When you experience a fall and land on your arm, the immediate onset of pain and difficulty with movement can be alarming. While some arm injuries might be minor and heal with simple home care, others can be more serious and require professional medical attention. Understanding the potential types of injuries and appropriate steps to take can help manage the situation effectively.
Types of Arm Injuries
Falls can lead to several types of arm injuries. Sprains involve the stretching or tearing of ligaments, which are the fibrous bands connecting bones at a joint. A wrist sprain can occur when landing on an outstretched hand, forcefully moving the wrist in an unnatural direction. Symptoms often include pain, swelling, bruising, and limited ability to move the affected joint.
Strains, often called pulled muscles, are injuries to muscles or tendons, the tissues that connect muscles to bones. These can range from a slight tear in muscle fibers, causing tenderness and mild pain, to a complete tear resulting in severe pain, significant bruising, and loss of movement. Strains cause sudden pain, soreness, and sometimes muscle spasms.
Fractures are another common injury from falls. The distal radius, located near the wrist, is the most frequently broken bone in the arm, often occurring when falling onto an outstretched hand. Fractures can present as severe pain, swelling, bruising, and a visible deformity in the arm. Children may experience specific types like buckle (torus) or greenstick fractures, where the bone partially breaks.
Dislocations happen when bones are forced out of their normal alignment at a joint. The shoulder is the most frequently dislocated joint, while elbow dislocations also occur, often from falling on an outstretched arm. Symptoms include intense pain, a visibly deformed or out-of-place joint, swelling, bruising, and an inability to move the arm. Dislocated shoulders can also cause numbness, weakness, or tingling in the arm or hand due to potential nerve involvement.
When to See a Doctor
Seek medical evaluation for an arm injury to ensure proper healing and prevent complications. If you experience severe pain that does not lessen over time, or if there is a noticeable deformity in the arm, seek medical attention. Visible swelling or significant bruising that appears rapidly after the fall also indicates a potentially serious injury.
An inability to move the arm, bend a joint, or bear any weight on it signals a need for immediate care. If you feel numbness, tingling, or a sensation of coldness in your hand or fingers, this could indicate nerve or circulation issues. Any instance where a bone is protruding through the skin is a medical emergency, and you should not attempt to push the bone back in.
Hearing or feeling a distinct “pop” or “grinding” sound can also suggest a more severe issue, such as a fracture or a complete ligament or muscle tear. If your pain worsens instead of improving after initial home care, or if swelling does not subside within 1-2 days, consult a healthcare provider. For children, any injury to the end of a long bone near a joint should be checked by a doctor, as it might affect growth plates.
Immediate Care at Home
For arm injuries not requiring immediate medical intervention, applying the R.I.C.E. protocol can help manage pain and swelling. Rest involves avoiding movement of the injured arm to allow healing, resting the affected area for 24 to 48 hours before gradually resuming activity.
Applying ice to the injured area helps reduce pain by numbing the affected nerves and minimizes swelling and internal bleeding from torn blood vessels. Use a cold pack or ice wrapped in a towel for 15 to 20 minutes at a time, every 2 to 3 hours. Never apply ice directly to the skin, as this can cause frostbite.
Compression helps control swelling by applying gentle pressure to the injured area. An elastic bandage, such as an Ace wrap, can be used, ensuring it is snug but not overly tight to avoid restricting blood flow. Signs that a bandage is too tight include numbness, tingling, increased pain, coolness, or discoloration in the area below the wrap.
Elevation involves keeping the injured arm raised above the level of your heart. This utilizes gravity to help drain fluids away from the injured site, reducing swelling and associated pain. You can use pillows or cushions to prop up the arm while sitting or lying down, elevating it as often as possible during the first two days. Over-the-counter pain relievers such as ibuprofen or acetaminophen can also help manage pain and reduce inflammation.
Medical Diagnosis and Treatment
When seeking professional medical help for an arm injury, the diagnostic process begins with a physical examination. The healthcare provider will assess your range of motion, check for any visible deformities, and gently feel the injured area for tenderness or swelling. To determine the extent of the damage, imaging tests are commonly used.
X-rays are the initial diagnostic tool, as they are effective at visualizing bones and detecting fractures, dislocations, and bone abnormalities. While X-rays provide clear images of bone structures, they are less effective for assessing soft tissues like muscles, ligaments, and tendons. If an initial X-ray is negative but a fracture is still suspected, repeat X-rays may be performed in 7 to 14 days.
Magnetic Resonance Imaging (MRI) is used for evaluating soft tissue injuries, including ligament tears, tendonitis, and muscle damage. MRI uses powerful magnets and radio waves to create detailed images of both bones and soft tissues, offering detailed visualization of structures. This imaging can detect subtle injuries like bone bruises or stress fractures that might not be visible on X-rays. In more complex cases, or when a quicker assessment is needed, a Computed Tomography (CT) scan may be used, which provides detailed cross-sectional images and can assess complex fractures and bone tumors.
Treatment options vary based on the type and severity of the injury. For fractures and severe sprains, immobilization is necessary to allow the injured area to heal properly. This can involve using slings to support the arm, splints to stabilize the joint while accommodating swelling, or casts for more rigid support to prevent movement of fractured bones. Pain management may include over-the-counter medications or prescription pain relievers for more severe discomfort.
Physical therapy and rehabilitation are important for regaining strength, flexibility, and range of motion after an injury. These therapies involve guided exercises to restore normal function and prevent stiffness in the joints. In cases of severe fractures, complete ligament or tendon tears, or dislocations that cannot be manually reduced, surgical intervention may be considered. Following all medical advice, including adherence to immobilization periods and participation in rehabilitation, is important for recovery.