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Hello, doctors - I'm overseas in SE Asia. Ten days

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Posted on Fri, 8 Mar 2019
Question: Hello, doctors - I'm overseas in SE Asia. Ten days ago, before I left the U.S. I slipped in my bedroom and fell badly. Didn't hurt very much - but in a couple of days, I noticed big bruise on my left buttock and smaller bruises on the left side of my back - obviously from the fall. Went to local doctor a week ago, here in Laos, who x-rayed my back - no broken bones...gave me some anti-inflammatory meds. and painkillers. Bottom line: my back in the mid-left side is still very uncomfortable - I'm ambulatory...every day - but at the end of a day - even now, having been relaxed for a few hours, it is painful. Any ideas? Local doctor says muscle contusion - but the week of meds. has not helped - perhaps pain is worse. What to do? Unfortunately, health care in Laos is very sub-standard. My mid-back area left side is painful. I'm a very young, very active 75 yr. old - walk briskly for at least 90 mins. each day - and when in U.S. do daily workout at gym.
doctor
Answered by Dr. Dorina Gurabardhi (1 hour later)
Brief Answer:
Probably muscle contusion, follow the advice below.

Detailed Answer:
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Your symptoms seem to be related to a muscle contusion.

I recommend to use anti-inflammatory medication for the pain such as Ibuprofen 400 mg three tablets per day.

I recommend using cool compresses at the area of
pain.

I suggest to avoid movements that can trigger the symptoms.

The symptoms may need two to four weeks to go away.

Hope I have answered your query. Let me know if I can assist you further.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Dorina Gurabardhi (28 minutes later)
Dear Dr. Gurabardhi - many thanks for your reply. It is reassuring to know that you agree with the local doctor here in Laos, that my symptoms appear to be muscle contusion. I will get some ibuprofen 400 mg. and take as you suggest. I was going to go back to the local doctor, but I feel safe in trusting your recommendations/advice. Sitting here (it's 5:30 a.m. here in Luang Prabang!), I'm conscious of my middle back seeming like it's in a vice. I don't feel anything 'spinal' - that's to say, I have flexibility of my spine in all directions, with no pain, thank heavens. But the muscle contusion is obviously severe in its constant painfulness. Since it covers a large area - how about if I wet a large towel, put it in the refrigerator to chill, then into a plastic bag and lie on it....will that serve me well as a compress? And for how long - how many times a day should I apply it?
As mentioned, I walk a lot here - back and forth/to class (I serve as a volunteer English teacher to a great group of Lao high-school students)...and rent a studio on the 2nd floor of the house in which I live. Since this injury, I've tried not to carry anything heavy - but going to class, I carry my laptop/charger/and my bag - no choice.
You state avoid movements that would trigger/exacerbate symptoms: could you please perhaps specify such as? The pain is constant - even lying in bed (semi-firm/comfortable mattress) I feel it.
Many thanks for your time. XXXXXXX XXXXXXX
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Follow up: Dr. Dorina Gurabardhi (7 minutes later)
P.S. I note your disclaimer, re: gen'l informational purposes only, and to seek nearest physician. As initially stated, I'm here in Laos, where quality healthcare is so very lacking. That's why I hold little confidence in the local doctor....sadly. I was thinking I might need an MRI to check muscles for any tear/whatever...but there is no MRI facility here in Luang Prabang. I would have to go to Bangkok, Thailand.
I've never had such an injury before...but, God-willing, in another two weeks, the contusion will have lessened. I fell the morning of April 8, while getting ready to leave for the airport in the U.S....4:00 a.m. - and still somewhat sleepy - obviously the reason for my fall!
doctor
Answered by Dr. Dorina Gurabardhi (11 minutes later)
Brief Answer:
Follow up queries explained below in details.

Detailed Answer:
Hi again dear,

Thank you for your questions.

Yes, you can use a wet towel to compress after putting it in the refrigerator to chill.

You can use it for 15 to 20 minutes, four times a day.

You can use it as long as you will need it, it will help with the pain.

Some gentle stretching and movement of the contused muscle also helps to encourage the damaged tissue to recover faster.

Any other movement is not advised during the period of healing.

Feel free to contact me again for further clarification.

Wishing you a fast recovery.

