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Suggest Treatment For Pain In The Shoulders Post An Accident

Posted on Mon, 22 Aug 2016

Question: I am a 67 yr old man, good health, farmer and an engineer. Staunton, VA. I travel a lot and farm when not traveling. I was putting away large hay bales, Monday, and I fell off a tall trailer, 8ft drop. I hit hard on my left shoulder and left side. By the impact, I knew I did some damage. I never lost consciousness. I got up, with extreme pain, and walked to the main house for help with other people there. I could not use the left arm and big pain in my left upper chest area. I went to an emergency hospital and after x-rays and examination from a emergency PA, I had no breaks on my arm/shoulder, but I broke, fracture, 9th rib. I was let go with some pain medicine. I had a job in NY City, for a day or two, and I needed to drive myself. I could not drive Monday but I did drive Tuesday to NY and for the next three days did my job. Thursday, Noon, I could see my left hand was starting to swell some. I called my family doctor and made an appointment for Friday. I drove home. Driving was not too painful but required slow movements. My left arm is still not useable. I can use my forearm but from the should down, very limited movement without extreme pain. Friday I went to my doctor and she has me scheduled for an MRI Monday, early. I am trying to take it easy now. It is Sunday and I have more swelling not only for my left arm/hand but my left leg/foot and some now in my right leg/foot. The pain for the broken rib is very bad after I try sleeping or resting with no movement. It takes @30 minutes to go through the chest pains. After that time, I have little pain. I have little pain from my left shoulder, as long as I don't try to move it. My worry is, could I have damaged something internally causing body swelling.

Answered by Dr. Dr.Arnab (25 minutes later)

Brief Answer:
There are Several in fact.... as following..

Detailed Answer:
Hello xxxxxxxxxxxxxx, Welcome to HCM,

I've gone through your query and understand your concern..

Yes, it does seem like a bad fall resulting in so many injuries..

Keep taking the pain killers, as fracture rib takes several days to weeks to heal, and it's extremely important that you breath properly, so to maintain that, analgesic and pain killer support will be required for a while..

Good to know that there was no fracture arm/shoulder..but you should note that in acute stage minor hairline fractures don't get picked up by the initial X-rays, so you may be needing follow-up X-ray later on..

Please don't drive for the time being, don't indulge in to any strenuous activities at all..

Try ice compression gently over the arm/shoulder three to four times a day for next 2-3 days..

Yes, it's the right decision to do MRI because there can be bruised ligaments/tendons with neuro-muscular damage which takes time to heal and to rule them out MRI should be done at the earliest(good that it's scheduled for Monday)..

With such a severe intensity of injury, swelling can be due to several structural damage(mild-moderate degree, can only be assessed after a clinical examination), as well as underlying formation of hematoma (swelling of clotted blood in internal tissues) , these are very likely possibilities and these swellings will gradually go down within a few days only, don't worry..

There are likely changes in the tissues after injury resulting in to accumulation o of serous fluids for healing purpose, and they tend to cause a lot of swelling too..

Keep you arm and legs elevated with the help of pillows, stay rested..

Let me know how it goes in the due course..

Any further queries, feel free to share..

Take Care
Kind Regards

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Arnab Banerjee