Lingering Injuries

It’s pretty easy to lose an eye, hand, or organ… in D&D! Let’s talk about lingering injuries. The fifth edition Dungeons and Dragons Dungeon Master’s Guide provides a handy new optional rule for combat with consequences beyond draining hit points and hit dice. Lingering injuries make it so a player character can suffer a more debilitating injury (like losing a body part or internal organ damage) after suffering a critical hit, falling to 0 hit points, and/or failing a death saving throw by 5 or more. These injuries come with a mechanical penalty which makes sense when paired with the flavor of the wound.

Some folks out there, like my main man David Gibson of 5-Minute Workday, have taken issue with lingering injuries as presented in the Dungeon Master’s Guide. They feel the chances of losing an eye or a limb are too great for most games. What if someone wants to play with lingering injuries, but does want to have to cast the regenerate spell every session? Ya know, gritty lite instead of straight up gritty.

Perhaps there are others of you who would like to see more opportunities for PCs to suffer lingering injuries. You might feel like combat is hazardous to the PCs’ health and the rules should reflect that. You’re looking for whole grit in your campaign. None of the 2% stuff.

Well in today’s post I’m going to address these issues by presenting a variant rules which affect how often lingering injuries occur plus a bunch of new lingering injuries to add to your game. Get excited people! It’s time to hurt some PCs.

Lingering Injuries Variant Rules

Here are some variant rules you can add to the Lingering Injuries module presented on pages 272 and 273 of the Dungeon Master’s Guide.

Variant Rule: You Fireballed My Leg Off

In addition to the options already presented in the Dungeon Master’s Guide, a creature may sustain a lingering injury after rolling a natural 1 on a saving throw against a spell, magical, or trap effect that deals damage to the creature.

Variant Rule: Lose an Eye, I Choose You

When you score a critical hit by attacking a paralyzed or unconscious creature within 5 feet of you, you can choose the lingering injury which effects the creature as a result of the critical hit instead of rolling on the Lingering Injuries table.

Variant Rule: Confirm Lingering Injury

When you suffer an effect that would cause you to roll for a lingering injury, first roll a d20. If you roll a 1-9, roll on the Lingering Injuries table as normal. If you roll a 10-20, the effect does not cause you to suffer a lingering injury. This variant rule is meant to reduce the number of lingering injuries which occur at the table.

Variant Table: Expanded Lingering Injury

The table below is meant to expand the injury options from the ones presented in the Dungeon Master’s Guide. Whenever you would roll on the Lingering Injuries table, you can choose to roll on the Expanded Lingering Injuries table instead.

