As I have mentioned once or twice elsewhere on the boards, last week my SO took a nose-dive off his road bike and broke his elbow in the process. A check-up today showed that although it’s “just” a fracture, it has shifted a bit and will never quite heal properly, though he’ll likely regain most of his flexibility. He also has damage to his wrist (same arm) which wasn’t apparent when we went to the ER last Friday. He needs to see a specialist, and they will decide whether it will heal or if he needs surgery.
His arm is in a cast - it was in a regular partial cast (just underneath the arm, held on by tensors) up until today, and now has a partial fiberglass and tensor cast. He is wearing a sling.
Since the first day, he has been getting frequent (3-4 times a day) spasms in his upper arm (bicep). He has to stop whatever he’s doing when these spasms occur, and try and hold the muscle and massage it to get it to stop. For the first couple of days he was taking Tylenol with codeine (16mg of codeine at a time) to deal with the pain in his elbow, but this doesn’t affect the spasms. Now he only takes the Tylenol at night, so he can sleep better and pain-free.
My question is, is this normal? Is it a reaction to having the weight of the cast on (although the fiberglass one is pretty light)? Is there anything we can do to stop it? He didn’t think to ask the doctor today at the clinic, and so I decided to ask here for advice about this. He should be seeing the specialist for his wrist within the next week or so, but if this is serious, then we’ll go to a doctor sooner.
Thanks in advance, and let me know if you need more information!
Several muscles in the arm attach close to (and some, like the brachioradialis, cross) the elbow. If one of the bones is broken and is somewhat dislocated, the muscles are moved too, and some of the tendons on the arm muscles will no longer be in their original position. This additional strain can indeed cause muscles cramping.
It is important to make sure the cramps are not due to the tightness of the cast, which usually occurs if the cast is applied but the arm continues to swell beneath it. A tight cast may present with pain, diminished pulses (on the far side of the cast), pins and needles and a slower capillary refill (if you push a fingernail, it should turn from “flesh” to white and return to whichever flesh colour within about two seconds).
But no, this sounds fairly common to me.
Thanks Dr_ Paprika!
I don’t think the cast is on too tight - he said the first one might have been a little tight, but the second one is fine. The doctor says theres no dislocation, just a slight displacement of the bone at the site of the injury. I looked at the X-rays, but I can’t see anything at all (but then, I’m not a doctor).
So I guess it’s just common cramps and spasms, then. Is there anything particular he can do to alleviate them or prevent them? Or how long will they occur? Apparently the doctor had commented about taking the cast off entirely this week if it hadn’t have been for the damage to his wrist too. If it’s healed that much, shouldn’t these spasms go away?
I know I’m asking a lot of questions, but I feel so bad for him, and I wish I could help, or help the spasms stop! I hate knowing that he gets woken up in the middle of the night because of this, or has to stop working or whatever he’s doing because of them 
I put on a lot of casts, and this problem has not been reported to me very often. I would probably bivalve the cast (cut it into two halves) and bandage it in place to ensure this is not the problem. (A big cast only has to be too tight at one point). I would ensure any angles to the cast are appropriate (at the elbow, between 80 and 90 degrees). I might try a muscle relaxant like Flexeril or Robaxicet too. Whether I would remove the cast would depend on why I applied it.