Management of a Soft Bump on Arm After Falling
Apply ice mixed with water to the soft bump for 10-20 minutes at a time, using a thin towel barrier between the ice and skin, and assume this could be a fracture until proven otherwise. 1
Immediate First Aid Treatment
Cold Application Protocol
Apply a mixture of ice and water (not ice alone) through a plastic bag or damp cloth to the injured area. 1 This combination is more effective than ice alone at reducing hemorrhage, edema, pain, and disability from soft-tissue injuries. 1
Limit each cold application to 10-20 minutes maximum. 1 If 20 minutes causes discomfort, use 10-minute intervals instead. 1
Place a thin towel barrier between the cold container and skin to prevent cold injury. 1
Avoid refreezable gel packs as they do not cool as effectively as an ice-water mixture. 1
Critical Assumption About Fractures
Assume any extremity injury includes a bone fracture until proven otherwise. 1 A "soft bump" could represent a hematoma overlying an underlying fracture, muscle contusion, or soft tissue injury.
Do not move or try to straighten the injured arm. 1 There is no evidence that manipulation improves healing or reduces pain, and it may cause further injury.
When to Activate Emergency Medical Services Immediately
Call EMS if the injured arm is blue or extremely pale 1, as this indicates potential vascular compromise requiring emergency intervention.
Additional Warning Signs Requiring Medical Evaluation
Seek healthcare provider evaluation if any of these are present:
Fall from greater than standing height 1 - This increases risk of significant underlying injury including fracture or spinal injury.
Tingling in the extremities 1 - May indicate nerve involvement or spinal injury.
Progressive swelling or pain 1 - Suggests ongoing tissue damage or compartment syndrome risk.
Inability to move the arm normally - Indicates possible fracture, tendon injury, or significant soft tissue damage.
Splinting Considerations
If you are far from definitive healthcare, stabilize the extremity with a padded splint in the position found. 1 Expert opinion suggests splinting may reduce pain and prevent further injury, though evidence is limited. 1
Do not attempt splinting if medical care is readily accessible - Simply protect the injured area and await professional evaluation. 1
Common Pitfalls to Avoid
Do not apply heat to the acute injury. 1 Heat application is inferior to cold for acute soft-tissue injuries and contusions.
Do not use compression bandages routinely. 1 Evidence is unclear whether compression helps joint injuries, and the American Heart Association guidelines do not strongly recommend it for general soft tissue trauma.
Do not assume the injury is minor just because it's "soft." 1 Soft tissue swelling can mask underlying fractures, and delayed diagnosis can lead to complications.
Do not bear weight on an injured lower extremity (if this were a leg injury) until cleared by a medical professional. 1
Follow-Up Care
All extremity injuries with visible swelling ("bumps") should be evaluated by a healthcare provider to rule out fracture, assess for neurovascular compromise, and determine appropriate definitive treatment. 1 The soft bump may represent a hematoma, muscle contusion, or swelling overlying a fracture that requires imaging for proper diagnosis.