if you were carrying something weighty in your hand and let go, or if you worked with your hands (held or pulled while holding it with your hand); -it can be painful to squeeze the joint of the injured finger above and below with the fingers of the other hand (when rubbing) -it hurts when sharply but lightly touching the finger, shaking (even clapping the left palm)

The initial image shows a fracture of the middle phalanx of the 4th finger with several fragments displaced relative to each other. The main point: the integrity of the articular surface is compromised, which means that painless movements in the joint cannot be expected in this state of affairs. Such a fracture without surgery had no chance of good function after healing.

More detailed complaints six months after the fracture upon completion of the rehabilitation course:

If the hand is at rest, there is a pulling sensation in the finger somewhere from the middle of the palm, as if it is heavier than the rest, or as if stiff, this does not bother, it is just noticeable. When vibrating, shaking a finger, it hurts from slightly to very much, for example, if you touch something with your hand (not hit, but lightly) - get caught on clothes, hand in hand, furniture - it already hurts, I wince, but tolerable. My husband suddenly took my hand - I screamed, there was sharp pain. Holding a weighty object (salad bowl, book) in your hand (4 fingers at the bottom, big at the top) hurts, I immediately grab it with my other hand. I unclench my fist after I bring the bag from the store and have to endure it for a couple of minutes until the pain subsides - although the load seems to be greater on the other fingers, and it didn’t hurt to carry it. At the same time, bending and unbending a finger hurts only if you try to do it with effort, further than he can do. Yes, and when bending into a fist, a slight click is felt in the joint (like in the joint of the middle phalanx, but also in the metacarpophalangeal joint). And another point raises a question - the finger in the area of the joint of the first phalanx has become thinner than before the injury, as if the finger is flattened, and in this joint the finger does not straighten on its own (with help you can straighten it, but it seems to be not controlled).

There are many different situations that can be described when the pain reminds you that the finger is injured and can’t do everything it could before, but the pain is not “to the point of tears” or short-term, and it is certainly possible to adapt to the inferiority of the left hand. Only I need to know and understand the situation, in case something can or even needs to be done. At the moment, I don’t even quite understand what exactly hurts in my finger - either the injured joint, or the first one, or the entire phalanx... if you hit this particular finger, then your vision generally goes dark from the sensations.

This is what the finger looked like on x-ray six months after the injury. We see fusion of the fragments, a straight, even axis of the phalanx, but the disruption of the articular surface remains.

My choice to repair this injury was an osteochondral block graft from the hamate bone.

In the English-language literature, this technique is called hemihamate arthroplasty. I first saw this operation in Baltimore at the Curtis National Hand Center. The detailed operation scheme is available HERE

To be honest, my first experience with this manipulation was unsuccessful, but later I managed to take into account all the shortcomings and get a good result.

The essence of the operation is to take a block of bone with cartilage from the wrist and install it in a specially prepared bed at the base of the middle phalanx.

The main difficulties are as follows:

It is necessary to accurately localize the place where the block is taken and take a fragment slightly larger than it may be needed. For the fence, you must use a special mini-oscillating saw with the narrowest and thinnest blade.
Access to the joint looks very traumatic and difficult, but in fact it is performed without any particular difficulties; local anesthesia provides quite good pain relief for this manipulation. The picture compares opening the joint to reloading a gun (shotgun approach).
On the articular surface, using the same narrow and thin saw, it is necessary to very carefully prepare a chair-shaped bed for the osteochondral graft.
To fix the block, you need screws 1-1.2 mm in diameter; finding such ones was not easy. 1.5 mm lead screws are too thick for this operation. Knitting needles are definitely not suitable, because... full active movements are required immediately after surgery.

The photo shows the crushed articular surface of the middle phalanx, and then the installed bone block, fixed with two screws. This bone block is ideal for the base of the middle phalanx; it has a prominence in the middle that fits perfectly into the notch between the condyles of the proximal phalanx.

This is what the post-op pictures look like. It is necessary to insert screws across the entire width of the bone, but without extending beyond the dorsal cortical layer. The direction should be kept close to parallel to the articular surface.

After surgery, no immobilization can be performed. Active flexion and extension are required to avoid problems with flexor profundus gliding. The stitches are removed after 14 days.

Here is a review 3 months after surgery:

I feel terribly sorry for myself and my finger, although I understood that it would no longer be as good as new, but to understand one thing, but to survive, it turned out, was another. At least for me (in terms of the inner crybaby). I thought that I could handle it better, I didn’t want to send you a letter of panic, but even today it’s still hard to give a substantive report, it looks like I need to take the glycinny one)))

I perform all the actions that I could not do with my hand before the operation because of pain in the finger, I only feel slightly painful when I try to fully bend it and immediately straighten it completely and vice versa, but the pain is not sharp and goes away immediately.

The set of rehabilitation exercises that the doctor showed me at the handclinic began slowly - now I perform it much more actively, the strength in the finger is almost on par with the rest, plus the steering wheel (a good compression trainer), plus briefcases - I use my hand actively, even the muscle of the left forearm is already aligned with the right one, otherwise I compared them in August by accident, I was quite surprised at how weak my left arm was in six months after the fracture).

And the moral of this whole story is this: even if after the initial treatment you are not satisfied with the result, this does not mean that the situation is irreparable.

Why does my arm hurt after a fracture when the cast is removed?

