1. < Bones, Joints & Muscles

Is it normal to have continuing pain 5 weeks after ORIF of the wrist

Posted by walk4life @walk4life, Sep 2 4:44pm

I feel while jogging on July 21. Xray showed a comminuted fracture. I saw the orthopedist the following day. I was in a heavy splint and had surgery scheduled for July 30. It is now September 2 almost 5 weeks post op. I still have a significant amount of chronic pain. My staples were removed 2 weeks post op amd xray was taken . According to the PA everything looked good. I have been going to OT twice aweek since surgery. The therapist told me between weeks 3- 4 post op , the pain should be less. The surgeon’s office told me that i can alternate Tylenol and Ibuprofen for pain. I do that during the day. I take a 5 mg Percocet in the early evening and then one before bed. Is it normal to still be having this much pain. The severity of the pain is less, but it is chronic.

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Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 4 10:51am

@walk4life Sorry, my computer ate my reply yesterday - let's try again.
So the PA said, "According to the PA everything looked good." That means the fixation is holding, the wound is healing, and there is no sign of infection. It does not mean you are by any means healed and ready to go.

A comminuated fracture (bone breaks in2 or more places) is complex, requires internal fixation with screws, wires, plates and/or grafts. These can take a long time to heal, depending on your other physical challenges. It also means muscles, tendons and/or nerves may have been damaged by the fall or irritated by the surgery and possibly the fixation devises. The bottom line is that pain can continue, even when you are successfully doing PT and healing.

My daughter did this over 3 years ago, and recovery was longer than 9 months. ICE, Ice, ice... was and is her constant companion (her hardware still hurts at times.)

Did they anyone you to ice to relieve inflammation and swelling? Two-three times a day - after PT, when it aches and before bed might help. After I had knee surgery (about a million years ago) I iced off and on for at least 5 months - the hardware caused my leg to ache - especially at night, when I overdid things (I was Mom of 2 young kids) and when the barometer fell.

I also took one pain pill at bedtime for weeks after my last hip revision - my nerves and muscles were furious at repeated invasions!

REPLY
1 reply
walk4life | @walk4life | Sep 4 6:11pm
In reply to @sueinmn "@walk4life Sorry, my computer ate my reply yesterday - let's try again. So the PA said,..." + (show)
@sueinmn

@walk4life Sorry, my computer ate my reply yesterday - let's try again.
So the PA said, "According to the PA everything looked good." That means the fixation is holding, the wound is healing, and there is no sign of infection. It does not mean you are by any means healed and ready to go.

A comminuated fracture (bone breaks in2 or more places) is complex, requires internal fixation with screws, wires, plates and/or grafts. These can take a long time to heal, depending on your other physical challenges. It also means muscles, tendons and/or nerves may have been damaged by the fall or irritated by the surgery and possibly the fixation devises. The bottom line is that pain can continue, even when you are successfully doing PT and healing.

My daughter did this over 3 years ago, and recovery was longer than 9 months. ICE, Ice, ice... was and is her constant companion (her hardware still hurts at times.)

Did they anyone you to ice to relieve inflammation and swelling? Two-three times a day - after PT, when it aches and before bed might help. After I had knee surgery (about a million years ago) I iced off and on for at least 5 months - the hardware caused my leg to ache - especially at night, when I overdid things (I was Mom of 2 young kids) and when the barometer fell.

I also took one pain pill at bedtime for weeks after my last hip revision - my nerves and muscles were furious at repeated invasions!

Jump to this post

@sueinmn , thanks for the reply. Yes, i have been icing - probably not as consistently as i should be. Thanks for reassuring me that it is not uncommon for the pain to linger. I also have arthritis in my hand/thumb area and the OT told me that is also contributing to the pain. I will see the surgeon on Monday for my 6 week post op visit. I know surgeons are more concerned with the mechanics. However i am going to ask if he has any other suggestions for easing pain during the day. I would like to be pain free at least 50% of the day.

REPLY
1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 4 6:32pm
In reply to @walk4life "@sueinmn , thanks for the reply. Yes, i have been icing - probably not as consistently..." + (show)
@walk4life

@sueinmn , thanks for the reply. Yes, i have been icing - probably not as consistently as i should be. Thanks for reassuring me that it is not uncommon for the pain to linger. I also have arthritis in my hand/thumb area and the OT told me that is also contributing to the pain. I will see the surgeon on Monday for my 6 week post op visit. I know surgeons are more concerned with the mechanics. However i am going to ask if he has any other suggestions for easing pain during the day. I would like to be pain free at least 50% of the day.

Jump to this post

After numerous hand and wrist surgeries for arthritis, may I suggest you try a compression glove? Between that, ice and stretching probably 10-15 times a day I found it kept the fluids moving and reduced swelling.
When you say pain, are you talking about stabbing or searing pain, or a persistent ache like a bad toothache? A lot of time, hardware can be seriously irritating and your body responds with inflammation.

When you see the surgeon, ask for a custom made moldable splint that can be adjusted with heating, stretching, cutting, padding - much better than the off-the-shelf adjustable splint. Good OT's can make and adjust them as you heal. My hand surgeon and OT went to bat with insurance to get me one so it could relieve pressure on my arthritic thumb and other tender spots. The upside is that I still wear it to protect my wrist when doing heavy work.

