Most children have pain after an arm cast comes off. Here are some explanations of why this happens.
Number one cause of pain after the cast comes off
If the fracture has healed, all this means is that the bones have knit together and they are solid and strong.
Most pain after the cast comes off, after the fracture has healed, comes from the joints around the fracture.
Joint pain comes from nerve fibers that supply the joint lining. After six weeks or so of being in the cast, the joint lining is stiff and can’t bend as easily as before the break. When your child moves his wrist or elbow, this stretches the joint lining and causes pain.
This improves very quickly in most situations, sometimes after only a few days. As the child moves her arm and gets used to how it feels out of the cast, the joints become flexible and the joint lining will stretch out and stop aching.
Other causes of pain after cast removal
Sometimes the skin can get irritated inside the cast. Be sure to check for this when the cast comes off. Usually, though, this skin pain is present even before the cast comes off, so it shouldn’t be a brand new pain after the bone has healed.
If the fingers were stiffened by the cast, moving the tendons along with the stiff finger joints can cause some temporary pain.
Encouraging range of motion exercises is important after the cast comes off, especially for older children. Therapy is helpful but rarely necessary after broken arms heal.
In rare situations, a cast can irritate a small skin nerve and cause temporary numbness or a “pins and needles” feeling. Sometimes as the nerve wakes up over several weeks, this can be uncomfortable and feel like a painful sensation.
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