3 year old injury, a couple questions

A little background about myself. I am not new to HW, but usually post on the Crohn's forum. about 3 1/2 years ago I was in a car accident and tore ligaments in my right hand. I continued to see an orthopedic and he did steroid injections which helped substantially. Since the swelling and pain have persisted and spread across the hand, the ortho thought that maybe I have another auto-immune issue going on that is causing damage in my hand. I have not seen a rheumatologist yet.

My insurance has changed and I had to start seeing a new ortho. The appointment was today, and was horrible. He asked twice within a 10 minute span if I had Crohn's, then dismissed the suggestion that this might be crohn's related, or arthritis, and not an injury causing the pain anymore. He then said I should have PT before he would inject my hand again. (Though I stated that using my hand causes it to swell even more and hurt worse) Next, he left and sent a nurse in who informed me that he wanted xrays (which were done only 3 weeks ago and I refused to have done) and prescribed and anti-inflammatory which I cannot take because of the Crohn's.

My questions:
Have any of you had PT long after an injury and found that it helped?

Can an old injury be helped with physical therapy if using the joint causes pain and swelling? I understand that PT can be painful, but don't know how my hand would be changed by motion as using it thus far has not strengthened it, but made it worse.

How many injections can be done in a joint before joint damage can be done by the steroid? (I've read that after a while that small joints can have damage from repeated steroid injections)

If this might be arthritis, what other meds (besides NSAIDS, because I cannot take them) could be used to control the pain? I don't want to continue taking lortab in order to use my hand, which is why I made the appointment and wanted the injection. Are there medicines doctors will try for arthritis without going through the process of seeing a rheumatologist?

Thanks for the time you took to read this (my posts always end up longer than I intend them to be). I appreciate your help and support, and wish you all well. Many hugs!

I was just going to suggest something similar to the wax, and PT has similar therapies. They can use heat, and gentle massage to stretch and strengthen. It is worth a try.

   

     Good Morning Beckey!

   *hugg* I was floored last night when you told us in chat. If I were in your shoes.. I would seek a second opinion. He obviously spent no time going over your history. Prescribing you NSAIDs even though you told them you cannot take them is ridiculous. I am not against PT, not at all. I get a new at home program designed for me each year. I just think that handing you a referral to PT and walking out the door is careless. I am so sorry he treated you that you. Now, you have to go through the entire new patient process all over again    I hope you can find a new one quickly. You have been in way too much pain for far too long.

*warm hugg*
       dani

Hi Becky -

I have a slightly different point of view from having wreck-related injuries, also arthritis, bursitis and tendonitis,and have had hand surgery. I absolutely am not disagreeing with the other respondents, only teling my own individual experiences. I tend to believe doctors until they are proven wrong. It's usually my preconceived notions that are off base.

I get copies of all my MRIs, CTs, x-rays on disks and make copies of them for the next doctor. I also make copies of the written reports. I agree with refusing more x-rays, but suggest going back to the first doc and asking for a disk of the previous x-rays. You have a right to your records! They are usually free if you are taking them to another doctor, but they can charge a reasonable fee if they are just for your own files. I just got copies of my shoulder x-rays so I can get a second opinion about proposed surgery.

I don't have Cronhns or any autoimmune problems that I know of, and I've been tested. I do have pain in my knee which was injured in the accident and was operated arthroscopically. The original injury was corrected, but there's a tendon popping, or letting the kneecap slip back and forth. I think more PT will be prescribed. It didn't help with the torn cartilage, but it might be able to tighten up or strengthen the tendon.

I had hand surgery for trigger fingers related to taking a cancer med. This was last summer and I still have a lot of pain, have to keep working the tendons and the scars several times a day. The gentle PT helped a lot for a while, then the insurance covered visits ran out and it wasn't helping much anyway. I was not getting better as fast as I thought I should. In fact progress was not happening at all. My doc told me I needed to be more vigorous with my stretching and pushing on the scars to keep the tissue from reforming too tight. I have to push and stretch to the point it hurts quite a bit - which I was not told I needed to do when I was in therapy. Working the hand in fairly hot water or at least in my hot tub works fastest and relieves pain the best. I was told it can take a year or more to recover. I have one spot that clicks quite a bit and may need a further brief surgical release.

I've had injections for my hand (they have to try that first before surgery), for my knee, my slipping ribs, and a whole bunch for my spine. I've read and been told it's true that you can usually only have 3 in one area in a year or the tendons and cartilege break down.

Arthritis starts up where you've had an injury. That's what's wrong with my spine. Fell of horses for a start, but the wreck seems to have really done me in. It got worse fast and now causes a lot of pain. My shoulder has only a tiny bit of arthritis, but there's tendonitis and bursitis (aka impingement syndrome) causing pain too. That's pretty well controlled for now with injections, but I can't have any more and the next treatment is surgery to remove a couple of tiny bone spurs and the bursa that's inflamed. Sometimes a tiny bit of arthritis or inflamation can cause debilitating pain!

For pain I can only take tramadol or vicodin, the latter I save for after surgeries. I get away with Tylenol, but need the max dose to notice any relief, and I'd rather save my liver. My little bitty hot tub helps a lot too. It fits in the space of a closet.