Persistent Finger Pain After Fish Bone Injury: Seeking Solutions - Surgery

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It sounds like you are experiencing significant and persistent discomfort following a fish bone injury to your finger. The symptoms you describe—ongoing pain, numbness, swelling, and changes in color—are concerning and warrant further evaluation.
Initially, it is important to understand that injuries from foreign objects, such as fish bones, can lead to various complications, including infection, foreign body reactions, or even nerve damage. The fact that you had a fish bone removed and are still experiencing pain and other symptoms suggests that there may be underlying issues that need to be addressed.


Possible Causes of Your Symptoms
1. Infection: Although you mentioned that there were no signs of infection initially, it is still possible for an infection to develop later. Symptoms of infection can include increased redness, warmth, swelling, and discharge from the wound. If you notice any of these signs, it is crucial to seek medical attention.

2. Nerve Damage: The numbness and tingling you are experiencing could indicate nerve involvement. If the injury affected the nerves in your finger, it could lead to persistent pain and altered sensation. This is particularly relevant given that you mentioned a "tight" feeling and a "popping" sensation when bending your finger.

3. Scar Tissue Formation: After an injury, scar tissue can form, which may restrict movement and cause discomfort. The white protrusion you mentioned could be a sign of excessive scar tissue or a keloid, which can sometimes develop after injuries.

4. Complex Regional Pain Syndrome (CRPS): This is a chronic pain condition that can develop after an injury. Symptoms include prolonged pain, swelling, and changes in skin color and temperature. It is characterized by an exaggerated response to pain and can be quite debilitating.


Recommended Next Steps
Given your ongoing symptoms, I recommend the following steps:
1. Consult a Specialist: It would be prudent to see a hand specialist or an orthopedic surgeon who focuses on upper extremity injuries. They can perform a thorough examination and may recommend imaging studies, such as an MRI, to assess for any soft tissue damage, nerve involvement, or residual foreign material.

2. Physical Therapy: Continuing with physical therapy is essential. A physical therapist can help you with exercises to improve mobility, reduce pain, and strengthen the muscles around the affected area. They can also provide modalities such as ultrasound or electrical stimulation to help with pain management.

3. Pain Management: Discuss your pain management options with your healthcare provider. They may consider prescribing medications that target nerve pain, such as gabapentin or pregabalin, if nerve damage is suspected.

4. Monitor for Changes: Keep an eye on your symptoms. If you notice any worsening of pain, changes in sensation, or signs of infection, seek medical attention promptly.

5. Consider a Second Opinion: If you feel that the opinions you have received so far are not addressing your concerns adequately, it may be beneficial to seek a second opinion from another healthcare provider.


Conclusion
Your situation is complex, and it is essential to approach it with a comprehensive plan. Persistent pain and sensory changes following an injury should not be overlooked, as they can significantly impact your quality of life. By consulting with the right specialists and continuing your rehabilitation, you can work towards finding relief and restoring function to your finger. Remember, early intervention can often lead to better outcomes, so do not hesitate to seek further evaluation.