Work-from-Home Ergonomics 101: Setting Up Your Remote Office to Help Reduce Pain & Injury

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From Rachel Pelta at FlexJobs

Since many of us are working at home right now (and weren’t expecting it), lots of people are improvising their “workstation.” For some, that means working at a desk, and for others, that means sitting on the couch or commandeering the kitchen table during work hours.

We’ve got some advice on how to set up an ergonomic workspace at home. While it’s best if you can buy the right equipment, that doesn’t mean you have to. Sometimes simple works, so we’ve included some DIY work-from-home ergonomic hacks you can use with things you’ve probably got at home.

Why Ergonomics Matter

The dictionary definition of ergonomics is, “an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely.”

Efficiently and safely are the important parts of the definition. Think about it like this: you’re sitting at your desk typing away, and you get a pain in your neck or your back. Suddenly, you’re not thinking about completing the task as much as you are getting rid of the pain.

Having an ergonomically optimized workspace helps you work “efficiently and safely.” By protecting your body from injury (or recurring pain), you’re better able to focus on your task, which, in turn, makes you a more efficient and productive worker.

How to Set Up An Ergonomic Workspace at Home

Setting up an ergonomically correct workspace at home will take a little bit of doing on your part. At the office, you probably have access to or can order, plenty of items to help you achieve the most ergonomic setup.

While you’re working at home during the pandemic, that may not be the case. You can’t run out to the office supply store and buy what you need. And, even if you can, you may not want to drop the money on it, or take the health risk.

So, focus on helping yourself maintain a neutral spine. Contrary to what you may think, a neutral spine isn’t one that is perfectly straight. A neutral spine is one that stays in its natural curved shape.

A neutral spine is basically an S-shape. That means at the top of your spine, near your neck, your spine curves in (toward your front). In the middle, your spine curves out, and your low back curves back in.

A picture of a spine illustrating the natural S-curve

Image from Pixabay

Whether you stand or sit for long periods, this is the best position for your spine. It takes “less work” for you to maintain a neutral spine, meaning it’s not as hard on your muscles. As you set up your workspace, take a few moments to focus on how your back feels. Is it tight? Does the position feel “unnatural”? If so, you’re probably not in a neutral spine. Keep adjusting and testing until things feel more “neutral.”

Start with Your “Desk”

Using a real desk makes setting up a home office easier. However, given the unusual nature of many work-at-home situations right now, many people are using a “desk.” Whether it’s a dining room table, TV tray, or even a folding table, whatever your desk is right now, make sure it isn’t causing posture problems.

Specifically, your desk should fit your knees, feet, and thighs comfortably underneath. You shouldn’t feel that you have to press your legs together to fit, and your knees shouldn’t bang up against anything. If you can’t fit under the desk comfortably, try out a different “desk” until you find the right fit.

Get the Right Height

No matter what you choose as your “desk,” your keyboard and mouse should be at elbow height when you are seated. Sit at the desk, hold your arms naturally and comfortably at your sides, then bend your elbows. Hold out your arms (with your elbows just slightly in front of your body but still at your sides) as if you were typing. This is the proper height for the top of your work surface.

Some desks let you adjust the height of the desk (or keyboard tray). If you don’t have an adjustable desk or are improvising a desk, you can try some hacks. Use some books or a sturdy box to raise your work surface up. If your work surface is too high, adjust your chair up, or try sitting on a pillow or some books.

Get Your Computer Set

Thanks to its portability, laptops are a popular computing option. However, laptops are not very ergonomic. The main problem with a laptop is that the screen and the keyboard are connected, making true ergonomic placement of the laptop keyboard and screen impossible.

While working on a laptop for a short time is fine, using one for longer periods (like the full workday), will not do wonders for your body. However, there are things you can do to improve laptop ergonomics when you work on it for long periods. And, even if you use a desktop with a detached keyboard, mouse, and monitor, you still have to place everything correctly, so you don’t injure yourself.

Monitor Placement

Depending on how many monitors you use, you’ll need to place them at different points on your desk. However, there are a few things you should do, no matter how many monitors you use.

