Health Library Arm InjuriesFrom Healthwise

Minor arm injuries are common. Symptoms often develop from everyday wear and tear, overuse, or an injury. Arm injuries are often caused by:

• Sports or hobbies.
• Work-related tasks.
• Work or projects around the home.

Your child may injure his or her arm during sports or play or from accidental falls. Chances of having an injury is higher in contact sports, such as wrestling, football, or soccer, and high-speed sports, such as biking, in-line skating, skiing, snowboarding, and skateboarding. Forearms, wrists, hands, and fingers are the injured most often. An injury to the end of a long bone near a joint may harm the growth plate and needs to be checked by a doctor.

Older adults have a greater chance for injuries and broken bones because they lose muscle mass and bone strength (osteoporosis) as they age. Older adults also have more problems with vision and balance, which increases their chances of having an accidental injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve symptoms and promote healing.

Acute injuries

Acute injuries come on suddenly and may be caused by a direct blow, a penetrating injury, or a fall or from twisting, jerking, jamming, or bending a limb abnormally. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries usually require prompt medical evaluation and may include:

• Bruises (contusions), which occur when small blood vessels under the skin tear or rupture, often from a twist, bump, or fall. Blood leaks into tissues under the skin and causes a black-and-blue color that often turns purple, red, yellow, and green as the bruise heals.
• Injuries to the tough, ropelike fibers (ligaments) that connect bone to bone and help stabilize joints (sprains).
• Injuries to the tough, ropelike fibers that connect muscle to bone (tendons).
• Pulled muscles (strains).
• Muscle ruptures, such as a biceps or triceps rupture.
• Broken bones (fractures). A break may occur when a bone is twisted, struck directly, or used to brace against a fall. See a picture of a fractured arm.
• Pulling or pushing bones out of their normal relationship to the other bones that make up a joint (dislocations).

Overuse injuries

Overuse injuries occur when stress is placed on a joint or other tissue, often by "overdoing" an activity or repeating the same activity. Overuse injuries include:

• Pain and swelling of the sac of fluid that cushions and lubricates the joint area between one bone and another bone, a tendon, or the skin (bursitis).
• Pain and swelling of the tough, ropelike fibers that connect muscles to bones (tendinitis).
• Pain and swelling from tiny tears (microtears) in the connective tissue in or around the tendon (tendinosis). Other symptoms of this type of tendon injury include loss of strength or movement in the arm.
• Hairline cracks in bones of the arm (stress fractures).
• Pressure on nerves in the arm, such as carpal tunnel syndrome.

Treatment

Treatment for an arm injury may include first aid measures (such as using a brace, splint, or cast), "setting" a broken bone or returning a dislocated joint to its normal position, physical therapy, medicines, and in some cases surgery. Treatment depends on:

• The location, type, and severity of the injury.
• When the injury occurred.
• Your age, health condition, and activities (such as work, sports, or hobbies).

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• Signs of shock occur:
  • In children.
  • In adults and older children.
• Severe bleeding does not slow during the first 15 minutes of steady direct pressure.
• Any part of your arm is partially or completely cut off.
• You can see pieces of bone in a wound, or a bone is sticking through the skin. Do not try to push the bone back into the skin. Cover the area with a clean bandage.

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Bleeding: Go to the topic Cuts or Puncture Wounds.
• A burn on your arm: Go to the topic Burns.
• An injury to your elbow: Go to the topic Elbow Injuries.
• An injury to your hand: Go to the topic Finger, Hand, and Wrist Injuries.
• An injury to your shoulder: Go to the topic Shoulder Problems and Injuries.

