Sometimes doctors will cast the wrist on diagnosis in an attempt to relieve the pain and possibly begin a healing process. Whether that is done or not, there is usually some sort of cast worn after surgery to protect the healing joint.

When you must wear a cast, it can be irritating, heavy, itchy, tight, loose, stinky, or just plain burdensome.

If the information given on this page in any way contradicts what you've been told by your doctor, follow his advice, not mine.

A cast is a means of support and protection. No matter how tempted you are, don't cut it or weaken its structure. If you feel the structure of the cast has been weakened, contact your doctor for a new cast.

No matter how tempted you are, don't cut it or weaken its structure. Notice how that was repeated just then? DO NOT CUT OR REMOVE YOUR CAST!

It takes about 3 days for a plaster cast to fully dry after it is applied. Until then, handle it carefully; touch it only with the back of your hand. Fiberglass dries much more quickly.

Avoid hard bumps or knocks to the cast.

It is perfectly normal for a cast to feel quite warm the first few hours while it is drying. It is somewhat obvious that the heat is coming from the cast itself and not the arm. If there are hotspots after the first 8-12 hours, notify your doctor.

Close your eyes and have your caregiver touch each of your fingers. If you cannot feel the sensation, notify your doctor.

Your pain should decrease exponentially each day after surgery. If it does not, or if your pain increases after the first 24-48 hours, notify your doctor.

A cast should not be painfully tight. If it is, check for swelling and do what you can at home to relieve it. If you don't have any swelling and the cast is tight, contact your doctor. A cast that is too tight can cause pressure injuries.

A pressure injury is sometimes called a pressure sore or decubitus ulcer. It is caused by unrelieved pressure on the skin and is difficult to treat. It is most commonly seen in people who are bedbound and can't change positions by themselves and in diabetics or those with poor circulation.

A cast should not be so loose that the arm can move inside it. Often there is swelling at the time that a cast is applied. As the swelling subsides, the cast loosens. For that reason, doctors will often apply a sugar-tong splint or other temporary splint for the first few days, then apply the permanent cast once the swelling has gone down. If your cast is too loose, call your doctor for a new cast.

It is normal to be able to fit one or two fingers between the cast and your arm.

If there is drainage coming from under your cast or the cast develops a stain that comes from the inside, call your doctor immediately.

If the padding near the edges of the cast wears down, it can be padded with moleskin or medical tape and gauze. Make sure that it is tightly secured so that it doesn't fall into the cast. Never put gauze, tissues, cotton, or any other padding inside the cast.

If any foreign object falls into your cast and gets stuck, no matter how embarrassing, call your doctor. It must be removed to protect the skin.

Keep your cast dry. Keep it out of the water when you bathe. Shower only if your doctor says it's okay. Use something to protect the cast from the water, be it a bread sack carefully taped at the top or a commercial vacuum device designed specifically for the purpose.

Some fiberglass casts can be gotten wet. If yours can, you will be informed.

If something happens that frightens or overly worries you, (if your arm is accidentally twisted inside the cast, if you have sudden or sharp pain), call the doctor or go to the emergency room. Your peace of mind is worth it.

Do not insert anything into the cast. Yes, your skin will itch and you will be tempted to grab the nearest stick to reach in there and scratch, but the skin underneath is tender. It is easy to break the skin without realizing it, setting yourself up for an infection that may not be detected or treated until the cast comes off.

Do not sprinkle powders into the cast. Even though talc or baking powder would theoretically absorb odors and ease itching, any good it could do is far outweighed by the bad. The powder would clump after contact with sweat and could cause pressure injuries, even in small amounts.

For itching, use a vacuum cleaner to suck a breeze through the cast; set your hair dryer on cool (do not use warm or hot!), and direct the air into the cast.

After a while, a cast will develop an unpleasant odor. I've found nothing that can ease that. However, if the odor is particularly fetid, there could be an infection of the skin or surgical site. Your doctor should be notified.

If you have swelling, coldness, numbness, discoloration, or tingling in the fingers that doesn't go away with elevation, call your doctor.

Wiggle your fingers frequently unless you've been directed not to.

If the cast becomes damp inside, use a hair dryer on cool (do not use warm or hot!) to dry the padding.

If the cast becomes wet or begins to crumble, it will need to be replaced.

Rest your casted arm on a pillow or cloth to protect tabletops and furniture.

White casts tend to show dirt easily. If you are given a choice of colors for a fiberglass cast, pick a color that won't show dirt, like a dark blue.

To protect your cast from dirt, cut the toes off of a long, thick sock, cut a slit in one side for your thumb, and wear it like a glove over the cast. Women's tights can also be cut in a similar way to protect, disguise, or dress up the cast.

In cold weather, protect the fingers from exposure. A stretchy, knitted glove, a sock, a large mitten, a scarf, or anything that covers the fingers will work.

If there are sharp edges on the cast, especially where the strips of plaster or fiberglass overlap, a file can be used to smooth them.

If you wear a sling, it should keep your elbow down and your wrist at or above the level of your heart. A pad (a shoulder pad from a dress, a piece of flannel, a folded sock) can be placed on the back of the neck to ease the chafing.

For women, an attractive scarf can be used as a soft sling which coordinates with the outfit of the day.

Wear loose clothing as much as possible; short sleeves, t-shirts, and oversized shirts are easier to manage.

When it's time to cut the cast off, don't be afraid. The saw the doctor uses does not have a sharp blade. It breaks apart the plaster or fiberglass by vibrating rapidly, not by actually cutting it. It will not hurt the skin.

NEVER attempt to cut off a cast at home. The cutting instruments you have available at home can seriously injure your arm.

Once the cast is removed, the delicate skin underneath will be sensitive. Protect it from sunlight and harsh soaps. It is fine to use lotions on the skin.

If you have a surgical scar under your cast, it will need to be protected from sun exposure for up to a year.

Often the hair on the arm will have grown in much darker than is normal for you. It will fade quickly to its normal color.

Your arm will likely be pale and thin. As your skin is exposed to normal conditions, the color will return. As you begin to reuse your muscles, they will regain tone.

It is normal to feel a little fragile after a cast is removed. After weeks of heavy protection, your arm is suddenly on its own. It is not normal or healthy to be paranoid or phobic about injuring your arm. If you begin to experience anxiety over the use of your arm, call your doctor for a referral to a therapist or psychiatrist.