Managing Pain After Pelvic Fracture: When to Seek Medical Advice

Pelvic fracture

Hello Doctor, my mother has been hospitalized for a month due to a left pelvic fracture.
She underwent skeletal traction treatment for four weeks and has been discharged for over ten days.
The doctor advised her not to bear weight, so she mostly remains in bed and uses a walker to take a few steps to the bathroom (without putting weight on her left foot).
In the past two days, my mother has reported experiencing discomfort and soreness in her lower back.
I am concerned that this might be related to her pelvic injury, although she occasionally complained of lower back pain before the injury.
Should I be worried and seek an earlier follow-up appointment to confirm her condition? My mother mentioned that the pain in her left pelvic area has significantly decreased.
Thank you for your guidance.

Cai Xiaojie, 20~29 year old female. Ask Date: 2021/03/07

Dr. Shi Guozheng reply Orthopedics

Pelvic fractures typically show initial callus formation around six weeks post-injury, at which point the fracture site gains a certain degree of stability, leading to a gradual reduction in pain rather than an abrupt decrease.
Therefore, there is no need to rush for an earlier follow-up appointment.
Usually, follow-up X-rays are sufficient at six weeks and twelve weeks post-injury.

Reply Date: 2021/03/07

More Info

Managing pain after a pelvic fracture can be a complex process, especially in elderly patients or those with pre-existing conditions. Your mother's situation, having undergone skeletal traction for a month and now being in a recovery phase, requires careful monitoring and management of her pain and mobility.

Firstly, it’s important to understand that pain in the lower back or pelvis after a pelvic fracture can arise from several sources. Given that your mother has a history of occasional lower back pain, it is possible that her current discomfort could be related to her pre-existing condition rather than directly from the pelvic fracture. However, the healing process of the fracture itself can also lead to pain as the body adjusts and compensates for the injury.

When to Seek Medical Advice
1. Persistent or Worsening Pain: If your mother’s pain in the lower back or pelvis persists or worsens, it is advisable to seek medical advice. While some discomfort can be expected during recovery, significant changes in pain levels should be evaluated by a healthcare professional.

2. Changes in Mobility: If your mother experiences any new difficulties in mobility, such as increased difficulty using the walker or performing daily activities, this could indicate a complication that requires medical attention.

3. Signs of Complications: Look for signs that may indicate complications, such as swelling, redness, or warmth in the area of the fracture, fever, or any unusual symptoms. These could suggest an infection or other issues that need immediate evaluation.

4. Psychological Well-being: Recovery from a fracture can be mentally taxing, especially for older adults. If your mother shows signs of increased anxiety or depression related to her condition, it may be beneficial to discuss these concerns with her healthcare provider.

Pain Management Strategies
In the meantime, managing her pain effectively is crucial. Here are some strategies that may help:
- Medication: Ensure that she is taking any prescribed pain medications as directed. Over-the-counter options like acetaminophen or NSAIDs (if appropriate for her health conditions) can also be considered for pain relief.

- Physical Therapy: Once cleared by her doctor, physical therapy can be beneficial. A physical therapist can provide exercises tailored to her recovery stage that can help strengthen the muscles around the pelvis and lower back, potentially alleviating pain.

- Heat and Cold Therapy: Applying heat or cold packs to the affected area can provide relief. Heat can help relax tense muscles, while cold can reduce inflammation.

- Gentle Movement: Encourage gentle movement as tolerated. While she should avoid putting weight on her left leg, gentle stretching and movement can help maintain flexibility and reduce stiffness.

Follow-Up Care
Given that your mother has been advised not to bear weight and is primarily resting, it is essential to have regular follow-up appointments with her healthcare provider. These visits will allow her doctor to monitor her healing progress and adjust her treatment plan as necessary. If her pain continues to improve, it may not be urgent to return to the doctor immediately, but keeping an open line of communication with her healthcare team is vital.

In summary, while some discomfort can be expected during recovery from a pelvic fracture, any significant changes in pain or mobility should prompt a visit to her healthcare provider. Regular follow-ups and effective pain management strategies will be key to her recovery process.

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