	Yes	Is your arm twisted, bent out of shape, or out of its normal position after an injury?
When to See a Doctor See significance of an arm that is twisted, bent out of shape, or out of its normal position if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you think you have broken or dislocated a bone in your arm, use a splint to keep your arm from moving. Keep your arm propped up and supported while someone takes you to the doctor. Do not try to drive. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Does your arm look twisted, bent out of shape, or out of its normal position? Yes Do you have a cut, scrape, or puncture wound on your arm and think you may have broken or dislocated the bone under it? Call your health professional today if you answer "Yes" to the following question. Yes Did your arm pop, move, or get pulled out of its normal position and then return to its normal position? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Did you feel or hear a snap or pop when you injured your arm?
When to See a Doctor See significance of feeling or hearing a snap or pop if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Note: If you think you have broken or dislocated a bone in your arm, use a splint to keep your arm from moving. Keep your arm propped up and supported while someone takes you to the doctor. Do not try to drive. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Has your arm become very swollen within 30 minutes after the injury? Yes Does your arm look twisted, bent, or out of its normal position? Yes Are you unable to move your arm normally? Call your health professional today if you answer "Yes" to the following question. Yes Did you feel or hear a snap or pop when you injured your arm, but your arm looks, feels, and moves normally? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Does your arm look pale, white, or blue, or feel cold after an injury?
When to See a Doctor See significance of pale, white, blue, or cold skin after an injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Does your arm look pale, white, or blue, or feel cold below the injured area? Yes Do your fingers or hand look pale, white, or blue, or feel cold after having a brace, cast, or splint applied? Note: See care for a cast or splint. If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have numbness or tingling in your hand or arm after an injury?
When to See a Doctor See significance of numbness or tingling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have new numbness or tingling and the skin on the injured arm looks more pale, white, or blue, or feels colder than your other arm? Yes Are you unable to move your arm normally (not because a splint is in the way or because of pain)? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had steady numbness or tingling in your arm or hand, without other symptoms, for 1 hour or longer? Yes Is numbness or tingling getting worse? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Have you had numbness or tingling that comes and goes for 24 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Are you having trouble moving your arm normally after an injury?
When to See a Doctor See significance of inability to move an arm normally after an injury if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Are you unable to move your arm? Yes Do you have severe pain? Yes Are you unable to move your arm normally after having a brace, cast, or splint applied (not because the splint is in the way)? Note: See care for a cast or splint. Yes Is a young child carefully protecting or refusing to use his or her arm? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Are you still having trouble moving your arm normally after 48 hours of home treatment? Yes Do you have decreased strength in your arm after 48 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Is your arm painful or tender after an injury?
When to See a Doctor See significance of pain or tenderness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have severe pain? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have moderate pain that is getting worse? Yes Is a young child carefully protecting or refusing to use his or her arm? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Do you have moderate pain that has not gotten better after 24 hours of home treatment? Yes Do you have mild pain when you move or lift your arm after 48 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have swelling after an arm injury?
When to See a Doctor See significance of swelling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Does the skin below the swollen area feel cold or look white? Call your health professional today if you answer "Yes" to the following question. Yes Has your arm become very swollen within 30 minutes after an injury? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you have moderate swelling after 48 hours of home treatment? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you think that an arm injury may have been caused by abuse?
When to See a Doctor See significance of abuse if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have an arm injury because someone hurt you? Yes Do you think that another person's arm injury may have been caused by abuse? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have signs of infection?
When to See a Doctor See significance of signs of infection if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have diabetes? Yes Do you have peripheral arterial disease? Yes Do you have a disease or take medicine that causes problems with your immune system? Yes Do you have red streaks extending from the injured area? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have increased pain, swelling, redness, or warmth around the injured area? Yes Do you have pus in or around the injured area? Yes Do you know or think you have a fever? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Have you had mild pain and swelling with redness of less than 1 in. (2.5 cm) around the injured area for 24 hours or longer? Yes Have you had swollen glands (lymph nodes) in your elbow or armpit for 48 hours or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Is your arm bruised after an injury?
When to See a Doctor See significance of bruising if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional today if you answer "Yes" to the following question. Yes Do you have a large (the size of the injured person's palm), painful, swollen bruise within 30 minutes of an injury? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Are you worried about how easily you bruise? Yes Have bruises from an injury lasted longer than 2 weeks? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

Do you have any of the following symptoms?

• An arm problem not related to an injury: Go to the topic Arm Problems, Noninjury.
• Bites: Go to the topic Animal and Human Bites.
• Bruises: Go to the topic Bruises and Blood Spots Under the Skin.
• Scrapes: Go to the topic Scrapes.
• A sunburn: Go to the topic Sunburn.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

First aid for a suspected broken bone

• Control bleeding.
• Remove all bracelets and rings. It may be difficult to remove the jewelry if your arm or hand swells. Swelling without removal of jewelry can cause other serious problems, such as nerve compression or restricted blood flow. See a picture of removing a ring that is stuck.
• Do not try to straighten the injured arm. If a bone is sticking out of the skin, do not try to push it back into the skin. Cover the area with a clean bandage and use a splint to support the arm in its current position.
• Splint an injured arm to protect it from further injury. Loosen the wrap around the splint if you have numbness, tingling, increased pain, swelling, cool skin, or other symptoms. The wrap may be too tight.
• Use a sling to support the injured arm.

Cast and splint care

If your arm is in a cast or splint, your doctor will give you instructions on how to care for your cast or splint. Try to move the uninjured parts of your arm as normally as possible to help maintain muscle strength and tone.

Home treatment for a minor injury

If you have a minor injury and do not need to be checked by a doctor, you may be able to use home treatment to help relieve pain, swelling, and stiffness.