Expanded Lingering Injuries

d100	Injury
1-2	Lose an Eye. You have disadvantage on Wisdom (Perception) checks that rely on sight and on ranged attack rolls. Magic such as the regenerate spell can restore the lost eye. If you have no eyes left after sustaining this injury, you’re blinded.
3-4	Lose an Arm or a Hand. You can no longer hold anything with two hands, and you can hold only a single object at a time. Magic such as the regenerate spell can restore the lost appendage.
5-6	Lose a Foot or Leg. Your walking speed is halved and you must use a cane or crutch to move unless you have a peg leg or other prosthesis. You fall prone after using the Dash action. You have disadvantage on Dexterity checks made to balance. Magic such as the regenerate spell can restore the lost appendage.
7-8	Lose an Ear. You have disadvantage on Charisma (Persuasion) checks and Wisdom (Perception) checks that rely on hearing. You have advantage on Charisma (Intimidation) checks. Magic such as the regenerate spell can restore the lost ear.
9-10	Lose Nose. You have disadvantage on Charisma (Persuasion) checks and Wisdom (Perception) checks that rely on smell. You have advantage on Charisma (Intimidation) checks. Magic such as the regenerate spell can restore the lost nose.
11-15	Blurred Vision. You have disadvantage on Wisdom (Perception) checks that rely on sight and on ranged attack rolls. The injury heals if you receive magical healing. Alternatively, the injury heals after you spend three days doing nothing but resting.
16-20	Broken Arm or Hand. You can no longer hold anything with two hands, and you can hold only a single object at a time. The injury heals if you receive magical healing. Alternatively, the injury heals after someone sets the bone with a DC 15 Wisdom (Medicine) check and you spend thirty days doing nothing but resting.
21-25	Broken Foot or Leg. Your walking speed is halved and you must use a cane or crutch to move. You fall prone after using the Dash action. You have disadvantage on Dexterity checks made to balance. The injury heals if you receive magical healing. Alternatively, the injury heals after someone sets the bone with a DC 15 Wisdom (Medicine) check and you spend thirty days doing nothing but resting.
26-30	Ringing Ears. You have disadvantage on Wisdom (Perception) checks that rely on hearing. The injury heals if you receive magical healing. Alternatively, the injury heals after you spend three days doing nothing but resting.
31-35	Limp. Your walking speed is reduced by 5 feet. You must make a DC 10 Dexterity saving throw after using the Dash action. If you fail the save, you fall prone. Magical healing removes the limp.
36-40	Lose a Finger. You have disadvantage on Dexterity (Sleight of Hand) checks and Dexterity checks to use fine tools (such as thieves’ tools) using the hand with which you lost the finger. Magic such as the regenerate spell can restore the lost finger. If you lose all the fingers from one hand, then it functions as if you had lost a hand.
41-45	Break a Finger. You have disadvantage on Dexterity (Sleight of Hand) checks and Dexterity checks to use fine tools (such as thieves’ tools) using the hand with the broken finger. The injury heals if you receive magical healing. Alternatively, the injury heals after someone sets the finger with a DC 10 Wisdom (Medicine) check and you spend ten days doing nothing but resting.
46-50	Break an Item. A randomly determined nonmagical item you hold, wear, or carry on your person is broken or ruined. Roll a d10. On a roll of 1, the item broken is a weapon, on a roll of 2 the item is armor or a shield, and on a roll of 3-10 it is an item that’s not a shield or weapon.
51-55	Teeth Knocked Out. You have disadvantage on Charisma (Persuasion) checks. When you cast a spell with a verbal component there is a 25% chance the spell will not work. If the spell fails, you still used your action to try to cast it, but the spell did not use any slots or material components. The injury heals if you receive magical healing.
56-60	Festering Wound. Your hit point maximum is reduced by 1 every 24 hours the wound persists. If your hit point maximum drops to 0, you die. The injury heals if you receive magical healing. Alternatively, someone can tend to the wound and make a DC 15 Wisdom (Medicine) check once every 24 hours. After ten success, the injury heals.
61-65	Open Wound. You lose 1 hit point every hour the wound persists. The injury heals if you receive magical healing. Alternatively, someone can tend to the wound and make a DC 15 Wisdom (Medicine) check once every hour. After ten success, the injury heals.
66-70	Skull Fracture. Whenever you attempt an action in combat, you must make a DC 20 Constitution saving throw. On a failed save, you lose your action and can’t use reactions until the start of your next turn. The injury heals if you receive magical healing or if you spend thirty days doing nothing but resting.
71-75	Punctured Lung. You can take either an action or a bonus action or your turn, but not both. The injury heals if you receive magical healing. If you puncture both lungs your hit points drop to 0 and you immediately begin dying.
76-80	Internal Injury. Whenever you attempt an action in combat, you must make a DC 15 Constitution saving throw. On a failed save, you lose your action and can’t use reactions until the start of your next turn. The injury heals if you receive magical healing or if you spend ten days doing nothing but resting.
81-85	Broken Ribs. This has the same effect as Internal Injury above, except that the save DC is 10.
86-90	Horrible Scar. You have disadvantage on Charisma (Persuasion) checks and advantage on Charisma (Intimidation) checks. Magical healing of 6th level or higher, such as heal and regenerate, removes the injury.
91-95	Painful Scar. You have a scar which gets painful whenever it rains, sleets, hails, or snows. Whenever you attempt an action in combat and your scar is giving you pain, you must make a DC 15 Constitution saving throw. On a failed save, you lose your action and can’t use reactions until the start of your next turn. The injury heals if you receive magical healing.
96-100	Minor Scar. The scar doesn’t have any adverse effect, but chicks dig it. Magical healing of 6th level or higher, such as heal and regenerate, removes the scar.

PDF

If you like these variant rules for lingering injuries and want them to have and hold forever, go ahead and grab them in the PDF below.

Lingering Injuries

If you want to grab the PDF later you can head on over to the Free Game Resources section of the site where it will live forever alongside plenty of other resources for your game like monsters, D&D fifth edition rules modules, backgrounds, spells, magic items, adventures, and more.

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