A cast immobilizes a broken bone or injured joint, allowing the body to repair itself. Casts are typically made from traditional plaster, which is heavier, or modern fiberglass, which is lighter and more durable. The structure provides a rigid layer of protection, but wearing a cast requires mindful adjustments to your routine. Proper care for this medical device is fundamental to ensuring an efficient and comfortable healing period.
Essential Daily Care and Hygiene
Maintaining the structural integrity of your cast and the cleanliness of the surrounding skin is important for recovery. Moisture is the primary threat, as it can weaken plaster or cause padding to harbor bacteria and irritate the skin. When showering or bathing, keep the cast completely dry by covering it with specialized cast covers or heavy-duty plastic bags sealed tightly with waterproof tape. Never submerge the cast underwater, even with protection, as leaks can saturate the padding and necessitate replacement.
Prevent small foreign objects, such as crumbs or dirt, from falling inside the cast, as they can irritate the skin and lead to infection. Do not apply lotions, powders, or deodorants near the cast edges. Check the skin around the cast opening twice daily for signs of redness, chafing, or breakdown; moleskin or soft padding can be applied to rough edges for comfort. If the cast material becomes soiled, a fiberglass cast can be wiped gently with a damp towel, but a plaster cast should not be cleaned with water.
Managing Discomfort and Itchiness
Itchiness is a common side effect of wearing a cast, often caused by dry skin or perspiration trapped beneath the padding. For relief, use a hair dryer on a cool setting to blow air into the ends of the cast to circulate and dry the area. If the itch is localized, gently tapping on the exterior of the cast may provide a sensory distraction. Mild swelling, which causes discomfort, is best managed by elevating the casted limb above the level of your heart, especially during the first 48 to 72 hours after injury.
Avoid sticking any objects, such as rulers or pencils, inside the cast to scratch the skin. Inserting objects can easily break the skin, leading to infection and requiring immediate cast removal. For persistent itching that affects sleep, an over-the-counter oral antihistamine may provide systemic relief, but discuss this with your healthcare provider first. Applying an ice pack wrapped in a thin towel to the exterior of the cast can also help soothe both the itch and mild swelling.
Adapting Mobility and Clothing
Moving around with a cast, particularly on a lower limb, requires a focus on stability and eliminating trip hazards. If using crutches, support your weight with your hands, not your armpits, to prevent nerve damage. When sitting down, back up until you feel the chair with your uninjured leg. Hold both crutches in the hand opposite the injured side, and use the armrest with your free hand to safely lower yourself.
Adapting your wardrobe can significantly reduce frustration when dressing. For an arm cast, always put the casted limb into the sleeve first, and look for oversized, loose-fitting tops or those with front closures like buttons or snaps. For a leg cast, opt for wide-leg pants, shorts, or specialized adaptive clothing that incorporates zippers or snaps along the side to accommodate the bulk of the cast. To sleep comfortably, use several pillows to prop the casted limb, ensuring the heel or elbow is not resting directly on an edge to prevent pressure sores.
Recognizing Signs of Complication
While minor discomfort is common, certain symptoms indicate a serious problem that requires immediate medical attention. Persistent or worsening pain not relieved by elevation or standard pain medication could signal excessive swelling beneath the cast. You should urgently contact your doctor if you experience numbness, tingling, or a burning sensation under the cast, which may signal pressure on the nerves.
Any significant change in the color or temperature of the fingers or toes extending from the cast, such as paleness, blueness, or coldness, indicates a potential circulation issue. Similarly, seek prompt medical advice if you notice excessive swelling in the exposed digits or an inability to wiggle your fingers or toes. A foul odor, draining fluid, or an unexplained spot of wetness on the cast exterior can be a sign of a skin breakdown, pressure sore, or infection beneath the cast material.