Managing Knee Pain and Swelling After Injury: Recovery Insights

Knee swelling and pain, bilateral foot edema?

Dear Dr.
Yang,
About two months ago, I sustained injuries from an accident that resulted in fractures of the eleventh and twelfth thoracic vertebrae, as well as the first lumbar vertebra, a shattered patella in my right knee, and fractures of the third and fourth toes on both feet.
After undergoing surgeries on my spine and knee, and having both feet casted, I have now entered the rehabilitation and healing phase.
However, since I started practicing bending and walking with my knee, I have experienced severe redness, swelling, and pain, along with occasional sounds resembling bone friction.
Additionally, I have significant edema below the knee, particularly in the soles of my feet, which are very painful on the outer sides.
At night, my spine and feet ache excessively, making it difficult to sleep.
Therefore, I would like to ask you:
1.
Are these symptoms normal during the rehabilitation phase, or could they be due to excessive practice time?
2.
How can I improve the edema? The swelling and pain in my knee are quite severe; should I return to the hospital to request pain medication from a physician?
3.
Based on my current condition, how long do you think it will take before I can return to normal work, walking, and driving?
I appreciate your time and look forward to your response.
Thank you!
Sincerely,
Xiao Zhu

Xiao Zhu, 30~39 year old female. Ask Date: 2003/12/10

Dr. Yang Zhengfan reply Orthopedics

Dear Xiao Zhu, your injuries are quite severe and likely caused by significant trauma.
Generally, the healing time for a simple fracture is about three to six months; however, the duration of swelling and soreness often exceeds the healing time.
This is because the resolution of swelling and soreness requires not only healing but also the re-establishment of microcirculation.
The more complex the injury, the longer the recovery time will be.
During this period, the only effective method is to keep your leg elevated.
Whether you need pain medication depends on the severity of your pain.
As for work and walking, you will need to return for follow-up X-rays to determine the next steps.

Reply Date: 2003/12/10

More Info

Dear 小竹,
Thank you for reaching out with your concerns regarding your recovery after such significant injuries. It’s understandable to feel anxious about your symptoms and the rehabilitation process. Let’s address your questions one by one.

1. Are these symptoms normal during the rehabilitation period?
Yes, the symptoms you are experiencing, such as severe swelling, pain, and the sensation of grinding in the knee, can be common during the rehabilitation phase after significant injuries like yours. After surgeries involving fractures and soft tissue damage, it’s typical for the body to react with inflammation, which can lead to swelling and discomfort. However, if you feel that your practice sessions are excessively long or intense, it may contribute to increased pain and swelling. It’s crucial to balance your rehabilitation exercises with adequate rest and not to push beyond your comfort level, as this can exacerbate your symptoms.

2. How can I improve the swelling? Should I return to the doctor for pain relief medication?
To manage swelling, elevating your legs above heart level when resting can help reduce fluid accumulation. Applying ice packs to the swollen areas for 15-20 minutes several times a day can also alleviate swelling and pain. Compression wraps or stockings may provide additional support. If your pain is severe and affecting your quality of life, it would be wise to consult your physician about pain relief options, including medications. They may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) or other pain management strategies tailored to your needs.

3. How long will it take to return to normal activities such as work, walking, and driving?
Recovery timelines can vary significantly based on the severity of your injuries and your overall health. Generally, for complex injuries like yours, it may take several months to regain full function. The rehabilitation process often involves gradual increases in activity, and it’s essential to follow your physical therapist’s guidance closely. Regular follow-ups with your healthcare provider will help monitor your progress and adjust your rehabilitation plan as needed. If you continue to experience significant pain or instability, further imaging studies, such as an MRI, may be warranted to assess any underlying issues that could be affecting your recovery.

In summary, while some discomfort and swelling are expected during your recovery, it’s essential to manage these symptoms proactively. Elevation, ice, and appropriate pain management can help. Additionally, maintaining open communication with your healthcare team will ensure that you receive the best care tailored to your recovery needs.
Wishing you a smooth and speedy recovery. Please take care of yourself, and don’t hesitate to reach out if you have further questions or concerns.

Best regards,
Doctor Q&A Teams
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