Take care,

Dr.Dorina Gurabardhi


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dorina Gurabardhi (1 hour later)
Thank you so very much, Dr. Gurabardhi, for your care and patience for this on-line patient! All so very appreciated.

I just have one more question, which I neglected to ask previously: there's an excellent 5-star hotel close to where I live here in Luang Prabang - I occasionally do part-time work for the management and am 'rewarded' by the luxury of aromatherapy massages in the hotel Spa, by equally excellent, professional masseuses!

Would an hour's aromatherapy massage help or hinder my healing process? In your response just now, you recommend no movement during healing period, except gentle stretching/light movement of muscle. If not immediately, then, perhaps in a week or so?

Is all the walking and moving around I do, OK? Unfortunately, since I'm out most of each day, I won't be able to apply the towel compress except in the mornings and at night...but, of course, if and when I do find myself at home with some free time, I will certainly apply the compress whenever possible.

I've been awake most of the night, worrying about this contusion issue - and it's now coming up to 7 a.m. local time here in Laos....so I'll go back to bed for an hour or so, but keep this screen open for your response re: the above. Again, I do so greatly appreciate your expertise.....now I don't need to fly to Bangkok and, God-willing, will feel less pain within the next couple of weeks. Important: I will buy the ibuprofen when I'm up and around later this morning - that is, IF I can find ibuprofen at a pharmacy here....failing that, do you have another recommendation as effective? (Nothing containing aspirin).

Thanks so much. XXXXXXX XXXXXXX
doctor
Answered by Dr. Dorina Gurabardhi (10 hours later)
Brief Answer:
You can do a aromatherapy gentle massage.

Detailed Answer:
Hi again dear,

I am glad that I could help you.

Regarding the aromatherapy massage I would recommend postponing it in a week.

The massage should be very gentle to encourage a higher volume of blood flow to the area.

I do not recommend deep tissue massage which does more damage.

This may break the blood vessels under the skin and make the contusion area larger.

I would suggest to do moderate movements which does not trigger the healing process.

If you don't find Ibuprofen you can try Acetaminophen 500 mg which should be used three times a day.

You will feel better in a week. The complete healing process may require a few weeks.

Wishing you all the best dear.

Take care,

Dr.Dorina Gurabardhi
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dorina Gurabardhi (26 minutes later)
Dear Dr. Gurabardhi - and dear you are, to answer all my questions so very thoughtfully!
Thank you so very, very much - your expertise is so reassuring. I have used the towel as a compress twice today, and will do so again this evening, when I get home from teaching my students. I lie on my bed, and place it under my mid-back....very soothing!
I've also found ibuprofen 400 mg. and will take one pill 3x/day as you prescribe, starting tonight, after I've had dinner. God-willing the pain will subside sooner rather than later...it is so uncomfortable!
Again - thank you for all your time and kindness. God-willing I can find you again on-line at 'Ask A Doctor' in a couple of weeks and I will give you an update as to how I feel!
Please would you kindly reply to this message, Dr. Gurabardhi, so that I can click on "Close Discussion and Review Doctor". It would be my great pleasure to most assuredly give you rave reviews!
Also - thank you for the advice about massages....I will not hurry to get one - better to wait a while as you suggest.
All good wishes to you and 'Sabaidee' from beautiful Luang Prabang...which will be even more beautiful when my back muscle contusion has left me!! Gillian XXXXXXX
doctor
Answered by Dr. Dorina Gurabardhi (13 minutes later)
Brief Answer:
You are welcome dear.

Detailed Answer:
Hi again dear,

Thank you very much for your kind words.

I am glad that I could help you.

You are welcome any time for further queries.

Wishing you a good health.

Take care dear,

Dr. Dorina Gurabardhi
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Dr. Dorina Gurabardhi

General & Family Physician

Practicing since :2013

Answered : 9678 Questions

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Hello, doctors - I'm overseas in SE Asia. Ten days

Brief Answer: Probably muscle contusion, follow the advice below. Detailed Answer: Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Your symptoms seem to be related to a muscle contusion. I recommend to use anti-inflammatory medication for the pain such as Ibuprofen 400 mg three tablets per day. I recommend using cool compresses at the area of pain. I suggest to avoid movements that can trigger the symptoms. The symptoms may need two to four weeks to go away. Hope I have answered your query. Let me know if I can assist you further.