Your arm and/or hand muscles don’t always act the way you wish, sometimes never doing so. A muscle may be permanently contracted or lacks fine motor control. IE serves as a guideline for specific effects and generally a −(IE) penalty on all Strength checks and saving throws and attacks. Spells with somatic components usually need to be modified to work within your physical range, requiring a day for every hour normally needed to inscribe into your spellbook and double the cost due to experimentation materials.

Real-world Examples

Cerebral Palsy, Muscular Dystrophy, Multiple Sclerosis, Spina Bifida, Amyotrophic Lateral Sclerosis, Arthritis, Parkinson’s Disease

Assistive Options

No mundane technology can normally assist with this, but be creative.

Magical Assistance

The Telekinesis or Mage Hand spells and items that duplicate their effects can assist with this for minor tasks.

My spine doesn’t quite align, and everything is squinty, but don’t underestimate me. Although everything from the ribcage down is 10% dysfunctional, everything above works, and it’s the 90% functional that gets me into trouble!

– Dorian

Your spine has openings, exposing the neural tissue within, leaving you vulnerable to a variety of conditions and, at IE 4, Infection. You have −(IE) to Constitution saving throws against disease. You have (IE) of these related traits: Spine Difference, Muscle Control & Gait Difference, Body Rash, Sleep Disruptions, Diverse Face Shape, Skeletal Flexibility, Head and Neck Pain, or Incontinence. You have a heightened awareness of your own body and can predict internal changes. This gives you a +(IE) bonus to saving throws against magic that alters your body shape or internal function such as the Polymorph spell or Werewolf, and when recurring Pain or other physical traits manifest, a successful DC 10 passive Wisdom (Perception) check will alert you to its onset 1d20 minutes in advance.

Real-world Examples

Spina Bifida

Assistive Options

Spinal surgery is too dangerous in most fantasy world settings, so no mundane options help, although many of the related traits benefit from mobility aids and other options.

Magical Assistance

Magic that helps cure disease can help against frequent infections. Consult the related traits for additional assistance.