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Got hit on head. Started pain in chest, swollen shoulder and breathing difficulty. Any ideas?

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Emergency Medicine Specialist
Practicing since : 2000
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A week ago I fell off a horse while he was running. I hit my head off a fence post, my helmet was split. I have no recall of what happened immediately following my fall. I was taken to the ER and had a head CT. I have a concussion but recovering well from that. Since the fall my main complaint has been, even at the hospital, pain across my chest. I landed on my back, my shoulder blade is a bit swollen still, but my pain is across my right chest from my collar bone, sternum and down my right arm to my elbow and it encompasses my armpit area as well. I had chest and shoulder films and there are no breaks. I'm having trouble breathing because of the pain. And can't sleep through the night and it feels like almost cramp like pain in my chest. Any ideas?
Posted Thu, 22 Nov 2012 in TMJ
Answered by Dr. R.A. Singh 6 hours later
Thanks for writing to us.

After reading your post, it seems to me that in addition to concussion injury, you are also having muscular injury of the shoulder and thoracic region. The intercostal muscles present in the thoracic area help in respiration. Injury to these muscles can result in pain during breathing.

My advice will be that you should take proper rest, as this will help you both in healing of concussion and muscular sprain. Painkillers like Diclofenac with muscle relaxant like Tizanidine will be helpful in reducing pain and to relax the muscles. You should get yourself examined by an orthopedic surgeon. Medicines should be taken under medical supervision only.

Physiotherapy will be very helpful in your case. Give proper rest to the injured part. Also, avoid lifting heavy weights as they can aggravate your pain.

I hope this is useful to you. If you have any further doubts, I will be happy to help.
Wishing you a speedy recovery.
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