Chest Injury After Car Accident: When to See a Specialist?

For a left chest contusion after a car accident, with no fractures but experiencing abnormal pain for several days, you should see a specialist in either Emergency Medicine or Orthopedics. It is also advisable to consult with a Primary Care Physician or a Pain Management specialist. Experiencing persistent pain after a contusion can be normal, but it is important to have it evaluated to rule out any underlying issues?

I apologize for the interruption.
After the car accident on July 20 (X-rays showed no fractures), the diagnosis indicated a contusion of the left chest.
Initially, after a few days of rest, the pain significantly decreased.
However, on July 26, I woke up with severe pain, chest tightness, and pain upon breathing, which radiated into the chest cavity and to the back.
The pain was so intense that I was afraid to breathe, cough, or sneeze.
(I am unsure if this was caused by sleeping on my side.) On July 27, the severe pain had decreased upon waking, and I immediately consulted a pulmonologist.
X-rays and an electrocardiogram were normal, with no fractures or bleeding.
As of July 30, I still experience pain, particularly in the lower ribs of the chest when coughing.
1.
I would like to know if this is classified as a contusion of the bone surface or a muscle contusion?
2.
How long should I expect the pain from either of these two types of injuries to last before it is considered normal?
3.
Given the uncertainty regarding the type of injury and the absence of fractures, should I consult an orthopedic specialist or a rehabilitation specialist? Thank you for your response.

9m, 30~39 year old female. Ask Date: 2023/07/30

Dr. Wang Zhaomin reply Rehabilitation

1.
Contusions of the ribs, intercostal muscles, and associated soft tissues within the thoracic cavity are possible, and subtle linear rib fractures that cannot be detected by X-ray cannot be ruled out.
2.
The duration can range from several days to weeks.
3.
Either orthopedic or rehabilitation specialists can manage the condition.

Reply Date: 2023/07/30

More Info

After a car accident, experiencing persistent pain in the chest area can be concerning, especially when it escalates to the point of affecting your ability to breathe comfortably. Given the details you've provided, it seems that you are dealing with a soft tissue injury, likely involving bruising of the muscles or connective tissues in the chest area, rather than a bone fracture, since your X-rays have shown no fractures or internal bleeding.

1. Nature of the Injury: The pain you are experiencing could be attributed to either a contusion (bruise) of the chest wall muscles or a strain of the intercostal muscles, which are the muscles located between the ribs. These types of injuries can occur from the impact of the accident, even if there are no visible fractures. The fact that the pain worsens with certain movements, such as coughing or sneezing, suggests that it may be related to muscle strain or irritation of the soft tissues rather than a bony injury.

2. Duration of Pain: Recovery from soft tissue injuries can vary significantly from person to person. Generally, mild to moderate muscle strains or contusions may take anywhere from a few days to several weeks to heal. In your case, since you mentioned that the pain initially decreased but then intensified, it could indicate that you may have aggravated the injury or that the initial healing process was disrupted. It’s not uncommon for pain to fluctuate during the healing process, especially if certain movements or positions exacerbate the discomfort. If the pain persists beyond 4 to 6 weeks or worsens, it would be advisable to seek further evaluation.

3. Specialist Consultation: Given that your pain has not resolved and is affecting your daily activities, it would be prudent to consult with a specialist. Since you have already ruled out fractures and serious internal injuries through imaging, a visit to a rehabilitation specialist (physiatrist) would be beneficial. They can provide a comprehensive assessment of your soft tissue injury and develop a tailored rehabilitation program to help alleviate your pain and restore function. They may also recommend physical therapy, which can include modalities such as ultrasound, electrical stimulation, and specific exercises to strengthen the affected area and improve flexibility.

In summary, while it is reassuring that your X-rays have shown no fractures, the ongoing pain warrants further evaluation and possibly a referral to a rehabilitation specialist. They can help determine the exact nature of your injury and guide you through an appropriate recovery plan. Additionally, if you experience any new symptoms, such as difficulty breathing, increased pain, or any signs of infection, you should seek immediate medical attention. Remember to listen to your body and avoid activities that exacerbate your pain during the healing process.

Similar Q&A

Chest Pain After Car Accident: Understanding Possible Causes and Remedies

Dr. Ke would like to ask a question regarding a friend who, after a car accident, discovered a painful spot just above the right chest. The pain worsens when laughing or coughing. He has seen an orthopedic doctor who stated that there are no issues with the bones and that it is l...

Dr. Ke Zhengchang reply Pulmonology
Hello: Based on your description, if there are no fractures, pneumothorax, or hemothorax on the X-ray after the car accident, muscle contusion or tendon strain is most likely. Generally, with adequate rest and treatment with anti-inflammatory pain relievers for 1 to 2 weeks, impr...

Post-Car Accident Injuries: Which Specialist Should You See?

I was in a car accident yesterday. Initially, I assessed my injuries and found that my calf was hurt, but I still went to the emergency room for an X-ray. The doctor said there was nothing serious and prescribed anti-inflammatory medication. However, last night my right shoulder ...

Dr. Ye Qianyu reply Family Medicine
Hello! I recommend you see an orthopedic specialist.

Post-Crash Chest Pain: Should You See a Pulmonologist or Internist?

Yesterday, I fell off my motorcycle after an emergency brake while carrying a passenger on the back seat. Both of us fell to the ground, and the person on the back landed on top of me. I have some abrasions on my body and face, and I felt pain in my chest from the impact. Could t...

Dr. Jian Shuntian reply Pulmonology
Hello, direct or indirect impact to the chest can potentially cause bleeding within the thoracic cavity or pleura. Please visit a thoracic specialist for a chest X-ray to confirm and receive further treatment. Thank you. This response is respectfully provided by Dr. Jian Shun-Tia...

Understanding Chest Pain After a Car Accident: What to Watch For

Hello doctor, a few days ago I was in a car accident where I experienced a strong forward impact and the seatbelt tightly constricted my chest, resulting in chest pain without any external injuries. Due to my pregnancy, I am unable to undergo an X-ray, and the emergency room doct...

Dr. Yang Wenda reply Pulmonology
Hello: 1. If there is difficulty breathing, seek medical attention; typically, in the absence of trauma, it does not lead to rib fractures or internal bleeding. 2. If necessary, during the 6-9 months of pregnancy, abdominal protection can be added when taking a chest X-ray. Best ...