First, the top of the monitor should be at or slightly below your eye level. When you look at the middle of the screen, your eyes should look slightly down. You should be able to hold your neck straight and easily see the top third of the screen. If you find yourself bending your neck up or down, adjust the screen again.

If your monitor doesn’t adjust height (or you can’t raise it any more), consider propping the monitor up on a riser (or books) to achieve the right height. If the monitor is too high and won’t lower, adjust your chair up.

The monitor should be at least arm’s length from you. This lets you view the entire screen at once—meaning you won’t have to move your head from left to right.

If the screen is arm’s length away and you still can’t see what’s on screen, enlarge the text (or wear your glasses). Larger screens may need to be farther away than “arm’s length” for you to see everything properly. If your screen is already at the far edge of the desk (away from you), move your keyboard farther from the desk to achieve the right distance.

You may also need to adjust the tilt on your screen. If you can see the screen just fine when it’s straight, leave it. However, you will likely need to angle the screen to reduce glare and achieve proper head positioning. The top will push away from you, and the bottom will come toward you.

Most people tilt the screen back between 10 and 20 degrees. However, if you wear bifocals, you may need to adjust the tilt by 30 to 40 degrees. This helps you use your bifocal lenses the right way without craning your neck.

Lastly, try to avoid direct light on the monitor. No matter how you tilt the screen, you’ll have a harsh glare that can be hard on the eyes. Try to keep the lighting to the side of the screen for indirect (and less harsh) lighting.

Which Monitor Where

Depending on how many monitors you use, you’ll need to place them differently.

One screen: center it in front of you.

one screen setup for work-from-home ergonomics

Image from Pixabay

Two screens: line the screens up side by side without a gap. If you use the two monitors equally, then they should meet in the middle of your sightline (when your head is straight). If you use one more than the other, offset the less used monitor to the side. Tilt the screens slightly in, like this:

Image from Pixabay

Three screens: the main monitor should be in the middle. The other two should be one each side of the main monitor with no gap and pointed slightly in.

three screens remote work ergonomics

Image from Bigstock

Laptop Screen

When you use a laptop, you should use the same ergonomic setup for the screen. This means propping your laptop up on something to bring the top of the screen to eye level. Of course, this makes it harder to type, which is why you should use an external keyboard and mouse when you must use a laptop for extended periods.

Keyboard Placement

Placing your keyboard at elbow height is only the beginning of proper keyboard ergonomics. To ensure you’ve got the right keyboard height, place the keyboard on your work surface then try to type a few lines. As you type, your wrists should remain straight, and your upper arms should stay close to your body, without you forcing it.

With the height correct, adjust the keyboard to the proper distance. You don’t want the keyboard too close to you, and you don’t want to overreach. As you type, your elbows should hang naturally by your sides without discomfort. Consider using a wrist rest to help achieve proper keyboard placement. If you don’t have one, a sock filled with rice will do, as will a rolled-up towel.

Use a keyboard that is either flat or has a “negative tilt.” Many keyboards tilt “up,” meaning the top row of the keyboard is raised. This forces your wrists to bend up as you type and can cause discomfort.

A flat keyboard is better since it helps you hold your wrists straight. A negative tilt keyboard tilts away from you (meaning the bottom row of the keyboard is raised) and also helps promote better wrist placement.

Mouse Placement

Your mouse should be near the keyboard and easy to reach without overextending any part of your body. In general, this means placing the mouse by your dominant hand, slightly in front of, and next to the keyboard like this:

A picture that demonstrates proper mouse placement

Image from Pixabay

In general, you should use a keyboard without an attached numeric keypad. This helps you keep the mouse at the proper height and within easy reach while also keeping the keyboard centered.

Consider getting a mouse riser. Similar to a keyboard or monitor riser, this is something you can attach to your desk or keyboard tray to raise the mouse to the proper height without taking up desk space or forcing the keyboard off-center.

