Microsoft word - notes for patients who are one-armed.docx
Michael Kurer FRCS FRCS(Orth) NOTES FOR PATIENTS WHO ARE ONE-ARMED There are several conditions which result in a patient being unable to use one of his/her arms.
It may be an injury, such as a fracture of the humerus (broken arm), it may be as a result of
These notes are aimed at helping to inform and prepare for the consequences of this.
Pain relief: The first big problem that you will have is pain and this can be divided into pain
It is extremely important that medications are taken to reduce pain and that the arm is held
still or supported on a pillow or pillows to prevent movement, which tends to make the pain
As a general rule, painkillers must be taken regularly and re-started before the pain becomes
Painkillers always have side effects, for example, painkillers including Codeine which are
Codeine tablets or Codydramol and Cocodamol, will cause constipation. Additional
medicine or treatments should be taken to prevent the constipation. Codeine can also make
people feel giddy or detached, in which case, it should probably be stopped.
For patients taking anti-inflammatories such as Neurofen/Ibuprofen or Voltarol/Diclofenac,
may give rise to gastric irritability and should therefore be taken after food. Sometimes it
Night pain is a major problem with shoulder and arm problems. The pain can be so severe
that it is not possible to get to sleep. Lying down makes the pain worse and it may be
necessary to sleep semi-sitting up, propped up on pillows or on a settee.
Turning over causes pain and you may wake up in the early hours of the morning with acute
pain and an inability to get back to sleep. It is important to take analgesia for this and to
accept that your sleeping pattern will be disrupted certainly for a week and maybe longer.
Getting dressed and undressed: The next biggest problem you will find is with getting
dressed and undressed. For the first week it is simplest to have an oversized T-shirt or
tracksuit top and not to put the affected arm through the sleeve but just to pull the clothes
over the arm and the sling. The good arm will of course come through the sleeve. Always put
the bad arm in first and then your head and good arm.
After a week or so, it may be possible to put on your normal shirts and pullovers. The bad
arm is put in first and then the head and good arm. Alternatively, keep on wearing stretchy,
knitted type fabrics for the first 6 weeks.
Going out
For women, handbags are a problem. It is difficult to open a handbag carried on the
unaffected arm using the unaffected arm. One solution would be to carry essentials e.g.
house keys, some loose change, mobile, oyster card etc. in jacket/coat pocket on the
Consider buying a shopping trolley to pull along with the unaffected arm. Your handbag can
You will discover various activities which are normally done with both hands together, about
which you were not aware. These include doing up trousers, doing up buttons, putting on
socks and tying shoelaces. None of these is possible one-handed. You either have to have
help or use alternative methods. Tracksuit bottoms are much easier. One can get a sock on
one-handed with some difficulty, by pulling it over the big toe first and then the other toes.
Tucking shirts in, is very difficult one-handed. Putting on a belt one-handed is very difficult.
Washing: Another major problem is washing. Standing in a shower can be slippery and you
only have one arm to stabilise yourself. It may be helpful to purchase a stool or chair to put
inside the shower or some sort of seat across the bath.
Getting in and out of a bath will be very hard just using one arm. It is also very slippery you
have no balancing arm because you are pulling or pushing with the good arm. It’s best just
not to have a bath for a few weeks and to stick to a shower.
Washing with one arm is difficult. It is hard at first to wash under the armpit of the good arm
with the good hand but this improves as mobility is regained. A bar of soap in the good hand
is best. One needs two hands for gel. Be very careful when washing below the knees.
Drying oneself one-armed is also very hard and initially you will certainly need help with the
There are various things which are quite hard to do with the non-dominant arm if it is the
dominant side that is affected. These obviously include writing, use of a razor for men and
putting on make-up for women, dealing with contact lenses, eating, use of a keyboard and a
computer mouse. With one arm, one cannot cut up food so one has to have food which can
be eaten with one arm or have it cut up.
In principle the first ten days are the worst and things get better with time. Expect also to be
very tired, particularly if you are not sleeping well at night.
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