Severe Arm Pain After a Fall: Possible Causes and Concerns - Orthopedics

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After a fall, experiencing severe arm pain can be concerning, especially when the pain is exacerbated by touch or movement. In the case of your aunt, who fell and landed on her elbows, there are several potential causes for her symptoms that need to be considered.

1. Soft Tissue Injury: One of the most common injuries after a fall is a soft tissue injury, which includes strains, sprains, or contusions. These injuries can cause significant pain and swelling, and the affected area may be tender to the touch. If your aunt's pain is primarily in the muscles or ligaments around the elbow, it could be a soft tissue injury.

2. Fractures: While you mentioned that you believe a fracture is unlikely since she did not experience pain upon touching the skin, it's important to note that some fractures, especially hairline or non-displaced fractures, may not cause immediate severe pain or deformity. However, they can still lead to significant discomfort when pressure is applied. An X-ray or CT scan would be necessary to rule out any fractures.

3. Nerve Injury: The mechanism of her fall could have resulted in nerve compression or injury, particularly if there was significant impact to the elbow area. Conditions like ulnar nerve entrapment can cause pain, tingling, or numbness in the arm and hand. If the pain is radiating or associated with numbness, this could indicate a nerve issue.

4. Complex Regional Pain Syndrome (CRPS): Although less common, CRPS can develop after an injury and is characterized by severe pain, swelling, and changes in skin color or temperature. The pain can be disproportionate to the initial injury and may spread beyond the injury site.

5. Psychological Factors: Sometimes, the fear of movement after an injury can lead to heightened pain perception. This phenomenon is known as "pain catastrophizing," where the anticipation of pain can amplify the experience of pain itself.

Regarding your concern about whether not having her arm fixed by the paramedics could worsen her condition, it is essential to understand that while immobilization can help prevent further injury, the immediate priority should be to ensure she is comfortable and to seek appropriate medical evaluation. If she is experiencing severe pain, it is crucial to have her evaluated by a healthcare professional as soon as possible.
In summary, your aunt's severe arm pain could stem from various causes, including soft tissue injuries, fractures, nerve injuries, or even psychological factors. It is vital to await the results of her medical evaluation to determine the exact cause of her pain and to develop an appropriate treatment plan. If her pain persists or worsens, or if she experiences any new symptoms, it is essential to seek immediate medical attention.