Sit Pretty

If you’ve got an adjustable office chair, that’s great. Your work-from-home ergonomics are ahead of the game. But, just because you have an adjustable office chair, that doesn’t mean it’s adjusted correctly. And if you can’t get your hands on an office chair, don’t worry. There are plenty of ways to make a kitchen or dining room chair ergonomically awesome.

Support Your Spine

No matter what kind of chair you use, you want something that will support your spine’s natural S-shape. To do that, you need to sit properly. So, start at the bottom and work your way up.

As you sit in the chair, your feet should be flat on the floor. Make sure you’re sitting evenly on your bottom and not tilting to one side or the other. Your thighs should be parallel to the floor (or your knees at about hip height).

The problem is that once you’ve adjusted your chair to the right height, your arms may not be at the right height for the keyboard. And, of course, your standard kitchen chair isn’t adjustable.

To create the perfect work throne, you may need to get creative. For example, if you need a higher chair so you can reach the keyboard, your feet may not rest on the floor. So, try out some shoes (flat heels only!) to see if some combination of chair height and shoes gives you the proper support for your feet. If shoes are out, try a footrest, step stool, or even a pile of books to achieve the right sitting posture.

An office chair may have a back with lower back support that encourages your spine’s natural curves. Your kitchen chair probably does not. To achieve a neutral spine, try a rolled-up towel or small pillow in the small of your back.

To Stand or Not to Stand

For some, a standing desk is the ideal combination of work and exercise—without the trip to the gym. One study found that working at a standing desk burns about 88 calories an hour. That’s not much, but it is slightly better than sitting and typing, which burns 80 calories an hour.

Calorie blasting aside, some people like a standing desk because it’s something different, or it gives their back a rest from sitting in a chair all day. However, if you are going to use a standing desk, be aware that it does come with its own ergonomic risks.

If you’re not used to standing all day, don’t jump into the first day of a standing desk by using it for eight hours straight! Start with 30 minutes a day and gradually increase your standing time. This decreases the risk that you might develop leg, foot, or, you guessed it, back pain.

When you work at a standing desk, the same rules about keyboard and mouse placement apply, so make sure you aren’t working at a standing desk that’s too tall or short for you.

Lastly, make sure you can stand up straight. Again, this doesn’t mean with a ramrod-straight spine. You need to stand with a neutral spine. That means standing at a desk, not necessarily a high counter.

Just like sitting at a desk, you need a standing desk (or other high surface), that lets you get the right distance away from your keyboard and screen. Some counters, like your kitchen counter, have a toe kick, the part under the cabinet that lets you stick your toes under while you work.

However, if the toe kick isn’t deep enough, you may find yourself too far from the desk. That, in turn, will mean you’re overextending your arms or leaning too far forward, which could put pressure on your spine. And, if you’re using an external monitor, if you don’t get the screen placed right, you may crane your neck or lean back without realizing it.

Keep a watchful eye on your posture when you work at a standing desk. If you’re feeling pain, stop and examine how you’re positioned and adjust it. The last thing you want is to not be able to sit or stand while you work.

Successfully (and Ergonomically) Working Remotely

Sure, working on the couch sounds like a dream. But, after a few days, you might be fighting aches. Back pain, leg pain, even neck pain are all possible. Take the time to carefully consider your home-office ergonomics when working remotely. Your back, your arms, and every other part of your body will thank you.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Biceps Tendon Tear at the Shoulder

Biceps Tendon Tear at the Shoulder

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Tendons attach muscles to bones. Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow. If you tear the biceps tendon at the shoulder, you may lose some strength in your arm and have pain when you forcefully turn your arm from palm down to palm up.

Many people can still function with a biceps tendon tear, and only need simple treatments to relieve symptoms. If symptoms cannot be relieved by nonsurgical treatments, or if a patient requires complete recovery of strength, surgery to repair the torn tendon may be required.

Anatomy

Your shoulder is a ball-and-socket joint made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).

Biceps tendon

There are two attachments of the biceps tendon at the shoulder joint.

