FAQs
We understand that patients can often find themselves overwhelmed near the end of their office visit. This can result in questions not asked and explanations not fully understood. Among those frequently asked questions are those regarding:
- Cast and Dressing Care
- Pain, Swelling, and Discoloration
- About Commonly Ordered Tests
- About Commonly Prescribed Medications
- About Cortisone Injections
Cast and Dressing Care
Casts, splints and dressings should be left intact, unless specifically advised differently. They should be kept dry. To bathe or shower a commercial cast cover or garbage bag secured with an elastic band above the cast or dressing should be utilized. Hold the arm and hand elevated in the shower and out of the bath. If a cast or splint immobilizing a fracture should accidentally get wet, dry it thoroughly with a blow dryer. If a traumatic or surgical wound dressing gets wet, please call us for instructions. Casts, splints, dressings should not feel too tight, should not 'dig in' or 'rub'. We encourage you to notify us if you experience such discomfort.
Pain, Swelling, and Discoloration
These are common and to be expected after injury or surgery. The difficulty is determining when pain, swelling and discoloration is excessive. Of the three symptoms, pain is perhaps most important. Bruising and swelling accompanied with mild to moderate pain is normal in the context of an injury or surgery, particularly when the pain is diminishing over time. On the contrary, moderate to severe and increasing pain over time should raise concern. This is particularly so when the pain is exacerbated by moving the fingers and accompanied by numbness in the fingers. Under such circumstances or just if you are simply not sure, we urge you to notify us immediately.
About Commonly Ordered Tests
About Commonly Prescribed Medications
About Cortisone Injections
Corticosteroids (cortisone-like substances called "steroids") are produced naturally in your body's adrenal glands. One of the purposes of body cortisone is to reduce inflammation and irritation. Corticosteroids are not the same as the anabolic steroids that some athletes take to decrease body fat and increase the size of their muscles.
The inflammatory process is the way that nature heals injuries. First the blood brings white blood cells to the injury to fight off infection and clear up dead tissue. Nutrient building blocks assemble to rebuild weakened tissue. New blood vessels form to bring increased amounts of blood with oxygen to the site. Inflammation is a vital process, but the inflammation process can sometimes become chronic or excessive and decrease the normal ability of the body to heal. An example of this would be chronic tendonitis or a flare up of a joint with arthritis. When other measures such as medications, resting or special exercises fail, your doctor may elect to give you a steroid injection directly into the affected joint. The most common reason for injecting corticosteroids into a joint is to provide a localized anti-inflammatory effect, thereby decreasing swelling and reducing the accompanying pain. This is done without having the undesirable systemic effects that oral corticosteroids can have.
Usually with the steroid the doctor will include a novocaine-type medication. One reason for this is to decrease the pain following the injection itself. Another is to allow the doctor to know that he has injected the trouble causing spot because almost immediately the patient will have an increase in range of motion, or a decrease in pain with movement.
Before an injection, the skin around the site must be thoroughly cleansed. This is important so that no skin bacteria are introduced into the joint.
When the novocaine wears off, some patients will have increased pain in the joint for 24-48 hours. You may use aspirin, Tylenol, or ibuprofen products during this time. An ice pack applied to the affected area may also be helpful. Apply it for twenty minutes, remove for ten minutes, re-apply for twenty minutes, then remove. Do this 3-4 times daily. Do not use heat as it increases swelling and pain. If increased pain continues beyond 48 hours, you should notify your doctor.
The relief from a corticosteroid injection is variable. Many patients will have dramatic relief while others may have less or no relief. The relief may last from only days to months. Maximum effect generally occurs in 5-7 days. If pain persists for several weeks to a month, but it is less severe than before, the doctor may administer a second injection to provide additional relief.