# Paralysed arm.



## Abbas-Al-Morim (Dec 2, 2013)

I'm not very knowledgeable on medical conditions. What I know is for the most part the result of googling my own symptoms when I'm sick. A side-effect of googling symptoms is temporarily becoming a hypochondriac. But I don't know anything about paralysis and that's what one of my characters is coping with.

I'll outline the situation and be as concise as possible. One of my characters is an elderly knight and a spy for his Emperor. Nominally, he's still a brother in a knightly order but he's been out of the fight for quite some time. One of his arms is almost completely useless and he _carries_ it around in a sling. It's almost like dead weight.

My question is: what injury could a knight sustain to put him in that situation? So far, I've considered an arrow to the shoulder but that probably wouldn't paralyze him. It would hinder him in his use of the arm but it's not quite what I had in mind (though it's a plan b). 

It's important to me that he sustains the injury in a combat situation. Debilitating poisons are a possibility too (especially if applied to arrows) or perhaps an infection could be the cause. I want the arm to be paralyzed though - not dead. If his arm were dead, the surgeons would have to remove it but if it's paralyzed they'd probably forgo a risky treatment like that because it's not life-threatening. 

Does anyone have an idea? I try to aim for realism in my books, which is why I'd prefer to come up with a plausible solution. 

EDIT: I've already done some wikipedia research but the problem is I don't know what kind of trauma would paralyze the arm - and the arm alone. I don't want him to be stuck in a wheelchair  (which probably hasn't been invented in my world).


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## GeekDavid (Dec 2, 2013)

First thing that pops into my mind is an arrow damaging the nerve. No nerve signals to the arm, no movement.


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## buyjupiter (Dec 2, 2013)

Anything which severs nerve endings is a good cause of paralysis, though I'm sure those with more medical knowledge than myself could probably argue differently.

So, if the arrow (to use your example) is coated with a paralytic agent, it would be difficult to control the spread of paralysis, because, circulatory system (blood). You'd get a lot more areas affected than just the arm, although, the point of origin might feel the effects more dramatically than any other part of the body. I believe that most paralytic agents, if they don't outright kill you as well, would dissipate with time. Unless, of course they are magically based.

If you used an arrow without a paralytic agent, you could have the arrowhead sever an important nerve cluster near the elbow or the shoulder (anyone with anatomy knowledge feel free to help out here!), and use that as the reason for a dead arm.

A knife wound could also work, as could a wound caused by a spear, ax, sword, etc. 

I think the most crucial thing would be how much healing do you have in your world? Is it magically equivalent to modern medicine? Because if it's not...I think there could be the whole issue of bleeding out depending on how close your character was to a healer, the amount of damage, etc.

Also, if your world isn't as medically advanced as the 21st century, why not have the damage be the result of a healer who tried to fix the damage, but ended up causing more?


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## A. E. Lowan (Dec 3, 2013)

First of all, Abbas, I'm assuming this is an old injury you're talking about, and not a current one?  So he's dealing with the lingering effects, not a fresh wound.

First, you'll want to take an infection out of the running for consideration.  An infection bad enough to cause him to loose use of the arm would probably also inspire a medieval medical practitioner to remove it entirely (I'm making some assumptions of your medical technology here, based on your statement that he belongs to a "knightly order.")  Infections of that severity are life-threatening, and historically - hell, even in some instances even today - it was considered better to lose the limb than the whole patient.

As for what injury could have caused it, pretty much any major trauma to the shoulder that severed the major nerves - so slicing or crushing - that he survived would do the trick.  Warfare is ugly, so pick your weapon.  He's a knight, so we can assume armor?  Most likely the wound was sustained either by having a sword blade punched through his shoulder (not in  a slice, more like an awl), or a mace crushed it, maybe a crossbow bolt punched through (but I'm not sure about this one, you might want to check the Archery thread).  If the incident occurred when he was unarmored, then the field of injury opens right up to everything that armor would protect him from.


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## CupofJoe (Dec 3, 2013)

Variations on the Crush injury... A fall from a horse where the arm was trapped in the reins/saddle would wrench/twist the shoulder enough to paralyse the arm, especially if the ride was dragged along for some distance. 
I knew someone this happened to back in the 1940s  [it happened in the 40s, I met him in the late 70s]. He was riding cross country and was sort of thrown off his horse but got dragged through several hedges before he was torn free. It took him several hours to walk home [after catching the horse] and over a day before he was taken to hospital . By then the damage was done. His arm was limp and numb but the hand worked if only just. He could loosely hold something in his fist, so if leading a horse he would switch the reins to his "bad" hand when he had to open a gate with the "good" hand etc. If the horse shied, he couldn't hold the reins with his paralysed hand and it would pull free.


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## Dragev (Dec 3, 2013)

Damage done to the Brachial plexus would suit admirably; Brachial plexus - Wikipedia, the free encyclopedia
"Depending on the location of the injury, the signs and symptoms can range from complete paralysis to anesthesia". Apparently, it can also cause "abnormal muscle contractions (contractures) or tightening of the muscles, which may be permanent" (http://www.nlm.nih.gov/medlineplus/ency/article/001395.htm that's for newborns, but why the hell not)
The nerve itself is in the middle of the shoulder, so almost any wound at the clavicle or right around will do


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## Abbas-Al-Morim (Dec 3, 2013)

*To clarify a few points:* it's an old injury he's had for quite some time and their medicine is the equivalent of our 14th century medicine. 

I really like the idea of him falling of his horse and having his arm trapped. I don't think that's been used a lot in Fantasy even though it's likely that something like that could happen to a knight. I also like the idea that he might still use his hand for small tasks.


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## Nihal (Dec 3, 2013)

I know a little of paralyzed arms. It's not as glorious, but even a stroke can do that without paralyzing the whole person or side. It can happen that the movement returns—a bit clumsy now—but the tact doesn't, what makes the arm relatively functional but really hard to control and slightly dangerous. You can suffer grievous injuries and feel only a funny tickling sensation, besides losing the ability to feel the temperature with the affected limbs. On a side note, these arms also tend to pick up things without the owner realizing. 

Speaking of nerves, it's also possible to have the arm partially numb for long stretches of time. I've had a mild tendonitis that rendered half of my hand numb and certain regions of my arm sensible to touch, as if the skin was bruised (but no muscular pain). It happened due the elbow's nerve compression and lasted for months. I guess that a permanent damage would produce a permanent sensation (or lack of).


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