Hang in there - it gets better!

REPLY
1 reply
walk4life | @walk4life | Sep 4 7:01pm
In reply to @sueinmn "After numerous hand and wrist surgeries for arthritis, may I suggest you try a compression glove?..." + (show)
@sueinmn

After numerous hand and wrist surgeries for arthritis, may I suggest you try a compression glove? Between that, ice and stretching probably 10-15 times a day I found it kept the fluids moving and reduced swelling.
When you say pain, are you talking about stabbing or searing pain, or a persistent ache like a bad toothache? A lot of time, hardware can be seriously irritating and your body responds with inflammation.

When you see the surgeon, ask for a custom made moldable splint that can be adjusted with heating, stretching, cutting, padding - much better than the off-the-shelf adjustable splint. Good OT's can make and adjust them as you heal. My hand surgeon and OT went to bat with insurance to get me one so it could relieve pressure on my arthritic thumb and other tender spots. The upside is that I still wear it to protect my wrist when doing heavy work.

Hang in there - it gets better!

Jump to this post

@sueinmn , i have at times both a stabbing/ burning pain and a chronic dull pain. I do have a plastic moldable splint that was made for me at OT. They have adjusted it since i got it. The OT has put foam on some of the edges as i complained about the plastic pressing in and causing pain. I also have a thin compression sleeve to wear with it. I will ask about more padding for this. Thanks for your input and suggestions. The other issue I am dealing with is extreme fatigue. I sleep about 3-4 hours- wake up , take a pain pill,read a bit and them sleep another 3 hours. By the early afternoon, i need a nap.

REPLY
1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 5 10:17am
In reply to @walk4life "@sueinmn , i have at times both a stabbing/ burning pain and a chronic dull pain...." + (show)
@walk4life

@sueinmn , i have at times both a stabbing/ burning pain and a chronic dull pain. I do have a plastic moldable splint that was made for me at OT. They have adjusted it since i got it. The OT has put foam on some of the edges as i complained about the plastic pressing in and causing pain. I also have a thin compression sleeve to wear with it. I will ask about more padding for this. Thanks for your input and suggestions. The other issue I am dealing with is extreme fatigue. I sleep about 3-4 hours- wake up , take a pain pill,read a bit and them sleep another 3 hours. By the early afternoon, i need a nap.

Jump to this post

I think many of us can relate - fatigue comes with traumatic injury and repair surgery, as the body tries to heal. It also can come from the interrupted sleep you are having, and pain itself. Ongoing use of Percocet and other opioids also causes fatigue.

If you are using Percocet 3X a day at this point, and getting up in the middle of the night for the 3rd dose, it may be time to talk to the doc about some alternative that will allow for better sleep.

The pain should be gradually getting better at this point - are you feeling that is is?

REPLY
1 reply
walk4life | @walk4life | Sep 5 11:07am
In reply to @sueinmn "I think many of us can relate - fatigue comes with traumatic injury and repair surgery,..." + (show)
@sueinmn

I think many of us can relate - fatigue comes with traumatic injury and repair surgery, as the body tries to heal. It also can come from the interrupted sleep you are having, and pain itself. Ongoing use of Percocet and other opioids also causes fatigue.

If you are using Percocet 3X a day at this point, and getting up in the middle of the night for the 3rd dose, it may be time to talk to the doc about some alternative that will allow for better sleep.

The pain should be gradually getting better at this point - are you feeling that is is?

Jump to this post

@sueinmn , thanks for the response. Some days i feel that the pain is improving, but others days it seems worse. I will say the intensity of the pain has decreased , but the frequency is still high. Some days it feels like a level 5-6 of pain most of the day. I see the surgeon Monday and will ask for pain medication that will not interfere with sleep. I don’t remember the pain being this consistent after my hip replacement.

REPLY
1 reply
Mentor
Sue, Volunteer Mentor | @sueinmn | Sep 5 3:48pm
In reply to @walk4life "@sueinmn , thanks for the response. Some days i feel that the pain is improving, but..." + (show)
@walk4life

@sueinmn , thanks for the response. Some days i feel that the pain is improving, but others days it seems worse. I will say the intensity of the pain has decreased , but the frequency is still high. Some days it feels like a level 5-6 of pain most of the day. I see the surgeon Monday and will ask for pain medication that will not interfere with sleep. I don’t remember the pain being this consistent after my hip replacement.

Jump to this post

I too felt like my wrist surgery was more painful than hip replacement - and in your case, you have the added feature of trauma.
I hope the surgeon will have some answers for you. Sometimes hardware is not well-tolerated, so that could be part of it. There are a lot more nerves involved in the wrist and hand, and as much as we think we are not using the surgical arm...
Hoping you get some relief soon
Sue

REPLY
walk4life | @walk4life | Sep 5 6:51pm

@sueinmn Thanks for your support. I am glad to know I am not the only person thinking that this is more painful than hip replacement. I guess i mistakenly thought that since it was a smaller part of the vody the healing would be fasyer. I have created a list of questions for my visit with the surgeon.

REPLY
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