Managing Wrist and Elbow Pain After an Injury: Expert Advice

Wrist and elbow follow-up?

Hello, Doctor Shi: I am the girl who previously inquired about my injuries to my right wrist and elbow from a car accident.
It has been over three months since the injury.
I have been doing heat therapy and moving my wrist, which has improved its flexibility somewhat.
However, I still experience pain on both sides of the bones connecting my thumb and little finger to the wrist during movement.
When I grasp objects, I hear a clicking sound.
Bending my hand upwards towards my shoulder sometimes causes pain on the inner side of my elbow.
When putting on a jacket, I have to put my left arm in first; when I try to put my right arm in afterward, it causes pain in my wrist, so I have to put my right arm in first.
I can grip things better now, but I still cannot hold heavy items for long without pain returning.
What should I do? I would like to see an orthopedic specialist, but I heard that your Saturday clinic at NTU has been canceled due to SARS.
Are there any other clinics in Taipei you could recommend, or could you suggest a good doctor? Thank you for your response.

angela, 20~29 year old female. Ask Date: 2003/06/25

Dr. Shi Guozheng reply Orthopedics

The recovery of the wrist and elbow after injury is slow, and it may not fully heal in three months.
Continuing rehabilitation may help improve the condition.
Ligament injuries are more complicated than fractures, so patience is essential.
Director Chen at Taipei City Hospital has experience with hand-related conditions, and it would be beneficial to consult him.
I also have outpatient clinics at Hsinchu Hospital on Wednesday mornings.

Reply Date: 2003/06/25

More Info

Hello! It sounds like you have been dealing with quite a challenging recovery process following your wrist and elbow injury from the car accident. Given that it's been over three months since your injury, it's understandable that you're seeking further guidance on managing your pain and improving your functionality.

Firstly, it's important to recognize that pain and discomfort in the wrist and elbow after an injury can be attributed to several factors, including inflammation, soft tissue damage, or even joint instability. The symptoms you describe—pain during movement, clicking sounds in your fingers, and discomfort when lifting objects—are not uncommon in cases of wrist and elbow injuries.

Recommendations for Managing Your Symptoms:
1. Continued Physical Therapy: Since you've already started with heat therapy and some range of motion exercises, it might be beneficial to continue with physical therapy. A physical therapist can provide you with a tailored rehabilitation program that focuses on strengthening the muscles around your wrist and elbow, improving flexibility, and reducing pain. They may also use modalities such as ultrasound therapy or electrical stimulation to help manage pain and promote healing.

2. Pain Management: If you are still experiencing significant pain, consider discussing pain management options with your healthcare provider. Over-the-counter pain relievers like ibuprofen or acetaminophen can help reduce inflammation and pain. If these are not effective, your doctor may consider prescribing stronger medications or recommending corticosteroid injections to reduce inflammation in the affected areas.

3. Activity Modification: It’s crucial to listen to your body and modify your activities to avoid exacerbating your pain. For instance, if lifting heavy objects causes discomfort, try to limit those activities or use assistive devices to help reduce strain on your wrist and elbow. When dressing, as you mentioned, it may be easier to put on your right arm first to minimize discomfort.

4. Ergonomic Adjustments: Evaluate your daily activities and consider making ergonomic adjustments. For example, using tools with padded grips, adjusting your workspace to reduce strain, or using wrist supports can help alleviate some of the stress on your joints.

5. Follow-Up with a Specialist: Since you mentioned the difficulty in accessing orthopedic care due to scheduling issues, consider looking for other orthopedic clinics or specialists in your area. You can also explore telemedicine options, where you can consult with an orthopedic specialist remotely. They can provide you with a more comprehensive evaluation and suggest further imaging studies, such as an MRI, if necessary, to assess any underlying issues that may not have been addressed.

6. Alternative Therapies: Some patients find relief through complementary therapies such as acupuncture, massage therapy, or chiropractic care. These can be beneficial in managing pain and improving function, but it’s essential to consult with your healthcare provider before starting any new treatment.

Prognosis and Recovery Expectations:
Recovery from wrist and elbow injuries can vary widely depending on the severity of the injury and the individual’s overall health. It’s not uncommon for some patients to experience lingering pain or stiffness for several months after the initial injury. However, with appropriate treatment and rehabilitation, many individuals see significant improvements in their symptoms and functionality over time.

Mental Health Considerations:
Lastly, it’s important to address the emotional aspect of dealing with chronic pain and recovery. If you find yourself feeling anxious or frustrated about your recovery, consider speaking with a mental health professional. They can provide strategies to help you cope with the emotional challenges of your injury and recovery process.

In conclusion, continue to advocate for your health, seek out the appropriate resources, and don’t hesitate to reach out for help when needed. Your recovery is a journey, and with the right support and treatment, you can work towards regaining full function of your wrist and elbow. Best of luck, and I hope you find relief soon!

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