The head of your upper arm bone fits into a rounded socket in your shoulder blade. This socket is called the glenoid. A combination of muscles and tendons keeps your arm bone centered in your shoulder socket. These tissues are called the rotator cuff. They cover the head of your upper arm bone and attach it to your shoulder blade.

The upper end of the biceps muscle has two tendons that attach it to bones in the shoulder. The long head attaches to the top of the shoulder socket (glenoid). The short head attaches to a bump on the shoulder blade called the coracoid process.

Description

Biceps tendon tears can be either partial or complete.

  • Partial tears. Many tears do not completely sever the tendon.
  • Complete tears. A complete tear will split the tendon into two pieces.

In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes when lifting a heavy object.

Biceps tendon tear

Illustration shows a complete tear of the long head at its attachment point in the glenoid.

The long head of the biceps tendon is more likely to be injured. This is because it is vulnerable as it travels through the shoulder joint to its attachment point in the socket. Fortunately, the biceps has two attachments at the shoulder. The short head of the biceps rarely tears. Because of this second attachment, many people can still use their biceps even after a complete tear of the long head.

When you tear your biceps tendon, you can also damage other parts of your shoulder, such as the rotator cuff tendons.

Cause

There are two main causes of biceps tendon tears: injury and overuse.

Injury

If you fall hard on an outstretched arm or lift something too heavy, you can tear your biceps tendon.

Overuse

Many tears are the result of a wearing down and fraying of the tendon that occurs slowly over time. This naturally occurs as we age. It can be worsened by overuse – repeating the same shoulder motions again and again.

Overuse can cause a range of shoulder problems, including tendinitis, shoulder impingement, and rotator cuff injuries. Having any of these conditions puts more stress on the biceps tendon, making it more likely to weaken or tear.

Risk Factors

Your risk for a tendon tear increases with:

  • Age. Older people have put more years of wear and tear on their tendons than younger people.
  • Heavy overhead activities. Too much load during weightlifting is a prime example of this risk, but many jobs require heavy overhead lifting and put excess wear and tear on the tendons.
  • Shoulder overuse. Repetitive overhead sports, such as swimming or tennis, can cause more tendon wear and tear.
  • Smoking. Nicotine use can affect nutrition in the tendon.
  • Corticosteroid medications. Using corticosteroids has been linked to increased muscle and tendon weakness.

Symptoms

  • Sudden, sharp pain in the upper arm
  • Sometimes an audible pop or snap
  • Cramping of the biceps muscle with strenuous use of the arm
  • Bruising from the middle of the upper arm down toward the elbow
  • Pain or tenderness at the shoulder and the elbow
  • Weakness in the shoulder and the elbow
  • Difficulty turning the arm palm up or palm down
  • Because a torn tendon can no longer keep the biceps muscle tight, a bulge in the upper arm above the elbow (“Popeye Muscle”) may appear, with a dent closer to the shoulder.

Doctor Examination

Medical History and Physical Examination

After discussing your symptoms and medical history, your doctor will examine your shoulder. The diagnosis is often obvious for complete ruptures because of the deformity of the arm muscle (“Popeye Muscle”).

Biceps tendon tear

A biceps tendon tear is made more obvious by contracting the muscle (“Popeye Muscle”).

Partial ruptures are less obvious. To diagnose a partial tear, your doctor may ask you to bend your arm and tighten the biceps muscle. Pain when you use your biceps muscle may mean there is a partial tear.

It is also very important that your doctor identify any other shoulder problems when planning your treatment. The biceps can also tear near the elbow, although this is less common. A tear near the elbow will cause a “gap” in the front of the elbow. Your doctor will check your arm for damage to this area.

In addition, rotator cuff injuries, impingement, and tendinitis are some conditions that may accompany a biceps tendon tear. Your doctor may order additional tests to help identify other problems in your shoulder.

Imaging Tests

  • X-rays. Although x-rays cannot show soft tissues like the biceps tendon, they can be useful in ruling out other problems that can cause shoulder and elbow pain.
  • Magnetic resonance imaging (MRI). These scans create better images of soft tissues. They can show both partial and complete tears.

