Post-Injection Discomfort in Rehabilitation Therapy

Injection issues?

Hello Doctor: Recently, I have been experiencing a sensation of catching or slight soreness in my right wrist when performing rotational movements (such as using a key to open a door) and when picking up objects.
After consulting with a rehabilitation specialist, the doctor diagnosed me with triangular fibrocartilage complex (TFCC) inflammation through palpation and ultrasound.
I received an injection of an anti-inflammatory medication with a local anesthetic and was informed that slight soreness is normal.
I was advised to start physical therapy, including electrical stimulation and heat therapy, the following day.

As the effect of the anesthetic wore off, I began to experience significant soreness and swelling (initially, only certain movements would cause a catching sensation or mild soreness).
The day after the injection, the injection site was noticeably swollen, and almost all movements (excluding rotation) resulted in a catching sensation, along with intermittent soreness and swelling.
The rehabilitation therapist at the clinic informed me that soreness and swelling after the injection are normal phenomena and suggested that it might be due to poor absorption in my body.
They advised me that there was no need to see the doctor again and that I could proceed directly with rehabilitation.

Is it normal for symptoms to worsen after receiving an anti-inflammatory injection? Thank you for your valuable time and guidance!

Kait, 50~59 year old female. Ask Date: 2023/05/13

Dr. Wang Zhaomin reply Rehabilitation

After injection therapy, there may be swelling and soreness.
If there are no significant discomforts, rehabilitation treatment can be accepted.
However, if there is no improvement after three to five days or if the condition worsens, you should seek medical attention to discuss and reassess the situation in order to choose an appropriate treatment method.

Reply Date: 2023/05/13

More Info

Post-injection discomfort is a common experience in rehabilitation therapy, especially after receiving corticosteroid injections for conditions like triangular fibrocartilage complex (TFCC) inflammation. Your situation, where you experienced increased soreness and swelling after the injection, can be concerning, but it is not uncommon.

When corticosteroids are injected into an inflamed area, they work by reducing inflammation and pain. However, the injection itself can cause temporary irritation to the surrounding tissues, leading to increased discomfort. This is particularly true if the injection site is already inflamed or if there is an underlying condition that makes the area sensitive. The initial relief from pain due to the anesthetic can mask the discomfort that may arise from the injection process itself.

Here are some key points to consider regarding your symptoms:
1. Normal Reaction: It is not unusual for patients to experience increased soreness or swelling after an injection. This can be due to the body's inflammatory response to the injection or the local anesthetic used during the procedure. The swelling and discomfort may peak within the first few days post-injection and then gradually improve.

2. Duration of Symptoms: Typically, any post-injection discomfort should start to improve within a few days. If the symptoms persist beyond a week or worsen significantly, it would be advisable to follow up with your healthcare provider. Persistent swelling or pain could indicate an adverse reaction or an exacerbation of the underlying condition.

3. Rehabilitation Therapy: Engaging in physical therapy, such as electrical stimulation and heat therapy, as recommended by your rehabilitation therapist, can be beneficial. These modalities can help reduce inflammation, improve circulation, and promote healing in the affected area. However, it is essential to communicate any worsening symptoms to your therapist so they can adjust your treatment plan accordingly.

4. Individual Variability: Each patient's response to injections can vary significantly based on individual factors, including body composition, the severity of the condition, and overall health. Some individuals may have a more pronounced inflammatory response, leading to increased discomfort post-injection.

5. Monitoring Symptoms: Keep a close eye on your symptoms. If you notice any signs of infection (such as increased redness, warmth, or fever), or if the swelling does not begin to subside after a few days, it is crucial to seek medical attention.
6. Follow-Up: If your symptoms do not improve or if you have concerns about the severity of your discomfort, it is always best to consult with your physician. They may recommend further evaluation, such as imaging studies, to ensure there are no complications from the injection or the underlying condition.

In conclusion, while it is common to experience some discomfort after a corticosteroid injection, it is essential to monitor your symptoms closely and maintain open communication with your healthcare providers. They can provide guidance tailored to your specific situation and help ensure that your rehabilitation process remains on track.

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