Unexplained Orthopedic Issues: Seeking Solutions for Persistent Pain

Unexplained etiology?

Hello, I would like to consult a doctor regarding some issues.

1.
I was in a car accident about five years ago, where the first point of impact was my right elbow, and I landed on my right shoulder.
I have seen a doctor for this.

2.
For the past five years, I have been experiencing repetitive strain in my right thumb from playing basketball.
I have accidentally bumped my right thumb multiple times and have consulted a doctor about it.

3.
About a month ago, I injured my left middle finger when a heavy object fell on it while I was working.
I still cannot fully move it like my other fingers, and when I try to make a fist, it hurts slightly.
There is some swelling and bruising.
Effects:
1.
My right elbow is sensitive to cold air; I almost always wear a brace.
I frequently experience discomfort at the top of the elbow, which feels tight and sore.
I often need to stretch my elbow until I hear a "pop" to feel some relief.
Both pulling and pushing movements cause discomfort.
I have visited several hospitals, but doctors have said there is nothing wrong based on X-rays.
They mentioned that the condition is worsening, and I need to stretch more frequently, which also increases the pain and sensitivity, extending to my right shoulder.
I am unsure how much longer I can rely on the brace.
I hope the doctor can provide some advice.
2.
My right thumb has accumulated multiple injuries from playing basketball over the past five years.
Writing or holding things causes pain and weakness at the base joint of the thumb.
Sometimes it feels like it gets stuck, and I need to pull it to feel better.
Doctors have also looked at X-rays and said there is nothing wrong, but the symptoms seem to be worsening, especially in winter.
3.
My left middle finger has not fully healed after being crushed by a falling stone.
I applied ice immediately but have not seen a doctor.
After about a month, I still cannot make a complete fist, and even light contact causes pain, with some swelling present.

I hope the doctor can provide some suggestions.
When I visit the hospital, they only take X-rays and do not offer further assistance, but my hand is getting worse.
I am only 22 years old and hope to receive some advice and help.
Thank you.

kira yan, 20~29 year old female. Ask Date: 2005/11/20

Dr. Shi Guozheng reply Orthopedics

Based on your description, it seems to be an injury caused by exercise, involving damage to the joints or ligaments due to overuse.
This condition may not be visible on X-rays, and general orthopedic care may not provide effective treatment.
Consider consulting a specialist who focuses on sports injuries, as they may have solutions for your issue.

Reply Date: 2005/11/20

More Info

Hello! Thank you for reaching out with your concerns regarding your persistent orthopedic issues. It sounds like you’ve been dealing with a complex set of injuries that have not resolved despite seeking medical attention. Let’s break down your issues and explore potential solutions.

1. Right Elbow Pain: Given that your right elbow was the primary impact point during the car accident five years ago, it’s possible that you may be experiencing post-traumatic changes that are not visible on standard X-rays. Conditions such as tendinitis, bursitis, or even subtle ligament injuries can cause chronic pain and discomfort. The fact that you feel the need to "pull" your elbow to relieve discomfort suggests that there may be tightness or stiffness in the surrounding muscles and tendons. I recommend continuing with physical therapy focused on strengthening and stretching the muscles around the elbow. Additionally, modalities like ultrasound therapy or electrical stimulation may help alleviate pain and improve function. If symptoms persist, consider asking for an MRI, which can provide more detailed images of soft tissues, including ligaments and tendons.

2. Right Thumb Pain: The repetitive strain from playing basketball and the cumulative injuries to your thumb could lead to conditions like De Quervain's tenosynovitis, which affects the tendons on the thumb side of the wrist. The sensation of your thumb getting "stuck" could indicate tendon irritation or inflammation. Resting the thumb, using a thumb spica splint, and applying ice can help reduce inflammation. Over-the-counter anti-inflammatory medications like ibuprofen can also be beneficial. If conservative measures fail, a corticosteroid injection may be considered to reduce inflammation.
3. Left Middle Finger Injury: Since you mentioned that your left middle finger was crushed by a heavy object and has not healed properly after a month, it’s crucial to ensure that there are no underlying fractures or ligament injuries. The presence of swelling and pain when trying to make a fist suggests that there may be damage to the flexor tendons or ligaments. I recommend seeing a hand specialist who can perform a thorough examination and possibly order advanced imaging, such as an MRI or ultrasound, to assess the soft tissue structures. In the meantime, continue to ice the area, and avoid activities that exacerbate the pain.

In general, for all your orthopedic issues, it’s essential to maintain a proactive approach. Here are some additional tips:
- Physical Therapy: Engage in a structured physical therapy program tailored to your specific injuries. A therapist can provide exercises to improve strength, flexibility, and range of motion.

- Pain Management: Consider using non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief, but consult with a healthcare provider to ensure they are appropriate for your situation.

- Ergonomics: Pay attention to your hand and arm positioning during daily activities. Using ergonomic tools and techniques can help reduce strain on your joints.

- Follow-Up: If you feel that your concerns are not being adequately addressed, don’t hesitate to seek a second opinion, especially from specialists like orthopedic surgeons or sports medicine doctors who have experience with similar injuries.

- Lifestyle Modifications: Since you are young and active, consider modifying your activities to allow for healing. This might mean taking a break from basketball or other high-impact sports until your injuries are fully assessed and treated.

Remember, your body is still healing, and it’s important to give it the time and care it needs. I hope this information helps you find relief and a path toward recovery. Please take care and don’t hesitate to reach out for further assistance!

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