Sometimes the cause of pain both during the period of wearing a cast and after its removal is improper fusion of bone fragments . A doctor can diagnose it using examination, palpation and x-rays.
Another case is serious damage to nerve structures . For example:

if your arm hurts for a long time after a fracture of the humerus or radius, there is a possibility of damage to the radial, ulnar and/or median nerve;
If your hand hurts after a fracture of the wrist/wrist joint, there is probably a disorder of the ulnar nerve and the trunk of the median nerve, from which the motor nerves of the hand diverge.

In elderly patients, after a fracture, the arm often hurts severely for a long time due to age-related muscle atrophy - sarcopenia . Therefore, strengthening muscles is of paramount importance for them.
Another cause of debilitating and prolonged pain may be impaired or delayed healing of the fracture . Bone formation processes worsen with hormonal deficiency, deficiency of vitamins and other nutrients, and some infections. Also, treatment errors: insufficient alignment of bone fragments, weak fixation and frequent changes of plaster casts prevent full fusion.

A fracture is called non-united if, after two standard periods usually required for healing of the injury, pain and mobility are detected at the junction of the fragments, and a gap is visible on the x-ray. If the cavity is overgrown with superficial plates, we are talking about the occurrence of a false joint at the fracture site.

After a fracture, your arm hurts: what to do?

It is possible to competently deal with pain from a broken arm only by accurately establishing its causes. 1. Immediately after the injury and in the first days after it, it is appropriate to take analgesics and NSAIDs , which are mentioned above. However, their long-term use is undesirable due to a wide range of side effects on the cardiovascular, digestive system and liver. Ointments and gels will help reduce the dosage of painkillers.

So, your arm hurts after a fracture, what should you apply? In action are:

external warming agents (including those based on bee and snake venoms), which activate blood circulation in the fracture zone, which helps reduce inflammation and stimulate regeneration, however, such ointments and gels should not be used immediately, on the first or second day after injury;
cooling external agents that reduce sensitivity to pain; they can be used already on the day of injury.

When a hand in a cast hurts very badly after a fracture and there are symptoms of circulatory disorders and necrosis, you need to immediately consult a doctor . If you cannot get quick help from a specialist, you should carefully remove the bandage yourself and wait for medical help.
If the fracture heals incorrectly, surgery is indicated . If surgical measures are not taken, the pain may become lifelong, and the functions of the limb will never be fully restored.
If nerve structures are damaged, a neurologist may prescribe conservative therapy (B vitamins, vascular drugs, thioctic acid, physiotherapy, exercise therapy). If it is ineffective within 2–3 months, the patient may be offered neurosurgical intervention .
In case of muscle weakness, the emphasis during the rehabilitation period should be on exercise therapy, massage, physiotherapy and taking drugs that have a safe anabolic effect.
A non-union fracture requires elimination of the cause of the disorder in reparative osteogenesis. For endocrine problems, correction of hormonal status . If there is a lack of nutrition - providing the body with all the minerals, vitamins, amino acids, etc. necessary for bone formation. If there is an acute or chronic infection that prevents bone regeneration, its immediate treatment is required. In case of formation of a false joint, surgery .

How long does a bone hurt after a fracture?

Why a bone hurts after a fracture was discussed above. It is also important to understand how much the bone hurts after a fracture and in what time frame this clinical symptom should completely disappear.

So, the fracture heals within 40–60 days, depending on the complexity and location. There are four stages to this process:

the first is that in the area of violation of bone integrity, blood accumulates and fibrin protein settles - it is the main material that restores tissue integrity;
second – fibrin is compacted, a soft scar frame is created, which subsequently ossifies and turns into callus;
third - osteoclasts and osteoblasts settle in large numbers in the fibrous scar, the callus becomes hard and connects the fragments;
fourth – the blood supply and innervation of the limb below the fracture site is restored.

Pain in the first stage is always associated with an inflammatory reaction. At the second, third and fourth stages, pain is a symptom of damage to the nerve fiber or vascular bed.

Only an experienced doctor can determine the reason why a bone hurts for a long time after a fracture. During the examination, diagnostic functional tests are performed. They help identify post-traumatic compression or tunnel syndrome, impaired blood microcirculation with subsequent necrosis of soft tissues.

For example, if the patient had a fracture of the tibia or fibula of the leg and after removing the cast, acute pain persists, then the doctor measures the pulse wave on the inner bend of the foot. If the pulsation on the affected limb is reduced, then we can say that during the process of tissue fusion the main blood vessels were damaged. The second examination concerns tendon reflexes. If the intensity of their manifestation decreases, the doctor may suspect a disturbance in the conduction of the nerve fiber.

It is important to exclude post-traumatic dysfunction of the tendon, ligament and muscle apparatus. It is important to understand that prolonged immobilization of a limb during a fracture leads to:

disruption of microcirculation processes of blood and lymphatic fluid in the area of the fracture and below it;
decreased elasticity of tendon and ligament tissue - it subsequently contracts and does not allow full movement of the limb;
contractures with limited mobility are formed in the conjugate joints;
muscles lose tone, become sluggish and unable to perform certain movements.

All of these factors can cause soreness after the cast is removed. In order to eliminate the negative consequences, an individually developed rehabilitation course is needed.

How to speed up recovery after a fracture?

So, most patients normally have pain in their arm after a fracture for 2–3 months after the injury with a gradual fading of the pain syndrome. In case of complications, this symptom can darken the patient’s life for much longer. The general pattern is this: the faster and better the healing of a bone injury, the sooner the pain will subside.

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Osteomed Forte will be an excellent solution to speed up the healing process for those who have bone pain after a fracture or have bone fragility (osteoporosis or osteopenia). According to clinical studies, this drug accelerates the formation of callus by 2 weeks, and the overall healing time of fractures by one to one and a half weeks.

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