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Is it common to feel pain after cast is removed?

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Posted on Wed, 23 Jul 2014
Question: Hello
I had a broken ankle and am 4 weeks into surgery now (With a plate and 7 screws). I am a 40 year old male (used to smoke before, but have quit now). Today I got my cast removed and am having unbearable pain (Looks like the pain was much better with cast on). I am still non weight bearing for 2 weeks with an air boot. I had not taken any narcotic for past 2 weeks (Was taking Oxycodone for 2 weeks after surgery). But looks like I will have to start taking them again

The questions I have are below

(Note my weight is 202 lbs, 40 years male, 5 11 tall and no other medical history nor any surgery till this one)

1) Is it common to have some pain after cast is removed (Reading through some forums, it looks like it is common, but I would love to hear from a professional. My Ortho did not say anything about this today when the cast was removed and I was put in boots.

2) Is it ok to continue with narcotics till the pain reduces

3) Is there anything else I can do to reduce the pain (Also I feel lot of stiffness)

4) Also, there is a small amount of blood coming from the incision area onto the socks. I am planning to clean with warm water and put my sock and boot back. Will that cause any issue

5) I have been told to do couple of exercises daily and I will be sent to P therapy in 2 weeks from now. Are there any other recommendations from professionals that my Ortho did not share

(Note that I will call in to my Ortho tomorrow. But currently look forward to some answers)

doctor
Answered by Dr. Praveen Tayal (24 minutes later)
Brief Answer:
Details below.

Detailed Answer:
Hello,
Thanks for posting your query.
I have studied your case in detail.
1) Yes. It is usual to feel pain after the cast is removed. There is nothing to worry. This is normal. The pain will gradually subside as the stiffness lessens.
2) You can continue with narcotics or take ibuprofen three times a day after the meals for relief. It is available over the counter.
3) To decrease the pain and stiffness you can do a hot fomentation at the site of fracture and remove the boot while resting. Start doing the exercises after hot fomentation at least three times a day. It will help in decreasing the stiffness.
4) You can clean the area with warm water and keep it covered to avoid any infection.
5) Yes. Start with exercising as explained religiously as it will help in increasing the range of movement.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (1 hour later)
Thanks for your reply Dr.Tayal

Have couple of follow up questions

1) Looks like my pain is more on the outside of the ankle (Where the incision is and brushing the boot). Does this say anything ?
I just do not want to go back to cast as it would be couple of steps backwards. Also, putting the boot back and taking Oxycodone has reduced the pain for now.

2) Even though pain has reduced by 30 to 40 % from my original post, I am wondering if there is a possibility that I need to go back to cast (My Ortho said my bones have healed completely though)

Thanks and appreciate a response
XXXXXXX
doctor
Answered by Dr. Praveen Tayal (2 hours later)
Brief Answer:
Repeat cast is not needed.

Detailed Answer:
Hello.
Thanks for writing again.
1) The pain on the outer side of the ankle is due to the soft tissue injury caused by the incision. It is not likely to be related to the fracture or the implant.
2) There is no need to go back to cast again as clinically healing of the fracture site has been detected by your orthopedician. This can be confirmed after an X-ray of the ankle.
Hope my answer is helpful.
Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12170 Questions

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Is it common to feel pain after cast is removed?

Brief Answer: Details below. Detailed Answer: Hello, Thanks for posting your query. I have studied your case in detail. 1) Yes. It is usual to feel pain after the cast is removed. There is nothing to worry. This is normal. The pain will gradually subside as the stiffness lessens. 2) You can continue with narcotics or take ibuprofen three times a day after the meals for relief. It is available over the counter. 3) To decrease the pain and stiffness you can do a hot fomentation at the site of fracture and remove the boot while resting. Start doing the exercises after hot fomentation at least three times a day. It will help in decreasing the stiffness. 4) You can clean the area with warm water and keep it covered to avoid any infection. 5) Yes. Start with exercising as explained religiously as it will help in increasing the range of movement. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal