You experience stimulation unrelated to external stimuli in your extremities, even those you don’t have, such as an amputated limb or wings. This may manifest as tingling all the way to sharp pain. Whenever you experience this while you are concentrating on a spell, you must succeed on a DC 8 + (IE) Constitution saving throw to maintain your concentration.

Real-world Examples

Radiculopathy, Neuropathy, Diabetes, Multiple Sclerosis, Phantom Pain Syndrome

Assistive Options

Taking at least (IE) short rests each day (spread evenly throughout the day) will reduce Paresthesia by 1 IE until the next needed short rest.

You have trouble with larger body movements, such as jumping, throwing, walking, running, and maintaining balance. You have a −(IE) penalty on all melee attack rolls to hit and Strength (Athletics) and Dexterity (Acrobatics) checks and Dexterity saving throws. Spells with somatic components usually need to be modified to work within your physical range, requiring (IE) days for every hour normally needed to inscribe into your spellbook and double the cost due to experimentation materials. You may replace one of your other traits with Muscle Control & Gait Difference.

Real-world Examples

Dyspraxia, Friedreich’s Ataxia, Wilson’s Disease, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, Paraneoplastic Syndromes, Neuropathy, Spinal Injuries

Assistive Options

Leg braces, crutches, walkers, rollators, and canes can reduce the IE penalty by 1 for Dexterity checks and saving throws. Braces take one minute to put on and cannot be worn while sleeping, and the others, unless designed for use as weapons, require one hand to be used for balance.

You have trouble making precise movements, especially with your hands and arms. You have a −(IE) penalty on all Dexterity (Sleight of Hand) checks, Dexterity checks to write, or other attempts to use precision with your hands such as playing a musical instrument. Spells with somatic components usually need to be modified to work within your physical range, requiring (IE) days for every hour normally needed to inscribe into your spellbook and double the cost due to experimentation materials. Transcribing spells with only verbal components into your spellbook takes (IE) × 4 times as long as usual.

Real-world Examples

Dyspraxia, Friedreich’s Ataxia, Wilson’s Disease, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, Paraneoplastic Syndromes, Neuropathy, Spinal Injuries

Assistive Options

Assistance for fine motor control loss takes the form of adapting the space around you to your needs and allowing extra time for anything requiring fine motor movements.

You experience pain differently than most people. Choose or roll on the following table.

One thing I want others to understand about my experience with depression and chronic pain is that while I’m capable of doing most things that someone without my disabilities can do, the cost of my efforts on my energy levels and body are much greater than the other person. For example, walking three blocks feels like I walked a mile and a minor bump into a doorway feels like I was hit by a metal baseball bat.

– Heather Thomas

• Chronic Pain. You experience chronic pain throughout your body. Any action that requires concentration (e.g., maintaining a spell) requires a successful DC 10 + (IE) Constitution saving throw per round to maintain concentration. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.
• Hyperalgesia. You experience pain more intensely than most people. When you take physical damage, you also take (IE) × 5 percent psychic damage (minimum 1). Any rolls to maintain concentration also have a −(IE) penalty when taking damage. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.
• Hypoalgesia. You experience less pain from injury than most people. On any day spent on at least mild activity, you must succeed on a DC 8 + (IE) Dexterity saving throw. On failure, you sustain a sore or wound that you’re unaware of. You must then succeed on a DC 8 + (IE) Wisdom (Perception) check to identify the wound so it can be treated. If you receive help on this check, you make the roll with advantage. If identified, a successful DC 5 + (IE) Wisdom (Medicine) check will allow the wound to heal. If the check fails, you sustain 1d(IE) damage per day until successfully treated. Because you do not feel pain the way most people do, you have resistance to psychic damage.

Real-world Examples

Anxiety, Neuropathy, Diabetes, Hereditary Sensory and Autonomic Neuropathy, Muscle Spasticity, Fibromyalgia, Myofascial Pain Syndrome, Polymyalgia Rheumatica

Assistive Options

Pain can be managed by avoiding the stimulus that triggers it or limiting physical exertion. Depending on the location and nature of the pain, using a cane, walker, or support hose can reduce the IE by 1. Relaxation techniques can reduce pain levels. If a short rest is used for a relaxation and stretching technique, the IE is reduced by 1 for 1d4 hours. Alternately, receiving a 1-hour massage will reduce the IE by 1 for 1 day. Hypoalgesia depends heavily on friends and allies helping to watch for wounds or irregularities as noted in the description.

You experience chronic pain in your legs and/or feet. Any action that requires concentration (e.g., maintaining a spell) requires a successful DC 10 + (IE) Constitution saving throw per round to maintain concentration. Your daily walking distance is reduced by (IE) × 20 percent. In addition to the usual Frequency, any round when you exert your legs (e.g., running, combat, jumping), you must succeed on a DC (IE) × 2 + 8 Constitution saving throw or experience one level of exhaustion, cumulative each round of exertion, requiring 5d20 × (IE) per level of exhaustion to recover afterward. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.

Real-world Examples

Subungual Exostosis, Arthritis, Tendinitis, Bursitis, Osgood-Schlatter Disease, Paget’s Disease of Bone, Patellofemoral Pain Syndrome, Neuropathy, Sciatica, Varicose Veins, Muscle Spasticity, Complex Regional Pain Syndrome

Assistive Options

Applying ice for 10 minutes or a compression bandage can reduce the pain by 1 IE for 10d6 minutes. Wheelchairs or other mobility devices can help with mobility to reduce your need to walk everywhere.

Magical Assistance

A healing spell can target the legs and reduce the IE by 2 for 1 hour instead of regaining hp.

I look fine and healthy, but I’m not, and I can suddenly be in pain even if you can’t see it. I sometimes need to rest for my pain to subside even if I look alright.

– Diego Rodríguez

You experience chronic pain in your fingers, hands, and/or arms. Any action that requires concentration (e.g., maintaining a spell) requires a successful DC 10 + (IE) Constitution saving throw per round to maintain concentration. When you succeed on a melee attack, the vibrations from the impact are painful, and you need to succeed on a DC 8 + (IE) Constitution check to fight the pain and continue to hold your weapon. Because you’re used to managing pain, even though this doesn’t reduce the experience of pain, you have a +(IE) bonus to saving throws against psychic damage.

Real-world Examples

Arthritis, Carpal Tunnel Syndrome, Tendinitis, Gout, Lupus, Neuropathy, Erythromelalgia

Assistive Options

Applying ice for 10 minutes or a compression bandage can reduce the pain by 1 IE for 10d6 minutes per day.

Magical Assistance

A healing spell can target the hands and arms and reduce the IE by 2 for 1 hour instead of regaining hp.