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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Pain After Surgery

I have severe scoliosis and fell and broke my femur - a hemorragic break and fractured my hip.. I am in extreme pain now and my rib cage is touching my hip due to the surgery ..I am in constant pain- what are my options for long term functionality and pain management?
Fri, 30 Jun 2017
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Addiction Medicine Specialist 's  Response
Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment. First, you cannot have the rib cage touch the hip. What about intestines?

The context would be an important feature. Is it right after the fracture? in which case a lot of narcotics ouwld be quite reaonable for about 2 weeks and then less narcotics and more aspirin like drugs.

Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain.

Location of pain. There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerve

What hurts. Moving a particular way that triggers the pain tells what is hurting. Specifically it can distinguish outward structures like skin, muscles, tendons, joints from deep structures like organs and nerves.

``     Having a diagnosis leads to choice of medicine for the pain. Inflamed outer structures respond to treating inflammation. Inner structures need diagnostic tests because something internal is broken. MRI's.

And, structures that cannot be fixed need adaptations. Physical therapy, pillows, supportive structures internal and external.
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Suggest Treatment For Pain After Surgery

Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment. First, you cannot have the rib cage touch the hip. What about intestines? The context would be an important feature. Is it right after the fracture? in which case a lot of narcotics ouwld be quite reaonable for about 2 weeks and then less narcotics and more aspirin like drugs. Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain. Location of pain. There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it hit a nerve would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerve What hurts. Moving a particular way that triggers the pain tells what is hurting. Specifically it can distinguish outward structures like skin, muscles, tendons, joints from deep structures like organs and nerves. `` Having a diagnosis leads to choice of medicine for the pain. Inflamed outer structures respond to treating inflammation. Inner structures need diagnostic tests because something internal is broken. MRI s. And, structures that cannot be fixed need adaptations. Physical therapy, pillows, supportive structures internal and external.