Treatment

Nonsurgical Treatment

For many people, pain from a long head of biceps tendon tear resolves over time. Mild arm weakness or arm deformity may not bother some patients, such as older and less active people.

In addition, if you have not damaged a more critical structure, such as the rotator cuff, nonsurgical treatment is a reasonable option. This can include:

  • Ice. Apply cold packs for 20 minutes at a time, several times a day to keep down swelling. Do not apply ice directly to the skin.
  • Nonsteroidal anti-inflammatory medications. Drugs like ibuprofen, aspirin, or naproxen reduce pain and swelling.
  • Rest. Avoid heavy lifting and overhead activities to relieve pain and limit swelling. Your doctor may recommend using a sling for a brief time.
  • Physical therapy. Flexibility and strengthening exercises will restore movement and strengthen your shoulder.

Surgical Treatment

Surgical treatment for a long head of the biceps tendon tear is rarely needed. However, some patients who develop cramping of the muscle or pain, or who require complete recovery of strength, such as athletes or manual laborers, may require surgery. Surgery may also be the right option for those with partial tears whose symptoms are not relieved with nonsurgical treatment.

Procedure. Several new procedures have been developed that repair the tendon with minimal incisions. The goal of the surgery is to re-anchor the torn tendon back to the bone. Your doctor will discuss with you the options that are best for your specific case.

Complications. Complications with this surgery are rare. Re-rupture of the repaired tendon is uncommon.

Rehabilitation. After surgery, your shoulder may be immobilized temporarily with a sling.

Your doctor will soon start you on therapeutic exercises. Flexibility exercises will improve range of motion in your shoulder. Exercises to strengthen your shoulder will gradually be added to your rehabilitation plan.

Be sure to follow your doctor’s treatment plan. Although it is a slow process, your commitment to physical therapy is the most important factor in returning to all the activities you enjoy.

Surgical Outcome. Successful surgery can correct muscle deformity and return your arm’s strength and function to nearly normal.

Adult Forearm Fractures

Adult Forearm Fractures

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Article Featured on AAOS

Your forearm is made up of two bones, the radius and ulna. In most cases of adult forearm fractures, both bones are broken.

Fractures of the forearm can occur near the wrist at the farthest (distal) end of the bone, in the middle of the forearm, or near the elbow at the top (proximal) end of the bone. This article focuses on fractures that occur in the middle segments of the radius and ulna. Fractures that involve the wrist or the elbow are discussed in separate articles.

Anatomy

If you hold your arms at your side with your palms facing up, the ulna is the bone closest to your body and the radius is closest to your thumb. The ulna is larger at the elbow — it forms the “point” of your elbow — and the radius is larger at the wrist.

The primary motion of the forearm is rotation: the ability to turn our palms up or down. The ulna stays still while the radius rotates around it. This is the motion used to turn a screwdriver or twist in a light bulb. Forearm fractures can affect your ability to rotate your arm, as well as bend and straighten the wrist and elbow.

Description

Forearm bones can break in several ways. The bone can crack just slightly, or can break into many pieces. The broken pieces of bone may line up straight or may be far out of place.

Fractures of both the radius and ulna.

Fractures of both the radius and ulna.

In some cases, the bone will break in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone. This is called an open fracture and requires immediate medical attention because of the risk for infection.

Because of the strong force required to break the radius or ulna in the middle of the bone, it is more common for adults to break both bones during a forearm injury. When only one bone in the forearm is broken, it is typically the ulna — usually as a result of a direct blow to the outside of your arm when you have it raised in self defense.

Related Articles

DISEASES & CONDITIONS

Fractures (Broken Bones)

TREATMENT

Internal Fixation for Fractures

RECOVERY

Care of Casts and Splints

DISEASES & CONDITIONS

Distal Radius Fractures (Broken Wrist)

Cause

The most common causes of forearm fractures include:

  • Direct blow
  • Fall on an outstretched arm, often during sports or from a height
  • Automobile/motorcycle accidents

Symptoms

A broken forearm usually causes immediate pain. Because both bones are usually involved, forearm fractures often cause an obvious deformity — your forearm may appear bent and shorter than your other arm. You will most likely need to support your injured arm with your other hand.

