Managing Post-Injection Pain: When to Seek Medical Attention

Q: Managing Post-Injection Pain: When to Seek Medical Attention

Hello： Based on your description, the pain and bruising may be caused by a ruptured vein. <br>If it is phlebitis or extravasation of contrast media, there will typically be signs of redness and swelling. <br>It is recommended to apply ice and take oral anti-inflammatory pain reli

Pain persists after receiving the injection?

Hello, doctor.
On April 25th, I had a cardiovascular MRI with contrast injection, and a soft catheter was placed on the back of my right hand.
During the procedure, the nurse came in to inject the contrast, and it was very painful at that moment.
They handled it immediately, and the procedure was completed successfully.
Afterward, I applied pressure to the injection site for 10 minutes.
It hurts when I touch that area, but they mentioned that if there was extravasation, it would swell immediately, and the examination could not be completed, so I should not worry.
Today is the third day, and there is no swelling at the injection site on the back of my hand, but I feel pain when I move (for example, while typing now).
There is some bruising and tenderness around the protruding wrist bone area.
I am very concerned that I might have phlebitis or something similar.
How can I observe this at home (ice pack? heat pack? anti-inflammatory ointment?)? At what point should I seek medical attention, and which specialty should I consult? Thank you.

juli, 50~59 year old female. Ask Date: 2024/04/27

Dr. Lin Zhebin reply Family Medicine

Hello: Based on your description, the pain and bruising may be caused by a ruptured vein.
If it is phlebitis or extravasation of contrast media, there will typically be signs of redness and swelling.
It is recommended to apply ice and take oral anti-inflammatory pain relievers, and to keep your right hand elevated as much as possible.
If the pain persists without improvement and the area becomes red and swollen, it is advisable to seek medical attention, either at a family medicine clinic or a plastic surgery department.

Reply Date: 2024/04/27

More Info

After undergoing an injection, especially in the context of a medical procedure like an MRI with contrast, it is not uncommon to experience some level of discomfort or pain at the injection site. However, it is essential to differentiate between normal post-injection pain and symptoms that may indicate a more serious issue, such as phlebitis (inflammation of a vein) or other complications.

Based on your description, it seems that you are experiencing localized pain and some bruising at the injection site on your hand. This can occur due to the needle puncturing the skin and underlying tissues, which may lead to minor bleeding and subsequent bruising. The pain you feel when moving your hand or typing could be attributed to irritation of the surrounding tissues or nerves, especially if the injection was near a joint or a bony prominence.

Self-Care Measures
1. Ice Therapy: Applying ice to the affected area can help reduce swelling and numb the pain. It is advisable to use ice packs for 15-20 minutes every hour as needed, especially during the first 48 hours after the injection.

2. Heat Therapy: After the initial 48 hours, if there is no swelling, you may switch to heat therapy. Applying a warm compress can help relax the muscles and improve blood flow to the area, which may alleviate pain.

3. Topical Anti-inflammatory Creams: Over-the-counter anti-inflammatory creams or gels can be applied to the bruised area to help reduce pain and inflammation.

4. Rest and Elevation: Keeping your hand elevated can help minimize swelling. Avoiding strenuous activities that involve the affected hand can also aid in recovery.

When to Seek Medical Attention
While some discomfort is expected, you should seek medical attention if you notice any of the following:
- Increased Pain: If the pain worsens instead of improving over the next few days.

- Swelling: If you develop significant swelling at the injection site or if the area becomes red and warm to the touch, which could indicate an infection or phlebitis.

- Fever: If you experience a fever, this could be a sign of infection.

- Persistent Bruising: If the bruising spreads or does not improve after a week.

- Loss of Function: If you experience weakness, numbness, or difficulty moving your hand or fingers.

Which Specialist to Consult
If you decide to seek medical attention, you may start by consulting your primary care physician. They can evaluate your symptoms and determine if you need to see a specialist, such as a vascular surgeon or a neurologist, depending on the findings. If there is suspicion of phlebitis or a vascular issue, a vascular specialist would be appropriate. If nerve involvement is suspected, a neurologist would be the right choice.

In summary, while some pain and bruising after an injection can be normal, it is crucial to monitor your symptoms closely. Implementing self-care measures can help alleviate discomfort, but do not hesitate to seek medical advice if your symptoms do not improve or worsen. Your health and well-being are paramount, and timely intervention can prevent complications.

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