Managing Post-Accident Rehabilitation: Coping with Pain and Weakness

Post-traumatic sequelae after a car accident?

Hello, doctor.
I was hospitalized for over a month following a car accident in April of this year.
The diagnosis from Hospital A included: head trauma, concussion, cervical spine contusion, chest wall contusion, and a fracture of the fourth lumbar vertebra.
The neurosurgery department at Hospital A performed MRI and X-rays and assessed that no invasive treatment was necessary, so I was discharged.
After that, I went to Hospital B, where an orthopedic doctor reviewed the diagnosis from Hospital A, took X-rays, and diagnosed me with: traumatic cervical spine contusion, compression fracture of the fourth lumbar vertebra, and concussion.
I then underwent rehabilitation at Hospital C, where I received heat therapy and electrical stimulation for my neck and back for 20 minutes.
By early November this year, the rehabilitation doctor informed me that the results were limited and advised me to stop rehabilitation.
However, I am currently experiencing significant weakness in my right upper and lower limbs, persistent pain in my neck and lower back when bending my head down, and an uneven distribution of weight while walking.
Additionally, my right thumb trembles involuntarily, making it difficult for me to type normally for work.
At the end of November, I returned to the neurosurgery department at Hospital A, where I have been scheduled for a muscle electrical examination.
I am quite afraid of needles and feel anxious about the accuracy of the test results.
I have heard that taking a muscle relaxant to ease my anxiety before the examination might improve the accuracy.
Is this a feasible option? Thank you, doctor.

Niming, 30~39 year old female. Ask Date: 2019/11/28

Dr. Wang Zhaomin reply Rehabilitation

Generally, taking muscle relaxants or anti-anxiety medications does not affect the examination as long as the patient can maintain normal consciousness and cooperate with simple movements during the examination.

Reply Date: 2019/11/28

More Info

Managing post-accident rehabilitation, especially after a car accident resulting in multiple injuries, can be a complex and challenging process. Your situation involves a range of symptoms including weakness in your upper and lower extremities, persistent pain in your neck and lower back, and involuntary tremors in your right thumb. These symptoms can significantly impact your daily life and ability to work, making effective management crucial.

Firstly, it’s important to understand that recovery from injuries such as traumatic brain injury, cervical spine contusions, and lumbar compression fractures can take time. The body needs to heal, and this process can be influenced by various factors including the severity of the injuries, your overall health, and adherence to rehabilitation protocols.

Rehabilitation and Pain Management
1. Physical Therapy: Since you have already undergone physical therapy with limited results, it may be beneficial to seek a second opinion or explore different rehabilitation approaches. A physical therapist can tailor a program to address your specific needs, focusing on strengthening exercises for your upper and lower extremities, as well as flexibility and range of motion exercises for your neck and back.
2. Pain Management: Managing pain is crucial for rehabilitation. If you are experiencing significant discomfort, discussing pain management options with your healthcare provider is essential. This may include medications such as non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or even nerve pain medications, depending on your symptoms.

3. Neurological Evaluation: Given the tremors in your thumb and the weakness in your limbs, a thorough neurological evaluation is warranted. The muscle electrical study (EMG) you mentioned can provide valuable information about the health of your muscles and the nerves that control them. While it’s understandable to feel anxious about needle procedures, this test is crucial for diagnosing potential nerve damage or other neurological issues.

4. Psychological Support: Anxiety about medical procedures can be common, especially after traumatic experiences. It may be helpful to speak with a mental health professional who can provide strategies to cope with anxiety. Additionally, discussing your fears with your physician can lead to solutions such as sedation options during procedures to help you feel more comfortable.

5. Lifestyle Modifications: Incorporating gentle activities such as walking or swimming can help maintain mobility without putting excessive strain on your body. Additionally, practicing good ergonomics while working or using a computer can help alleviate some discomfort in your neck and back.

6. Alternative Therapies: Some patients find relief through complementary therapies such as acupuncture, chiropractic care, or massage therapy. While these should not replace conventional medical treatment, they can be useful adjuncts to your rehabilitation plan.

Monitoring Progress
Recovery from such injuries is often non-linear, meaning you may experience periods of improvement followed by setbacks. It’s important to maintain open communication with your healthcare team about your symptoms and any changes you notice. Regular follow-ups can help adjust your treatment plan as needed.

Conclusion
In summary, managing post-accident rehabilitation involves a multifaceted approach that includes physical therapy, pain management, neurological evaluation, psychological support, and lifestyle modifications. While the journey may be challenging, with the right support and treatment plan, significant improvements can be made. Don’t hesitate to advocate for your health and seek the care you need to facilitate your recovery.

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