Post-Fracture Pain: Right Wrist Injury and Shoulder Issues

Distal radius fracture of the right hand?

Hello, Doctor.
I would like to ask you the following: I suffered a distal radius fracture in my right wrist due to a car accident a year and a half ago.
I underwent surgery and had titanium metal fixation, which has not been removed.
However, due to my work, I have to use a mouse frequently (I am right-handed), and I am wondering if the frequent use of my right hand is the reason for the pain in my right shoulder and upper back.
My workload is similar to what it was before the accident, and I did not have any pain issues prior to that.
I would like to know if this could be considered a sequela.
Is there a way to address this? If I were to have the titanium hardware removed, would that potentially resolve the issue? (It was initially planned not to remove it, and it should have integrated with the surrounding muscle by now.) I have been trying to use my left hand more and practicing using the mouse with my left hand, but there has been no improvement.
I am eager to find a solution.
I apologize for bothering you again, and thank you.

Ms. Hsieh, 30~39 year old female. Ask Date: 2018/02/13

Dr. Shi Guozheng reply Orthopedics

Bone screws typically do not need to be removed as they do not affect function.
However, if it can be determined that the bone screw is causing an issue, then it should be removed.

Reply Date: 2018/02/13

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding the pain in your right shoulder and back following your wrist injury from a car accident. It’s understandable to be worried about ongoing pain, especially after a significant injury and surgery.

From your description, it seems that you are experiencing discomfort in your right shoulder and upper back, which could indeed be related to your previous wrist fracture and the subsequent surgery. When a person has an injury, especially one that requires surgery, the body often compensates for the affected area. In your case, since you are right-handed and have had a right wrist injury, it is likely that you have been using your right arm and shoulder more than usual to compensate for any limitations in your wrist. This overuse can lead to muscle strain, tendonitis, or even issues with the rotator cuff in the shoulder.

The pain you are experiencing could be classified as a post-injury syndrome, which is not uncommon after fractures. This syndrome can manifest as pain in areas that are not directly injured but are affected by changes in movement patterns or muscle usage due to the initial injury. The shoulder and upper back pain you are experiencing could be a result of muscle imbalances or overuse injuries that have developed as a consequence of your wrist injury.

As for whether this pain is a long-term consequence of your injury, it is possible. Chronic pain can develop after an injury due to various factors, including muscle tightness, nerve irritation, or even psychological factors related to the trauma of the accident. It is essential to address these issues early to prevent them from becoming chronic.

Regarding your question about the titanium hardware in your wrist, it is generally true that if the hardware is not causing any issues, it is often left in place. Removing it may not necessarily resolve your shoulder pain, especially if the pain is due to compensatory mechanisms rather than the hardware itself. However, if the hardware is causing discomfort or if there are complications, a consultation with your orthopedic surgeon would be necessary to evaluate the need for removal.

To address your shoulder and back pain, I recommend the following steps:
1. Physical Therapy: Engaging in a structured physical therapy program can help strengthen the muscles around your shoulder and back, improve flexibility, and correct any movement patterns that may be contributing to your pain.

2. Ergonomic Adjustments: Since you are using a mouse frequently, consider adjusting your workstation to ensure that it is ergonomically friendly. This may include using a mouse that is designed to reduce strain on the wrist and shoulder or adjusting the height of your chair and desk.

3. Pain Management: Over-the-counter pain relievers, such as NSAIDs (e.g., ibuprofen), may help manage your pain. However, it’s essential to consult with your healthcare provider before starting any medication.

4. Alternative Therapies: Techniques such as acupuncture, massage therapy, or chiropractic care may provide relief for some individuals. These therapies can help alleviate muscle tension and improve circulation.

5. Gradual Strengthening: As you are already practicing using your left hand, continue to do so, but also incorporate exercises that strengthen your right shoulder and back without overstraining them.

6. Follow-Up with Your Doctor: Regular follow-ups with your orthopedic surgeon or primary care physician are crucial. They can monitor your progress and make necessary adjustments to your treatment plan.

In summary, while your shoulder and back pain could be related to your previous wrist injury, it is essential to take a comprehensive approach to address these issues. Engaging in physical therapy, making ergonomic adjustments, and consulting with your healthcare provider will be beneficial steps toward recovery. If your symptoms persist or worsen, do not hesitate to seek further medical evaluation.

Best wishes for your recovery, and please take care of yourself.

Sincerely,
Doctor Q&A Teams

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