Work-Related Injury: Ongoing Abdominal and Lumbar Discomfort for Nearly a Month
A 37-year-old female employed in the healthcare sector, standing at 5'7", sustained an injury at work almost four weeks ago when a patient unexpectedly kicked her forcefully in the right side of her lower abdomen. Although she managed to maintain her footing, the incident triggered muscle spasms in her lower back as the shift progressed. After her shift concluded, she started experiencing discomfort in her hip and had tenderness, cramping, and pain in the right abdominal area. Following the injury, she reported the situation to human resources and sought medical assistance through urgent care and a hospital, leading to multiple follow-up visits over the past month due to persistent pain and difficulties with walking and standing for prolonged periods. Additionally, she made another emergency room visit related to side effects from taking a stronger NSAID for an extended period. Currently, she is receiving workers' compensation. The patient has been prescribed a variety of medications, including oxycodone for two weeks (which she found unpleasant), robaxin for 1-2 weeks, and subsequently switched to naproxen 500mg twice daily along with flexeril for nearly two weeks. After finding naproxen to be ineffective, her treatment included a more potent NSAID, Diclofenac, and higher-strength lidocaine patches for the past week. However, due to adverse reactions to the stronger NSAID, she was advised to return to naproxen, even though it too has failed to provide sufficient relief. As a result, she increasingly relies on hot/cold therapy and lidocaine products, along with flexeril for management. While she has noticed slight improvements, she continues to need flexeril and NSAIDs (currently naproxen), along with lidocaine applications, and is attempting to engage in stretching exercises two to three times daily. However, she still finds it challenging to walk or stand for long durations, experiencing elevated heart rates (120-130 bpm) after just 10-15 minutes of activity due to pain, and has difficulty bending down without discomfort. Nighttime sleep has been significantly disturbed due to ongoing pain symptoms. Fortunately, after about one to two weeks, most abdominal pain subsided; however, issues with back and hip pain remain severe, occasionally radiating down her right thigh, which urgent care is monitoring. CT scans have been performed with normal results. She acknowledges a gradual improvement yet feels anxious, as she still experiences these symptoms after nearly a month. Upcoming appointments with an orthopedic specialist concerning her hip next Wednesday and her back the following Monday offer some hope for further evaluation. She is seeking guidance regarding the expected healing timeline, as her current restrictions have prevented her from returning to work. Initially optimistic about a short recovery period, the ongoing nature of her condition during this fourth week is concerning. Thank you for your assistance, -SarahBearah
Answers (1)
6/21/2025, 3:10:48 AM
OpenHealth AI
Main Points: Ongoing abdominal and lumbar discomfort after a work-related injury is concerning but can be managed effectively. It's essential to focus on symptom management and preparing for upcoming specialist appointments.
Explanation: SarahBearah, your situation following the injury appears complex, with ongoing pain and discomfort in your abdomen, back, and hip. It’s understandable to feel anxious after a month of persistent symptoms, especially since you were hoping for a quicker recovery. Your experience of elevated heart rate following activity, persistent pain, and challenges with sleep are significant and warrant attention.
Your current treatment plan, including the use of NSAIDs, muscle relaxants, and lidocaine patches, shows that you’re proactive about managing these symptoms. However, the fact that these have been inadequate, and your ongoing pain and discomfort, indicates that a more holistic approach, alongside medical evaluations, may be necessary.
Next Steps:
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Prioritize Specialist Appointments:
- Attend the upcoming orthopedic appointments. Share all your symptoms comprehensively, including any changes in pain intensity, mobility limitations, and side effects from medications. This will help the specialists tailor the best management plan for you.
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Focus on Pain Management Techniques:
- Continue your hot/cold therapy, as this can help alleviate pain temporarily. Experiment with warm baths or heating pads for muscle relaxation, while ice packs can reduce inflammation.
- Use any prescribed lidocaine products as directed. They can help manage localized pain effectively.
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Engage in Gentle Exercise:
- Since you've already started stretching exercises, consider focusing on gentle yoga or physical therapy exercises designed for abdominal and back pain, if you're comfortable. Simple stretching can help alleviate muscle tension without overstraining your body.
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Monitor Your Activities:
- Keep a log of your daily activities and pain levels. This can help you identify any specific activities that exacerbate your symptoms and communicate effectively with your healthcare providers.
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Explore Anxiety Management Techniques:
- Since ongoing pain and the situation can impact your mental health, consider practicing relaxation techniques such as deep breathing, mindfulness, or light meditation to manage anxiety.
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Optimize Sleep Hygiene:
- Address sleep disturbances by promoting a comfortable sleep environment—consider using pillows to support your back and legs and practicing a calming bedtime routine to improve your sleep quality.
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Stay Communicative with Your Medical Team:
- If your pain or symptoms worsen, or if you experience new symptoms, notify your healthcare team promptly. Keep them informed about the effectiveness of any treatments you are trying.
Remember, healing can vary from person to person, and it’s important to give yourself grace during this time. Your proactive approach is a positive step toward recovery, and I hope the upcoming evaluations bring you relief and clarity. Please keep us updated on your progress and any new concerns.
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