You’ve had pain. Terrible pain. Finally you get your MRI, you waited for the results and they are finally ready. You have the results. The results are in and you have a fracture.
Working in personal injury law we often have clients who have a fracture and not even realize it. Persistent pain long after the muscle and tissues should have healed is usually a telltale sign.
Many people obtain their MRI report and will see one of the following things listed under the heading “Impression”: acute fracture, subacute fracture or stress fracture. What’s the difference?
An acute fracture will often include an emergency room visit they day the trauma occurred and are clearly evident on an x-ray.
A subacute fracture usually means that the patient had pain for some time. Usually if they are getting this diagnosis, the fracture occurred weeks or months prior but now is in the healing stage.
The fracture site will be painful for several weeks. In many of these cases, a person went to their primary care physician the day after the trauma and the doctor may have told them to expect pain for a few weeks or months. The person may have returned, received a referral for physical therapy or chiropractic care and while the person improved in all their other symptoms, a bony area remains painful and sensitive. At this point, a physician may order a x-ray or MRI now weeks or months post trauma and the imaging will reveal a fracture that is already in the healing process. While the bone and surrounding tissues are healing, pain will be present for some time until the fracture has healed.
Stress fractures primarily occur in the lower extremities typically the feet or legs. They may occur due to impact activity and/or repetitive activities. Certain athletes are prone to stress fractures. Gymnasts, runners and those involved in track and field may suffer a stress fracture. These activities can cause small cracks in the bones due to the bones absorbing force repeatedly. Stress fractures and fractures that are healing will be painful with weight bearing.
Pain may also exist for reasons other than the fractured bone itself. A person with a fracture will initially make every effort to avoid using that part of their injured body. When the person begins to use this part of their body again, they will experience pain since the muscles surrounding the injured area may be ‘stiff.’ This muscle stiffness can cause immobility. Depending on where the fracture occurred, physical therapy may be ordered afterwards to help the muscles surrounding the injured area become ‘pliable’ again. Once the muscles surrounding the fractured bone become stronger and able to tolerate more movement, the pain level will decrease.
When a bone is fractured, the pain felt immediately thereafter is acute pain. As the bone and soft tissue start to heal, there may be some sub-acute pain may present itself. According to Osteoporosis Canada, this happens because of the lack of movement that has occurred in order to get the bone to knit back together. There may also be some inflammation in the soft tissues surrounding the fracture that results in muscle stiffness.
If you have been injured in a car wreck or other traumatic incident, call me at the Law Offices of Edward A. Smith. I have been working with Californians to help them get back on their feet since 1982. My local number is (916) 921-6400 or elsewhere (800) 404-5400.
Photo Attribution: By Community Emergency Response Team (CERT) (http://www.citizencorps.gov/cert/IS317/medops/) [Public domain], via Wikimedia Commons