Post-Cast Care: Managing Elbow Pain After Wrist Surgery

After plaster immobilization

Hello, doctor! After my wrist surgery last month, I had a long arm cast for stabilization.
It's been a month, and the cast has now been changed to a short arm cast.
My next follow-up appointment is in a month, after which the surgical screws will be removed.
However, I am now experiencing elbow pain.
I have been trying to fully extend my elbow and do stretching exercises, but the elbow is still swollen and painful, and there is discomfort in the joint.
I would like to ask for your advice: should I return to the surgeon who performed my operation, or would it be sufficient to visit a nearby rehabilitation clinic?

Xiao Ai, 20~29 year old female. Ask Date: 2018/02/17

Dr. Li Yongheng reply Orthopedics

Hello, it is normal to experience elbow pain and limited range of motion four weeks after being in a long arm cast.
It is recommended that you undergo rehabilitation therapy at a nearby physical therapy clinic.
Wishing you a Happy New Year and a speedy recovery.

Reply Date: 2018/02/17

More Info

After wrist surgery, it's not uncommon to experience discomfort or pain in the elbow, especially when a long arm cast has been used. The transition from a long arm cast to a short arm cast can sometimes lead to changes in how the muscles and joints function, potentially causing pain or swelling in nearby areas like the elbow. Here are some considerations and recommendations for managing your elbow pain post-cast:

Understanding the Pain
1. Referred Pain: Sometimes, pain in the elbow can be referred from the wrist or forearm due to the interconnected nature of the musculoskeletal system. The immobilization of the wrist can lead to stiffness and discomfort in the elbow as well.

2. Muscle Atrophy: Prolonged immobilization can lead to muscle atrophy and weakness in the surrounding areas, including the elbow. This can contribute to pain and discomfort as the muscles are not functioning optimally.

3. Joint Stiffness: After being in a cast, joints can become stiff, leading to discomfort when trying to move them. This stiffness can be particularly pronounced in the elbow if it has not been used much during the healing process.

Recommendations for Management
1. Gentle Range of Motion Exercises: Continue with gentle stretching and range of motion exercises for the elbow. It's important to do this carefully to avoid exacerbating the pain. Gradually increase the range of motion as tolerated.

2. Ice Therapy: Applying ice to the elbow can help reduce swelling and numb the pain. Use an ice pack wrapped in a cloth for 15-20 minutes several times a day.

3. Elevation: Keeping the elbow elevated can help reduce swelling. Try to keep it above the level of your heart when resting.

4. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and reduce inflammation. Always follow the dosage instructions and consult your physician if you have any concerns.

5. Physical Therapy: If the pain persists, consider visiting a physical therapist. They can provide targeted exercises and modalities to help alleviate pain and improve function.

When to Seek Further Medical Attention
- Persistent Pain: If the elbow pain does not improve with home management strategies or worsens, it is advisable to consult your orthopedic surgeon or a healthcare provider. They may want to evaluate for any underlying issues, such as nerve compression or joint problems.

- Swelling and Redness: If you notice significant swelling, redness, or warmth around the elbow, these could be signs of infection or other complications that require immediate medical attention.

- Loss of Function: If you experience a significant loss of function in the elbow, such as an inability to bend or straighten it, this should also prompt a visit to your healthcare provider.

Conclusion
In summary, while elbow pain after wrist surgery and casting can be a common occurrence, it is essential to manage it appropriately. Gentle exercises, ice therapy, and pain management can help alleviate discomfort. However, if symptoms persist or worsen, seeking further evaluation from your surgeon or a physical therapist is recommended. They can provide a tailored approach to your recovery and ensure that you regain full function in your arm.

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