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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is it advisable to use an ice pack to reduce pain in my left hand due to strenuous work?

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Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3197 Questions

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Posted on Wed, 22 Aug 2018 in Bones, Muscles and Joints
Question: Hi, I had to spend all day Saturday doing a lot of physically demanding work, especially breaking down thick cardboard boxes. Saturday afternoon (i.e. after maybe six hours of this), and continuing since then, I've noticed a moderate to sharp pain in my left hand. Comparing my hands now, I notice a subtle swelling or thickening on top of my left hand such that I can't really see my veins, whereas they're prominent and easily noticeable in my right hand. Though I haven't been fully resting my hand since Saturday (still had to do some physical labor around the apartment, and I type for work -- my typing is mostly unimpeded; it's grosser clenching and opening motions that seem to evoke the pain, while typing is I guess enough of a fine motor control activity to cause only the occasional twinge of sharp pain and mostly a very manageable ache) I'd expected the pain to decrease. But it's been over three days and the pain is if anything getting worse -- now moderate to severe while doing everyday things like cooking, carrying objects, etc. Haven't bothered to use an ice pack (actually just thought of it) -- would that be helpful? I'm less worried about the pain, assuming it's short-term, than about the possibility of long-term injury. Can I wait this out? Should I be doing anything myself to assist healing? Do I need to see a physician in person? Thanks for your time.
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Answered by Dr. Matt Wachsman 55 minutes later
Brief Answer:
Several points.

Detailed Answer:

Hello,

I have reviewed your query and here is my advice.

First, there are limitations on what can be done without directly examining an area. BUT, the first issue is identifying where the problem is. this is generally pretty easy with pain. It's the joint(s), or the tendons outside of the joints, the bones (no, it isn't) or the muscles. These are generally pretty easily observed. Moving joints that hurt gives a localized pain and muscles and tendons are a broader area.

Without some real trauma the muscles and tendons do not break.

I cannot say in your particular case, but in general irritated muscles and tendons are helped by rest, Aspirin like drugs, ice pack in the first 24 hrs and warm deep soaks after that.

If the pain goes away mostly within 36 hrs with minimal treatment, there isn't much more that can be done. If the pain gets worse or if there are increasing visible signs of anything, then something is seriously amiss and it is not the usual situation at all. This would be an indication for being looked at. Mostly that does not occur.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Matt Wachsman 30 minutes later
Hi, thanks for your reply. I'm thinking it's a joint and/or tendon issue from what you said. I have two follow-up questions and I will also provide a little more specific information about the pain.

1) As I stated, it's been 3 days since the onset of the pain and it has gotten worse, on average. I surmise from your first reply that I should see a doctor. Assuming that's correct, how quickly should I do this? Could it wait a couple more days or do I need to get to Urgent Care or something tomorrow?

2) Not having used ice yet and its being 3 days on, should I begin with the warm-water soaks you mentioned? Or do I still do ice first for 24 hours?

More detail on the pain -- It's mostly in my hand around my knuckles and just "below" them, i.e. slightly closer to my wrist (as opposed to my fingers) . I sense a little soreness in my forearm as well, but 95 percent of the pain is in my knuckles and lower hand. Opening my hand all the way or almost, or closing it are the main motions that sharpen the pain.

Thanks again for your time. Really appreciate this service.
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Answered by Dr. Matt Wachsman 2 hours later
Brief Answer:
It's a general information service and not a "you've got this" service.

Detailed Answer:

Hello,

That being said, there's a lot to be said!

Ok, the really bad things would be in the joints and they would not be subtle.

You can have an infected joint but it would be like an infection and I haven't seen any that weren't really obvious (hot, red, painful, often with oozing AND, its like ONE joint).

I guess one emergency could be
XXXX

Yeah, I don't think so either.

"Opening my hand all the way or almost, or closing it are the main motions that sharpen the pain. "Would be flexing the tendons".

Then, good questions. If it has gotten worse over three days one strong possibility is that continued activity and increased the irritation. Alternatively, it is just getting worse and there isn't a choice but to go see the doctor. A few hours with a warm deep soak for 20 minutes and Aspirin like drugs will decide the matter perhaps.

Take care.

Dr. Matt Wachsman, Addiction Medicine Specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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