Additional symptoms include:

  • Swelling
  • Bruising (not as common as in other broken bones)
  • Inability to rotate arm
  • Numbness or weakness in the fingers or wrist (rare)

Doctor Examination

Most people with forearm fractures will go to an urgent care center or emergency room for initial treatment.

Physical Examination and Medical History

It is important that your doctor knows the circumstances of your injury. For example, if you fell from a ladder, how far did you fall? It is just as important for your doctor to know if you sustained any other injuries and if you have any other medical problems, such as diabetes. Your doctor also needs to know if you take any medications.

After discussing your symptoms and medical history, your doctor will do a careful examination. Your doctor will:

  • Examine your skin to see if there are any cuts from the injury. Bone fragments can break through the skin and create lacerations. This leads to an increased risk for infection.
  • Palpate (feel) all around your arm to determine if there are any other areas of tenderness. This can indicate other broken bones or injuries.
  • Check your pulse at the wrist to be sure that good blood flow is getting through your forearm to your hand.
  • Check to see if you can move your fingers and wrist, and can feel things with your fingers. Sometimes, nerves may be injured at the same time that the bone is broken, which can result in hand and wrist weakness and numbness.
  • The doctor may examine your shoulder, upper arm, elbow, wrist, and hand, even if you only complain of arm pain.

X-rays

X-rays are the most common and widely available diagnostic imaging technique. X-rays can show if the bone is broken and whether there is displacement (the gap between broken bones). They can also show how many pieces of broken bone there are.

Treatment

Treatment of broken bones follows one basic rule: the broken pieces must be put back into position and prevented from moving out of place until they are healed. Because the radius and ulna rely on each other for support, it is important that they are properly stabilized. If the bones are not accurately aligned during healing, it may result in future problems with wrist and elbow movement.

Most cases of adult forearm fractures require surgery to make sure the bones are stabilized and lined up for successful healing.

Immediate Treatment

While you are in the emergency room, the doctor may try to temporarily realign the bones, depending upon how far out of place the pieces are. “Reduction” is the technical term for this process in which the doctor moves the pieces into place. This is not a surgical procedure. Your pain will be controlled with medication. Afterward, your doctor will apply a splint (like a cast) to your forearm and provide a sling to keep your arm in position. Unlike a full cast, a splint can be tightened or loosened, and allows swelling to occur safely.

forearm fracture splint application

The emergency room doctor may apply a splint to protect your arm.

Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

It is very important to control the movement of a broken bone. Moving a broken bone can cause additional damage to the bone, nearby blood vessels, and nerves or other tissues surrounding the bone.

Additional immediate treatment will include applying ice to help reduce swelling, and providing you with pain medicine.

Nonsurgical Treatment

If only one bone is broken and it is not out of place, it may be possible to treat it with a cast or brace. Your doctor will closely monitor the healing of the fracture, and have you return to the clinic for x-rays frequently. If the fracture shifts in position, you may require surgery to put the bones back together.

Surgical Treatment

When both forearm bones are broken, or if the bones have punctured the skin (open fracture), surgery is usually required.

Because of the increased risk for infection, open fractures are usually scheduled for surgery immediately. Patients are typically given antibiotics by vein (intravenous) in the emergency room, and may receive a tetanus shot. During surgery, the cuts from the injury will be thoroughly cleaned out. The broken bones are typically fixed during the same surgery.

If the skin around your fracture has not been broken, your doctor may recommend waiting until swelling has gone down before having surgery. Keeping your arm immobilized and elevated for several days will decrease swelling. It also gives skin that has been stretched a chance to recover.

Open reduction and internal fixation with plates and screws. This is the most common type of surgical repair for forearm fractures. During this type of procedure, the bone fragments are first repositioned (reduced) into their normal alignment. They are held together with special screws and metal plates attached to the outer surface of the bone.

forearm fracture fixation with plates and screws

The broken bones of the forearm are held in position by plates and screws while they heal.

