Effective Rehabilitation Strategies for Post-Clavicle Fracture Pain Relief

Rehabilitation after Clavicle Injury

Hello Doctor, my mother had a car accident in December 2014, which resulted in a comminuted fracture of her clavicle.
After surgery, a metal plate was installed for over a year, and earlier this year, she underwent another surgery to remove the plate.
Over the past year, regardless of whether the plate was in place or not, she frequently wakes up at night due to pain and discomfort in her clavicle, which affects her sleep.
She describes the sensation as if her shoulder and head are separated.
In addition to the pain making it difficult to sleep, she also feels very uncomfortable.
However, during the day, she is busy with household chores and does not experience any discomfort.
She has been consistently undergoing rehabilitation, but the nighttime pain continues to disrupt her sleep.
Do you have any better suggestions to alleviate her pain? Should she adjust her sleeping position or consider other recommendations? Thank you!

Miss Mao, 30~39 year old female. Ask Date: 2016/02/21

Dr. Shi Guozheng reply Orthopedics

Clavicle fractures typically do not cause much pain after healing.
Since you have already had the bone screws removed, it indicates that healing has occurred.
The current pain may be related to the fascia or tendons.
I recommend taking some pain relievers before bed, and you can use a warm compress at night to alleviate local discomfort.

Reply Date: 2016/02/21

More Info

Effective rehabilitation strategies for post-clavicle fracture pain relief are crucial for improving the quality of life for individuals who have experienced such injuries. In your mother's case, her persistent pain and discomfort following a clavicle fracture, even after the removal of the hardware, suggest that there may be underlying issues that need to be addressed through a comprehensive rehabilitation approach.

Firstly, it is essential to understand that pain after a clavicle fracture can stem from several factors, including muscle tightness, joint stiffness, and even nerve irritation. The fact that she experiences pain primarily at night indicates that her sleeping position or the support she uses while sleeping may be contributing to her discomfort. Here are some strategies that may help alleviate her symptoms:
1. Sleep Position and Support: Encourage your mother to experiment with different sleeping positions. Using a supportive pillow that keeps her head and neck aligned with her spine can help reduce strain on the shoulder. A body pillow or a wedge pillow may provide additional support and comfort. She might also consider sleeping on her back with a pillow under her knees to relieve pressure on her shoulders.

2. Physical Therapy: Continuing with physical therapy is vital. A physical therapist can tailor a rehabilitation program that focuses on strengthening the muscles around the shoulder, improving flexibility, and enhancing range of motion. Specific exercises targeting the rotator cuff and scapular stabilizers can be beneficial. Additionally, modalities such as ultrasound therapy or electrical stimulation may help reduce pain and inflammation.

3. Pain Management Techniques: Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage pain and inflammation. However, it is essential to consult with her healthcare provider before starting any medication. Other pain management techniques, such as applying heat or cold packs to the affected area, may also provide relief.

4. Activity Modification: Since your mother feels discomfort primarily at night but is active during the day, it may be helpful to assess her daily activities. Encourage her to take regular breaks and avoid repetitive overhead movements that could exacerbate her pain. Gradually increasing her activity level while being mindful of her body's signals can help her regain strength without overexertion.

5. Ergonomic Adjustments: If your mother is involved in activities that require prolonged use of her arms, such as housework, consider making ergonomic adjustments. For example, using tools that reduce strain on her shoulders or adjusting her workspace can help minimize discomfort.

6. Mind-Body Techniques: Techniques such as yoga, tai chi, or mindfulness meditation can help manage pain and improve overall well-being. These practices promote relaxation and can help reduce the perception of pain.

7. Follow-Up with Healthcare Providers: Regular follow-ups with her orthopedic surgeon or primary care physician are essential to monitor her recovery. If her pain persists or worsens, further evaluation may be necessary to rule out complications such as nerve impingement or joint issues.

In conclusion, a multifaceted approach that includes adjustments to her sleeping position, continued physical therapy, pain management strategies, and ergonomic modifications can significantly improve your mother's quality of life post-clavicle fracture. Encouraging her to be proactive in her rehabilitation and to communicate openly with her healthcare providers will be key to finding effective solutions for her pain relief.

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