Post-Car Accident: Managing Wrist Pain and Nerve Issues

After the car accident, I started experiencing weakness in my hands and numbness in my palms?

Hello Doctor,
I was in a car accident on June 18th.
When the ambulance brought me to the hospital, there were no obvious external injuries, no need for stitches, and no fractures.
However, the impact was very strong; my motorcycle slid away, and the seat cushion flew off.
I only felt a strong agitation in my internal organs.
For the first week, I only experienced general body soreness, and my right hand had a noticeable abrasion with some discomfort in my wrist, but nothing severe.

As the wound healed, I gradually noticed that the bones in my right wrist were protruding.
I visited an orthopedic clinic, and after taking X-rays, they found no significant issues.
The doctor mentioned that the bone protrusion was due to displacement from the strong impact and that as long as it wasn't affecting function, it was okay.
They suggested that I might experience a 10-20% reduction in strength moving forward.

Subsequently, I sought treatment from a chiropractor and a traditional Chinese medicine clinic to see if they could realign the bones in my wrist.
They performed some massage and cupping, which made me feel much better.
However, after about three weeks, on the 23rd day, I experienced unusual soreness in the right side of my back and lower back, along with weakness in my right hand, which began to feel numb.
I quickly went to an orthopedic clinic where they took six X-rays and determined that the bones were fine.

Fearing gradual paralysis, I returned to the hospital where I was initially diagnosed to see an orthopedic doctor.
I inquired why my condition seemed to be worsening instead of improving, as is generally expected with injuries.
The doctor was concerned about potential nerve compression in my spine and prescribed anti-inflammatory medication, pain relievers, and muscle relaxants.
After about two weeks, I returned for a follow-up, but since there was no improvement, I underwent an MRI.
If there was nerve compression, spinal surgery might be necessary.

However, after returning home, I also began to feel soreness in my left hand.
Could this be related to the medication? Additionally, what methods are available to improve my condition? Both sides of my wrist are painful.
Should I be referred to a teaching hospital or a medical center for further evaluation?

Yan Xiansheng, 20~29 year old female. Ask Date: 2018/07/15

Dr. Shi Guozheng reply Orthopedics

If the above symptoms persist, further examination may be needed to check for nerve compression, as early intervention is better.

Reply Date: 2018/07/15

More Info

After a car accident, it's not uncommon to experience a range of symptoms, including wrist pain and nerve issues, as you've described. The impact from a collision can lead to various injuries, some of which may not be immediately apparent. In your case, it seems that while initial assessments did not show any fractures or severe injuries, the ongoing symptoms suggest that there may be underlying issues that need to be addressed.

Understanding Your Symptoms
1. Wrist Pain and Deformity: The "bump" or protrusion you mentioned in your wrist could be due to a few factors. It might be a result of soft tissue swelling, joint instability, or even a slight misalignment of the bones in the wrist. Even if X-rays do not show fractures, soft tissue injuries, such as ligament sprains or tendon injuries, can still cause significant pain and functional impairment.

2. Nerve Issues: The numbness and weakness in your right hand, along with the symptoms in your left hand, could indicate nerve compression or irritation. This can occur due to swelling in the surrounding tissues, which might be pressing on the nerves that run through the wrist (such as the median nerve, which is involved in carpal tunnel syndrome) or even higher up in the neck or shoulder area, especially if there was a whiplash-type injury during the accident.

3. Back and Shoulder Pain: The pain radiating from your back to your waist and the weakness in your arm could suggest that the injury has affected your cervical spine or upper back. The spine houses the spinal cord, and any injury or inflammation in this area can lead to nerve-related symptoms in the arms.

Recommended Actions
1. Follow-Up with Specialists: Given the complexity of your symptoms, it would be prudent to consult with a specialist, such as a neurologist or an orthopedic surgeon who specializes in upper extremity injuries. They can perform a thorough examination and may recommend additional imaging studies, such as an MRI, to assess for any nerve compression or soft tissue injuries that may not have been visible on X-rays.

2. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide exercises to strengthen the wrist and shoulder, improve range of motion, and alleviate pain. They can also use modalities such as ultrasound or electrical stimulation to help reduce inflammation and promote healing.

3. Pain Management: Continue to follow your doctor's advice regarding anti-inflammatory medications and muscle relaxants. If these are not providing sufficient relief, discuss alternative pain management strategies with your healthcare provider. This could include corticosteroid injections or other modalities.

4. Ergonomic Adjustments: If your daily activities involve repetitive wrist movements or prolonged positions that could exacerbate your symptoms, consider making ergonomic adjustments. This could involve using wrist supports, adjusting your workspace, or modifying how you perform certain tasks.

5. Monitoring Symptoms: Keep a detailed record of your symptoms, including when they occur, their intensity, and any activities that seem to exacerbate or alleviate them. This information can be invaluable for your healthcare providers in diagnosing and treating your condition.

Conclusion
In summary, while initial assessments may not have indicated severe injuries, the persistence and evolution of your symptoms warrant further investigation. Consulting with specialists, engaging in physical therapy, and managing pain effectively are crucial steps in your recovery process. If your symptoms continue to worsen or do not improve with conservative management, seeking care at a teaching hospital or medical center may provide access to more comprehensive diagnostic and treatment options. Your health and well-being are paramount, and addressing these issues promptly can help you regain function and improve your quality of life.

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