Arm Injury
Definition
Injuries to the arm (shoulder to fingers)
Injuries to a bone, muscle, joint or ligament
Excluded: Muscle pain caused by too much exercise or work (overuse). Covered in Arm Pain.
Types of Arm Injuries
Fractures. Fractures are broken bones. A broken collarbone is the most common broken bone in children. It's easy to notice because the collar bone is tender to touch. Also, the child cannot raise the arm upward.
Dislocations. This happens when a bone is pulled out of a joint. A dislocated elbow is the most common type of this injury in kids. It's caused by an adult quickly pulling or lifting a child by the arm. Mainly seen in 1 to 4 year olds. It's also easy to spot. The child will hold his arm as if it were in a sling. He will keep the elbow bent and the palm of the hand down.
Sprains. Sprains are stretches and tears of ligaments.
Strains. Strains are stretches and tears of muscles (such as a pulled muscle).
Muscle Overuse. Muscle pain can occur without an injury. There is no fall or direct blow. Muscle overuse is from hard work or sports (such as a sore shoulder).
Muscle bruise from a direct blow
Bone bruise from a direct blow
Skin Injury. Examples are a cut, scratch, scrape or bruise. All are common with arm injuries.
Pain Scale
Mild: your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
Moderate: the pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
Severe: the pain is very bad. It keeps your child from doing all normal activities.
When To Call
Call 911 Now
Serious injury with many broken bones
Major bleeding that can't be stopped
Bone is sticking through the skin
You think your child has a life-threatening emergency
Go to ER Now
Can't move the shoulder, elbow or wrist at all
Looks like a broken bone (crooked or deformed)
Looks like a dislocated joint
Large deep cut that will need many stitches
Call Doctor or Seek Care Now
Can't move the shoulder, elbow or wrist normally
Can't open and close the hand normally
Skin is split open or gaping and may need stitches
Cut over knuckle of hand
Age less than 1 year old
Severe pain and not better 2 hours after taking pain medicine
You think your child has a serious injury
You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
Very large bruise or swelling
Pain not better after 3 days
You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
Injury limits sports or school work
Dirty cut and no tetanus shot in more than 5 years
Clean cut and no tetanus shot in more than 10 years
Pain lasts more than 2 weeks
You have other questions or concerns
Self Care at Home
Bruised muscle or bone from direct blow
Pain in muscle from minor pulled muscle
Pain around joint from minor stretched ligament
Minor cut or scrape
Care Advice
What You Should Know About Minor Arm Injuries:
During sports, muscles and bones get bruised.
Muscles get stretched.
Here is some care advice that should help.
Pain Medicine:
To help with the pain, give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
Use as needed.
Small Cut or Scrape Treatment:
Use direct pressure to stop any bleeding. Do this for 10 minutes or until bleeding stops.
Wash the wound with soap and water for 5 minutes. Try to rinse the cut under running water.
Gently scrub out any dirt with a washcloth.
Use an antibiotic ointment (such as Polysporin). No prescription is needed. Then, cover it with a bandage. Change daily.
Cold Pack for Pain:
For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
Put it on the sore muscles for 20 minutes.
Repeat 4 times on the first day, then as needed.
Reason: Helps the pain and helps stop any bleeding.
Caution: Avoid frostbite.
Use Heat After 48 Hours:
If pain lasts over 2 days, put heat on the sore muscle.
Use a heat pack, heating pad or warm wet washcloth.
Do this for 10 minutes, then as needed.
Reason: Increase blood flow and improve healing.
Caution: Avoid burns.
Rest the Arm:
Rest the injured arm as much as possible for 48 hours.
What to Expect:
Pain and swelling most often peak on day 2 or 3.
Swelling should be gone by 7 days.
Pain may take 2 weeks to fully go away.
Call Your Doctor If:
Pain becomes severe
Pain is not better after 3 days
Pain lasts more than 2 weeks
You think your child needs to be seen
Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Arm Pain
Definition
Pain in the arm (shoulder to fingers)
Includes shoulder, elbow, wrist and finger joints
Includes minor muscle strains from hard work or sports (overuse)
Pain is not caused by an injury
Causes of Arm Pain
Muscle Overuse (Strained Muscles). Arm pains are often from hard muscle work or sports. Examples are too much throwing or swimming. They are most common in the shoulder. This type of pain can last from hours up to 7 days.
