If a person experiences pain or discomfort from a cast rubbing on their skin, they should contact a healthcare professional. This irritation requires medical attention.
It is typical for someone to feel some movement of a cast against the skin as the body moves. This is because the skin is flexible, and the cast is rigid. This type of movement should not hurt.
However, if the cast rubs the skin in an abrasive manner that causes pain, it is advisable to take action. This is usually a sign that the cast needs to be adjusted or replaced by a medical professional. If a person is only experiencing minor discomfort, they may be able to manage it at home.
Read on to learn more about why casts cause pain, how to manage it, and when to contact a doctor.
Some pain during the first few days of wearing a cast is typical. A person may also be experiencing pain related to the injury, such as soreness and bruising from a broken bone.
The affected area will also swell at first, making the cast feel snug and even a bit painful. This is typical and called the inflammatory phase of a broken bone.
A person can help manage the swelling and lessen the pain by:
- elevating the casted limb
- applying ice to the area
- gently exercising the joints not covered by the cast, such as the elbow, knee, fingers, or toes — if permitted
The swelling usually subsides within several days. If pain continues or worsens after the initial period, a complication with the cast may need attention, so a person should contact a healthcare professional.
If a cast is rubbing on the skin, the fit of the cast may need adjustment. This can happen because the cast is not fit exactly right or because pressure points develop.
A cast can also become too loose once the initial swelling decreases. If a cast is too loose, a person may experience uncomfortable rubbing.
It is important not to try to adjust one’s cast by pulling on it or adjusting the padding inside. A cast that does not fit properly should be corrected by a healthcare professional. Therefore if a person is having issues with their cast, they should seek medical advice.
If the cast is rubbing on the skin and causing someone pain, it is usually time to contact a healthcare professional. Although there are ways to make a cast more comfortable, a cast that causes pain or skin irritation requires medical attention.
Any useful home care specifically for cast rubbing pain is more a matter of what to avoid doing:
- Itching: After the first few days, if the cast is rubbing against the skin and making it itch, a person should resist the temptation to poke objects such as coat hangers or cotton swabs inside to scratch the itch. This may damage the skin or cause an infection.
- An object in the cast: If anything gets stuck inside the cast, it may rub on the skin and cause irritatation. People should contact a healthcare professional and refrain from getting the debris out themselves.
- Rough edges of the cast: A person should not break off or trim any cast edges if they are rubbing against the skin. They should not try to push or pull the cast, as this might weaken it or change the fit.
- Inflamed skin: People should not apply any products in or near the cast if it rubs the skin. The product could get under the cast and cause issues with moisture.
- Padding: A person should not alter or add further padding. This might change the cast’s fit or make it less effective.
The American Academy of Orthopaedic Surgeons (AAOS) recommends these basic cast care tips:
- Keeping the cast dry: It should not get wet unless it is waterproof. A cast or lining that remains wet for too long against the skin can lead to serious issues such as skin maceration, infection, or a weakened cast.
- Inspecting the cast: Examine the cast daily for soft spots, cracks, or breakage.
- Checking the skin: Look for any irritation, chafing, or sores in the skin around the cast.
- Noting an unpleasant smell: Casts get to smelling musty in time, but a bad smellinside the cast could mean an infection.
- Checking for bleeding: Check for any blood or sense of wetness inside the cast.
- Keeping it clean: Avoid getting dirt or sand inside a cast.
- Keeping it whole: If the cast gets damaged, it is ineffective, and a healthcare professional will need to replace it.
People should not hesitate to seek medical advice about an issue with the cast — waiting will only worsen any issues.
It is also important to note that having an issue with a cast is common. In a 2022 study, 97.5% of participants experienced at least one complication with their casts.
The AAOS recommends contacting a medical professional immediately if these symptoms develop:
- Continuing or worsening pain: Pain past the initial period, especially if it worsens, may be a sign of an ill-fitting cast, infection, sores, or other issues.
- The cast feels too tight: A feeling of tightness past the first few days may indicate the cast may need to be adjusted or replaced.
- Numbness or tingling in the extremities: This may signify that the cast is putting pressure on the nerves.
- Burning and stinging feeling under the cast: The cast may put too much pressure on the skin.
- Severe swelling below the cast: The cast may fit incorrectly and affect blood circulation.
- Loss of movement of toes or fingers: This could be an emergency requiring an immediate medical professional consult.
Casts are a standard treatment to immobilize broken bones and allow them to heal. It is typical for a cast to be snug and uncomfortable at first, but if it rubs against the skin and causes pain, it is a good idea for a person to contact a healthcare professional.
A medical professional can resolve most issues that cause a cast to rub on the skin by adjusting or replacing the cast if necessary. Following basic cast care tips and getting prompt medical advice if needed will help promote bone healing and a full return to pre-injury activities.