Having a broken bone is a painful injury in and of itself, and a cast may be necessary to heal the bone and keep it immobilized. The cast can cause discomfort while it is on, as well as after it is removed, due to inflammation, and the pain can impede rest and healing. This pain can be caused by a number of reasons, such as blood clots, swelling, or an indication of soft tissue damage. It is important to determine the reason to provide proper treatment. While the length the cast must be on varies due to the type and severity of the broken bone, there are ways to alleviate the pain, both during and after (Ref. 1, Paragraph 2). Pain management allows for rest, which helps the bone heal properly. (Ref. 2, paragraph
Pain While the Cast is On
If the broken bone is immobilized with a plaster or fiberglass cast, there can still be pain during the healing process. Swelling due to poor circulation can cause pain. While the cast is on, this pain may be alleviated by elevating the affected area above the heart to increase circulation. If you can wiggle your fingers or toes outside of the cast, this also helps to increase blood flow and decrease swelling. As swelling around the broken bone goes down, the cast may need to be changed to better fit the treated area. In order to help the bone heal, you will be asked by your doctor not to bear weight on the injured area.
Pain After Cast Removal
The cast is removed by a special cast saw, and should not cause any pain in the process, but has a slight vibration. (Ref 1, cast removal). After the cast is removed, the area will be stiff and tender, due to being immobilized. (Ref 2, activity). The surrounding muscles will have atrophied, due to inactivity, and are weak and can become easily tired. The cast is not removed until it is determined by an x-ray that the bone is fully healed. Just because the bone is healed does not mean there may not be further tissue, nerve, or muscle damage that may need to be addressed for healing. (Ref 3, cause). Pain can be alleviated by elevation, ice, movement, and by taking a non-steroidal anti-inflammatory medication.
Care After the Bone is Healed
It is important not to return to regular activities too quickly, to allow full mobility and strength to be restored. Your doctor or physical therapist will work with you to help strengthen and restore mobility to the area at this time. Anti-inflammatories like Ibuprofen can help alleviate pain due to exercise soreness or tenderness.
Pain Indicating Complications
It is important to keep a watch on the injured area for a pain that goes beyond normal healing, and can indicate infection or damage to the surrounding fascia to the bone. If the skin around the cast becomes irritated or red, contact your physician. If itching occurs, it could just be dryness of the skin, or may indicate an infection. Do not put any objects into the cast to handle the itching, but contact your physician if itching continues. If there is increased swelling, discoloration or your toes or fingers become numb, this may indicate infection and see your physician immediately.