Muscle Cramps. Brief pains that last 1 to 15 minutes are often due to muscle cramps. These occur in the hand after too much writing or typing.
Viral Illness. Mild muscle aches in both arms also occur with many viral illnesses.
Septic Arthritis (Serious). This is a bacterial infection of a joint space. Main symptoms are fever and severe pain with movement of the joint. Range of motion is limited or absent (a "frozen joint").
Pain Scale
Mild: your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
Moderate: the pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
Severe: the pain is very bad. It keeps your child from doing all normal activities.
When To Call
Call 911 Now
Not moving or too weak to stand
You think your child has a life-threatening emergency
Call Doctor or Seek Care Now
Can't use arm or hand normally
Can't move the shoulder, elbow or wrist normally
Swollen joint
Muscles are weak (loss of strength)
Numbness (loss of feeling) lasts more than 1 hour
Severe pain or cries when arm is touched or moved
Your child looks or acts very sick
You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
Fever is present
Bright red area on skin
You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
Cause of arm pain is not clear
Arm pain lasts more than 7 days
Arm pains or muscle cramps are a frequent problem
You have other questions or concerns
Self Care at Home
Caused by overusing the muscles
Cause is clear and harmless. (Examples are a sliver that's removed or a recent shot)
Care Advice
What You Should Know About Mild Arm Pain:
Strained muscles are common after using them too much during sports.
An example is throwing a ball over and over again.
Weekend warriors who are out of shape get the most muscle pains.
Here is some care advice that should help.
Pain Medicine:
To help with the pain, give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Use as needed.
Cold Pack for Pain:
For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
Put it on the sore muscles for 20 minutes.
Repeat 4 times on the first day, then as needed.
Caution: Avoid frostbite.
Use Heat After 48 Hours:
If pain lasts over 2 days, put heat on the sore muscle.
Use a heat pack, heating pad or warm wet washcloth.
Do this for 10 minutes, then as needed.
Reason: Increase blood flow and improve healing.
Caution: Avoid burns.
What to Expect:
A strained muscle hurts for 2 or 3 days.
The pain often peaks on day 2.
After severe overuse, the pain may last a week.
Call Your Doctor If:
Fever or swollen joint occurs
Pain caused by work or sports lasts over 7 days
You think your child needs to be seen
Pain gets worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Finger Injury
Definition
Injuries to fingers
Types of Finger Injuries
Cuts, Scrapes (skinned knuckles) and Bruises. These are the most common injuries.
Jammed Finger. The end of a straightened finger or thumb receives a blow. Most often, this is from a ball. The energy is absorbed by the joint surface and the injury occurs there. This is called traumatic arthritis. For jammed fingers, always check that the fingertip can be fully straightened.
Crushed or Smashed Fingertip. Most often, this is from a car door or a screen door. The end of the finger may get a few cuts or a blood blister. Sometimes, the nail can be damaged. Broken bones are not common with this kind of injury. If they do occur, they are at risk for a bone infection (osteomyelitis).
Fingernail Injury. If the nailbed is cut, it needs sutures to prevent a deformed fingernail.
Subungual Hematoma (Blood Clot under the Nail). Most often caused by a crush injury. This can be from a door crushing the finger. It can also be from a heavy object falling on the nailbed. Many are only mildly painful. Some are severely painful and throbbing. These need the pressure under the nail released. A doctor can put a small hole through the nail. This can relieve the pain and prevent loss of the fingernail.
Dislocations. The finger has been pushed out of its joint.
Fractures. Finger has a broken bone.
Pain Scale
Mild: your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
Moderate: the pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
Severe: the pain is very bad. It keeps your child from doing all normal activities.
