Dr. Sumit Chawla
Orthopedician and Traumatology
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Patient's Query
Hello doctor,
Last night, I fell from my bike on my right side as it got slipped while driving. My right hand and right shoulder directly hit the road and cause severe pain on the right side of the abdomen. A local doctor prescribed some medicine and I got relieved from my side pain. I went for an x-ray of the right chest, it was normal. But after 36 hours I am having pain in the right shoulder (scapula) and while sitting, or arising out of bed, or moving hand on the upper side the pain increases a lot. Is it normal or need better medical assistance?
Hello,
Welcome to icliniq.com.
You should get yourself examined by an orthopedic surgeon and x-ray of the shoulder region is required. Any pain in the shoulder after trauma requires evaluation and any pain cannot be considered as normal? There are chances of soft tissue alone with no bony injury, but I would recommend a re-evaluation. Till then you can apply ice to the affected area and take analgesics for pain relief. Kindly follow up with your x-ray and feel free to discuss further.
Patient's Query
Hi doctor,
For the last three days, I am admitted in the hospital and is under the observation of MS ortho. I have undergone six x-rays of my spine and blood test but everything came clear, but I am still groining with pain. There is still some swelling on the back of the right shoulder. I have been given Ceftriaxone and Sulbactam and Calvit injection, no other medication. Swelling is still there and pain is also there while movement. Please suggest.
Hello,
Welcome back to icliniq.com.
I understand your concern. Chest injuries are difficult to be assessed on an x-ray and even if there is a fracture of ribs no evaluation with a CT scan or other modalities is required unless the condition is affecting the vitals (oxygen saturation, blood pressure, respiratory rate, etc). Your treating doctor must have informed you of the provisional diagnosis. Kindly share more information so that treatment options can be discussed. Do you have pain constantly or on deep breathing or coughing? Are you able to walk and carry out the activities of your daily living on your own or not? Can you post your images of the abrasions to see whether intravenous antibiotics are required or not? Also, include the image of the back scapula region where you feel there is significant swelling. I am not asking for an X-ray and taking your word on that these X-rays are normal. If you wish to seek a second opinion about them too then please attach the X-rays as well. Kindly follow up with answers to these questions for a better evaluation of your condition.
Patient's Query
Hi doctor,
While normal breathing, there is no pain, but in case of a little faster breathing the pain starts. There is pain while moving the right-hand upside or while getting up from a chair or bed. Even in case of walking a little faster than normal, pain erupts. While sleeping when I try to turn aside it starts paining.
Hello,
Welcome back to ciliniq.com.
I have gone through the image posted along with this query (attachment removed to protect patient identity), and if there is no abrasion other than one seen here, then I would not recommend injection Ceftriaxone or any other antibiotic for that matter. There is no role of continued antibiotics in your case.You should keep your arm in an arm shoulder pouch. Take some analgesic preferably Tramadol when the pain is severe. Apply ice packs to the affected area. Use an extra pillow while sleeping on the side of the injury. There could be rib fracture or soft tissue injury to the surrounding structure to your rib cage. It usually takes a month or two for complete relief of pain. You still have not answered my other questions. I will repeat it again for you. Are you able to walk and carry out the activities of your daily living on your own or not? The answer to this question determines whether a hospital stay is required or not.
Patient's Query
Hi doctor,
I am able to do my daily routine work and normal walk but with a little pain. Walking normally is fine, but walking a bit fast creates pain and for normal routine work my left hand is working properly but even I lift a pen from my right hand the pain erupts. I am able to change the clothes as pain is always there. While sitting on the chair and getting down from the bed pain starts. When I sit or stand or sleep in a static position then no pain but as soon as I change my position pain erupts.
Hello,
Welcome back to icliniq.com.
If you are able to carry out your daily activities then hospital admission is not required. You should keep your arm in an arm shoulder pouch. Take tablet Ultracet when the pain is severe and apply ice packs to the affected area. You can also apply analgesic gel to the region once abrasions heal. Use an extra pillow while sleeping on the side of the injury. Avoid any exertional activities as increased breath rate causes more pain. If the pain is unbearable, then nerve blocks are recommended by pain management specialists usually an anaesthetist working in a pain management clinic setup.
I hope this helps.
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Orthopedician and Traumatology
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