• Rest and protect an injured or sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
• Ice will reduce pain and swelling. Apply ice or cold packs immediately to prevent or minimize swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times a day.
  • For the first 48 hours after an injury, avoid things that might increase swelling, such as hot showers, hot tubs, hot packs, or alcoholic beverages.
  • After 48 to 72 hours, if swelling is gone, apply heat and begin gentle exercise with the aid of moist heat to help restore and maintain flexibility. Some experts recommend alternating between heat and cold treatments.
• Compression, or wrapping the injured or sore area with an elastic bandage (such as an Ace wrap), will help decrease swelling. Don't wrap it too tightly, since this can cause more swelling below the affected area. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage. Talk to your health professional if you think you need to use a wrap for longer than 48 to 72 hours—a more serious problem may be present.
• Elevate the injured or sore area on pillows while applying ice and anytime you are sitting or lying down. Try to keep the area at or above the level of your heart to help minimize swelling.
• Remove rings, bracelets, watches, or any other jewelry from your hand and arm. It will be more difficult to remove the jewelry later if swelling increases.
• Wear a sling for the first 48 hours after the injury if it makes you more comfortable and supports the injured area. If you feel you need to use a sling for more than 48 hours, discuss your symptoms with your health professional.
• Gently massage or rub the area to relieve pain and encourage blood flow. Do not massage the injured area if it causes pain.
• Do not smoke or use other tobacco products. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Tobacco Use.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Pain or swelling develops.
• Symptoms of infection develop.
• Numbness, tingling, or cool, pale skin develops.
• Symptoms do not improve with home treatment.
• Symptoms become more severe or more frequent.

The following tips may prevent arm injuries.

General prevention tips

• Wear your seat belt.
• Don't carry objects that are too heavy.
• Use a step stool. Do not stand on chairs or other unsteady objects.
• Wear protective gear during sports or hobbies, such as roller-skating or soccer. Supportive splints, such as wrist guards, may reduce your risk for injury.
• Warm up well and stretch before any activity. Stretch after exercise to keep hot muscles from shortening and cramping.
• Use the correct techniques (movements) or positions during activities so that you do not strain your muscles.
• Try not to overuse your arm doing repeated movements that can cause an injury. In your daily routines or when doing hobbies, look at how often you make repeated arm movements. Try to find other ways of using your arms.
• Take lessons to learn how to do sports correctly. Have a trainer or person who is familiar with the sport check your gear to make sure it is right for your level of ability, body size, and body strength.
• If you think that something you do at work is causing pain or soreness from overuse, call your human resources department for information on other ways of doing your job or to discuss equipment modifications or other job assignments.

Reduce falls

• Make your home safe to reduce the chances of falls.
• Keep your baby or toddler safe from falls.

Keep your bones strong

• Eat healthy foods such as milk, cheese, yogurt, and dark green, leafy vegetables like broccoli. For more information, see the topic Healthy Eating.
• Exercise and stay active. Talk to your doctor about an exercise program that is right for you. Begin slowly, especially if you have been inactive. For more information, see the topic Fitness.
• Don't drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink a day if you are a woman. Drinking alcohol increases your chances of having weak bones (osteoporosis). It also increases your chances of falling.
• Do not smoke or use other tobacco products. Smoking increases your chances of having osteoporosis. It also causes problems with the blood supply in your arms and slows healing. For more information, see the topic Quitting Tobacco Use.
• Cut down on caffeine. Caffeine in coffee and soda pop may increase calcium loss from your body and put you at risk for osteoporosis.

Possible abuse

Arm injuries such as bruises, burns, fractures, cuts, or punctures may be caused by abuse. Suspect possible abuse when an injury cannot be explained or does not match the explanation, repeated injuries occur, or the explanations for the cause of the injury change. You may be able to prevent further abuse by reporting it and seeking help.

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your health professional diagnose and treat your condition by being prepared to answer the following questions:

• What are your main symptoms?
• How long have you had your symptoms?
• How and when did an injury occur? How was it treated?
• Have you had any injuries in the past to the same area? Do you have any continuing problems because of the previous injury?
• What activities, related to sports, work, or your lifestyle, make your symptoms better or worse?
• Do you think that activities related to your job or hobbies caused your symptoms?
• What home treatment measures have you tried? Did they help?
• What nonprescription medicines have you tried? Did they help?
• Were alcohol or illegal drugs involved in your injury?
• Do you have any health risks?

• Animal and Human Bites
• Arm Problems, Noninjury
• Bruises and Blood Spots Under the Skin
• Burns
• Bursitis
• Cuts
• Elbow Injuries
• Finger, Hand, and Wrist Injuries
• Puncture Wounds
• Quitting Tobacco Use
• Scrapes
• Shoulder Problems and Injuries
• Tennis Elbow

Author:	Jan Nissl, RN, BS	Last Updated: July 28, 2008
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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