When To Call
Go to ER Now
Bleeding that won't stop after 10 minutes of direct pressure
Looks like a broken bone or dislocated joint
Call Doctor or Seek Care Now
Skin is split open or gaping and may need stitches
Large swelling is present
Blood under a nail is causing more than mild pain
Fingernail is torn off
Base of nail has popped out from under the skin fold
Cut over knuckle of hand
Dirt in the wound is not gone after 15 minutes of scrubbing
Can't open and close the hand or use the fingers normally
Severe pain and not better 2 hours after taking pain medicine
Age less than 1 year old
You think your child has a serious injury
You think your child needs to be seen, and the problem is urgent
Call Doctor Within 24 Hours
You think your child needs to be seen, but the problem is not urgent
Call Doctor During Office Hours
Dirty cut and no tetanus shot in more than 5 years
Clean cut and no tetanus shot in more than 10 years
Pain not better after 3 days
Not using the finger normally after 2 weeks
You have other questions or concerns
Self Care at Home
Minor finger injury
Care Advice
What You Should Know About Finger Injuries:
There are many ways that children can hurt their fingers.
There are also many types of finger injuries.
You can treat minor finger injuries at home.
Here is some care advice that should help.
Pain Medicine:
To help with the pain, give an acetaminophen product (such as Tylenol).
Another choice is an ibuprofen product (such as Advil).
Use as needed.
Bruised/Swollen Finger:
Soak in cold water for 20 minutes.
Repeat as needed.
Small Cuts or Scratches:
For any bleeding, put direct pressure on the wound. Use a gauze pad or clean cloth. Press down firmly on the place that is bleeding for 10 minutes. This is the best way to stop bleeding. Keep using pressure until the bleeding stops.
Wash the wound with soap and water for 5 minutes.
For any dirt in the wound, scrub gently.
For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
Cover it with a bandage (such as Band-Aid). Change daily.
Jammed Finger:
Caution: Be certain range of motion is normal. Your child should be able to bend and straighten each finger. If movement is limited, your doctor must check for a broken bone.
Soak the hand in cold water for 20 minutes.
If the pain is more than mild, "buddy-tape" it to the next finger.
Smashed or Crushed Fingertip:
Wash the finger with soap and water for 5 minutes.
For any cuts, use an antibiotic ointment (such as Polysporin). No prescription is needed.
Cover it with a bandage (such as Band-Aid).
Torn Nail (from catching it on something):
For a cracked nail without rough edges, leave it alone.
For a large flap of nail that's almost torn through, cut it off. Use a pair of scissors that have been cleaned. Cut along the line of the tear. Reason: Pieces of nail taped in place will catch on objects.
Soak the finger for 20 minutes in cold water for pain relief.
Use an antibiotic ointment (such as Polysporin). No prescription is needed. Then cover with a bandage (such as Band-Aid). Change daily.
After about 7 days, the nailbed should be covered by new skin. It should no longer hurt. A new nail will grow in over 6 to 8 weeks.
Call Your Doctor If:
Pain becomes severe
Pain not better after 3 days
Finger not normal after 2 weeks
You think your child needs to be seen
Your child becomes worse
And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.
Hand-Foot-And-Mouth Disease (HFMD)
Definition
Tiny red spots and water blisters on the hands and feet caused by a virus
Rash is seen on the palms, fingers, soles and toes
The diagnosis cannot be made without these
Also can cause small mouth ulcers (sores)
Symptoms of Hand-Foot-and-Mouth Disease (HFMD)
Small red spots and tiny water blisters on the hands and feet. Seen on the palms, fingers, soles and toes.
The diagnosis cannot be made without these.
Small painful ulcers (sores) in the mouth. Look for them on the tongue and sides of mouth. Most children with HFMD have these, but they can be hard to see.
Also, small blisters or red spots on the buttocks (30%)
Low-grade fever less than 102° F (39° C)
Mainly occurs in children age 6 months to 4 years
Cause of HFMD
Coxsackie A-16 virus and other enteroviruses
Not related to any animal disease
Severe Form of HFMD
Since 2012, a severe form of HFMD has occurred in much of the world. It's caused by a new Coxsackie A6 virus.
The rash spreads to the arms, legs and face. The rash is made up of many small blisters.
Children with such a severe rash may need to be seen. Reason: to confirm the diagnosis. Exception: close contact with HFMD within the last 7 days.