So last week I told the story of how Joshua broke his arm on the playground and I didn't recognize it. Really, though, who could recognize if a limb is broken without an x-ray? The answer to that question is you can't. Of course, there are fractures (breaks) that are open and obvious. You don't need to be a genius to diagnose a piece of bone sticking out of the skin as a fracture. But in the absence of blood and shards of bone how can you or I tell if we need an x-ray?
A fractured limb can be very obvious or can be subtle. A hairline fracture may cause pain and swelling but so will a sprain. The easy answer and what healthcare workers use to determine if someone needs an x-ray and splint is what caused the injury in the first place. An example may be if you fall and catch yourself using your hands on the ground. You may experience pain in one or both wrists. The cause of the pain is the fall. Therefore, you should get an x-ray because that type of injury is very commonly a fracture to the many small bones that make up the wrist.
A sprain is a stretching or tearing of the ligament that links two bones together. A sprain can be minor only stretching the ligament or it can be major tearing through the ligament and requiring surgery. A sprain will always be at the location of a joint. Symptoms of a sprain include pain, swelling, discoloration and joint stiffness. The pain and swelling usually go away within 7-10 days but may last longer depending on the severity.
So what should we do if we suspect a break or sprain? The first thing you need to do is get an x-ray. The x-ray will rule out a fracture. Once a fracture is ruled out the diagnosis of a sprain can be made by the doctor using a good history and physical and noting how severe the swelling is, and how well you can move the affected joint.
Treating a sprain includes RICE: Rest, Ice, Compression and Elevation. An older sprain may also benefit from heat. Apply heat to the affected area to promote increased circulation and healing. A trip to the physical therapist my not be a bad idea either. Ask your doctor if he thinks it will be beneficial. The physical therapist will help you regain mobility to the joint as it heals.
Fractures and sprains are common summertime injuries. Have fun this summer and be careful.