Open reduction and internal fixation with rods. During this procedure, a specially designed metal rod is inserted through the marrow space in the center of the bone.

External fixation. If the skin and bone are severely damaged, using plates and screws and large incisions may injure the skin further. This may result in infection. In this case, you may be treated with an external fixator. In this type of operation, metal pins or screws are placed into the bone above and below the fracture site. The pins and screws are attached to a bar outside the skin. This device is a stabilizing frame that holds the bones in the proper position so they can heal.

Complications

Complications from Forearm Fractures

Forearm fractures can cause further injury and complications.

  • The ends of broken bones are often sharp and can cut or tear surrounding blood vessels or nerves.
  • Excessive bleeding and swelling right after the injury may lead to acute compartment syndrome, a condition in which the swelling cuts off blood supply to the hand and forearm. It typically occurs within 24 to 48 hours of the injury and causes severe pain when moving the fingers. Compartment syndrome can result in loss of sensation and function, and requires emergency surgery once it is diagnosed. In such cases, the skin and muscle coverings are opened and left open to relieve pressure and allow blood to return.
  • Open fractures expose the bone to the outside environment. Even with good surgical cleaning of the bone and muscle, the bone can become infected. Bone infection is difficult to treat and often requires multiple surgeries and long-term antibiotics.

Complications from Surgery

There are risks associated with all surgery. If your doctor recommends surgery, he or she thinks that the possible benefits of surgery outweigh the risks.

  • Infection. There is a risk of infection with any surgery, whether it is for a forearm fracture or another purpose.
  • Damage to nerves and blood vessels. There is a minor risk of injury to nerves and blood vessels around the forearm. Although some temporary numbness is common right after your injury, if you experience persistent numbness or tingling in your fingers, contact your doctor.
  • Synostosis. Another rare complication is healing between the two bones of the forearm with a bridge of bone known as synostosis. This can decrease the rotation of the bones and prevent full movement.
  • Nonunion. Surgery does not guarantee healing of the fracture. A fracture may pull apart, or the screws, plates, or rods may shift or break. This can occur for a variety of reasons, including:
    • The patient does not follow directions after surgery.
    • The patient has other health issues that slow healing. Some diseases, like diabetes, slow healing. Smoking or using other tobacco products also slow healing.
    • If the fracture was associated with a cut in the skin (an open fracture), healing is often slower.
    • Infections can also slow or prevent healing.

If the fracture fails to heal, further surgery may be needed.

Recovery

Bones have a remarkable capacity to heal. Forearm bones typically take 3 to 6 months to fully heal. The more severe your injury, however, the longer your recovery may be.

Pain Management

Pain after an injury or surgery is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover faster.

Medications are often prescribed for short-term pain relief after surgery or an injury. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids.

Be aware that although opioids help relieve pain after surgery or an injury, they are a narcotic and can be addictive.  It is important to use opioids only as directed by your doctor. As soon as your pain begins to improve, stop taking opioids. Talk to your doctor if your pain has not begun to improve within a few days of your treatment.

Rehabilitation

Nonsurgical treatment. Rehabilitation typically begins after a few weeks of keeping the arm still by using a cast or brace. In many cases, a physical therapist will help with rehabilitation, beginning with gentle exercises to increase range of motion, and gradually adding exercises to strengthen the arm.

Surgical treatment. Depending on the complexity of the fracture and the stability of the repair, a cast or brace may be necessary for 2 to 6 weeks after surgery. Motion exercises for the forearm, elbow, and wrist usually begin shortly after surgery. This early motion is important to prevent stiffness. Your doctor may also prescribe visits to a physical or occupational therapist, depending on how long your arm was immobilized.

Outcome

Some stiffness after healing is common, but this does not usually affect the overall function of your arm.

Your doctor will advise you on when you may return to work and sports activities. This varies depending on the fracture pattern and the type and stability of the repair.

If you have had surgery, the plates and screws are usually left in place forever. If you consider removal, this second surgery is typically not scheduled until your bones have fully solidified (1 to 2 years after initial surgery)