Post-Stair Fall: Pain and Swelling in the Lower Leg

Foot sprain after falling down the stairs?

Hello Doctor, I would like to inquire about an incident that occurred on Saturday.
I accidentally fell down a wet staircase from the first floor and rolled down, impacting my hands, feet, and head.
At the time, I experienced severe pain in the front of my left lower limb, so I went to the hospital.
The doctor performed a simple X-ray and informed me that the bones were fine, prescribing anti-inflammatory medication for me to apply at home.
However, today I still feel swelling in the front of my left lower limb with no improvement.
The swollen area feels warm, and pressing on it causes pain.
Is this normal? What should I do next?

Miss Hsu, 20~29 year old female. Ask Date: 2013/06/17

Dr. Chen Qingbin reply Internal Medicine

Hello, fractures can usually be detected through X-rays.
If the X-ray is normal, it is likely that the pain and swelling are due to a contusion from impact.
It is best to consult a surgeon or an orthopedic specialist for further evaluation.

Reply Date: 2013/06/17

More Info

It sounds like you’ve had quite a challenging experience after your fall down the stairs. Based on your description, it’s understandable to be concerned about the pain and swelling in your lower leg. While the X-ray results indicated that there are no fractures, there are still several possibilities to consider regarding your symptoms.

Firstly, it’s important to recognize that even if there are no fractures, soft tissue injuries can occur. These injuries can involve muscles, tendons, ligaments, or even the fascia surrounding these structures. Common injuries from falls include contusions (bruises), sprains, and strains, which can lead to significant pain and swelling. The fact that you are experiencing warmth in the swollen area suggests that there may be inflammation present, which is a natural response of the body to injury.

The pain you feel when pressing on the swollen area could indicate that there is still some underlying soft tissue damage. Inflammation can cause the area to feel tender and painful, and it may take time for the swelling to subside. It’s also possible that you may have sustained a hematoma, which is a localized collection of blood outside of blood vessels, often resulting from trauma. This can cause both swelling and pain.

In terms of management, here are some recommendations that may help alleviate your symptoms:
1. Rest: Avoid putting weight on the injured leg as much as possible. This will help reduce further irritation and allow the healing process to begin.

2. Ice Therapy: Applying ice to the swollen area for 15-20 minutes every hour can help reduce swelling and numb the pain. Make sure to wrap the ice in a cloth to prevent frostbite.

3. Compression: Using an elastic bandage or compression wrap can help control swelling. Just be careful not to wrap it too tightly, as this can impede circulation.

4. Elevation: Keeping your leg elevated above the level of your heart can help reduce swelling. You can prop it up on pillows while sitting or lying down.

5. Over-the-Counter Pain Relief: Since you mentioned that you were prescribed anti-inflammatory medication, continuing to take those as directed can help manage pain and inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can be effective.

6. Monitoring Symptoms: Keep an eye on your symptoms. If the swelling does not improve after a few days, or if you experience increased pain, redness, or warmth spreading from the injury site, it would be wise to follow up with your healthcare provider. They may consider further imaging studies, such as an MRI, to assess for any soft tissue injuries that may not be visible on X-ray.

7. Physical Therapy: If your symptoms persist, a referral to a physical therapist may be beneficial. They can provide targeted exercises and treatments to help restore function and reduce pain.

In conclusion, while it is not uncommon to experience pain and swelling after a fall, it is essential to monitor your symptoms closely. If there is no improvement or if your condition worsens, seeking further medical evaluation is crucial to rule out any serious underlying injuries. Remember, your health and recovery are the top priority, so don’t hesitate to reach out for help if needed.

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