Managing Persistent Pain After Leg Injury: Treatment and Specialist Guidance

Injury from a car accident, the wound on the left calf has healed for over six months, but there is occasional mild pain (which has become more noticeable recently while walking)?

I was injured in a car accident, and I have a deep wound on my left calf with a large affected area.
The wound has healed for over six months, but recently I occasionally experience mild pain while walking.
(The pain is not severe, but I am concerned about potential long-term effects.)
1.
What methods can be used to treat or reduce the pain?
2.
Since the wound has healed for a long time, which specialty should I consult now?
3.
In relation to question 2, do I have to go to a large hospital? Can general outpatient orthopedic or surgical clinics address the issue?

fred, 30~39 year old female. Ask Date: 2020/09/27

Dr. Chen Jiaming reply Surgery

Due to the large and deep area of injury at that time, although the wound has healed, some superficial sensory nerves in the skin have been damaged to varying degrees, making recovery difficult.
As a result, changes in weather (such as alternating temperatures and humidity) can easily trigger localized discomfort (mild pain).
For this type of discomfort, short-term use of analgesics like acetaminophen can be considered to alleviate the symptoms, and over time, individuals usually become accustomed to the sensations.
Additionally, since the discomfort is more pronounced during physical activities, it is important to consider the effects of scar tissue.
Gradually stretching the affected area may help reduce the tightness and discomfort associated with the scar, although this may also make the scar more noticeable.

Reply Date: 2020/09/27

More Info

Managing persistent pain after a leg injury, especially following a significant trauma like a car accident, can be a complex process. It’s important to approach this situation with a comprehensive understanding of the potential underlying issues and the available treatment options.

1. Treatment Options for Pain Management: Since your injury occurred over six months ago and the wound has healed, the persistent pain you are experiencing could be due to several factors, including nerve damage, scar tissue formation, or even changes in the biomechanics of your leg. Here are some methods that may help alleviate your discomfort:
- Physical Therapy: Engaging in a structured physical therapy program can be highly beneficial. A physical therapist can assess your condition and design a tailored rehabilitation program that includes exercises to strengthen the muscles around the injured area, improve flexibility, and enhance overall function. Techniques such as ultrasound therapy, electrical stimulation, and manual therapy may also be employed to reduce pain and promote healing.

- Pain Management Techniques: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help manage pain and reduce inflammation. However, it's essential to consult with your healthcare provider before starting any medication. In some cases, your doctor might recommend other pain management strategies, such as corticosteroid injections or topical analgesics.

- Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, massage therapy, or chiropractic care. These modalities can help alleviate pain and improve function, although their effectiveness can vary from person to person.

- Home Care: Simple home care strategies, such as applying heat or cold to the affected area, can also provide relief. Heat can help relax and loosen tissues and stimulate blood flow, while cold therapy can reduce inflammation and numb sharp pain.

2. Which Specialist to Consult: Given that your injury is related to a previous trauma and you are experiencing ongoing pain, it would be advisable to consult a specialist in either orthopedics or physiatry (rehabilitation medicine). An orthopedic surgeon can evaluate any structural issues related to the bones, joints, or soft tissues, while a physiatrist can focus on the functional aspects of your recovery and pain management.
3. Where to Seek Treatment: You do not necessarily have to go to a large hospital for your evaluation. Many general orthopedic or surgical clinics can effectively assess and manage your condition. These clinics often have the necessary diagnostic tools, such as X-rays or MRI, to evaluate any underlying issues. However, if your condition is complex or if you require specialized interventions, a referral to a larger facility may be warranted.

In conclusion, while it is common to experience some discomfort after a significant injury, persistent pain should not be ignored. Engaging in a comprehensive rehabilitation program, consulting with the appropriate specialists, and exploring various treatment options can significantly improve your quality of life and functional abilities. Always communicate openly with your healthcare providers about your symptoms and concerns to ensure you receive the most effective care tailored to your needs.

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