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Pain after bone plate fixation is a common clinical problem. Its relief strategies need to start from the pain mechanism, treatment principles and individualized needs of patients. The following are the specific methods:
First, drug treatment
Non-steroidal anti-inflammatory drugs (NSAIDs)
Mechanism: By inhibiting cyclooxygenase (COX), it reduces the synthesis of prostaglandins, alleviates inflammatory responses and pain.
Applicable scenarios: Mild to moderate pain, such as early postoperative inflammatory pain.
Long-term use may increase the risk of gastrointestinal bleeding, and the patient’s digestive tract medical history needs to be evaluated.
Opioid drugs
Mechanism: It acts on μ receptors in the central nervous system and inhibits the transmission of pain signals.
Applicable scenarios: Moderate to severe pain, such as severe pain after fracture reduction.
Precautions: Use strictly in accordance with the doctor’s instructions to avoid side effects such as addiction and respiratory depression.
Adjuvant analgesic drugs
Anticonvulsants (such as gabapentin) : used for neuropathic pain.
Antidepressants (such as amitriptyline) : Improve chronic pain by regulating neurotransmitters.
Second, physical therapy
Cold compress and hot compress
Cold compress (within 48 hours after surgery) : Reduces swelling and pain by constricting blood vessels.
Hot compress (48 hours later) : Promotes blood circulation and relieves muscle spasms.
Key points of operation: 15 to 20 minutes each time to avoid frostbite or burns.
Transcutaneous electrical nerve stimulation (TENS)
Principle: By stimulating sensory nerves with low-frequency pulsed current, the transmission of pain signals is blocked.
Applicable scenarios: Chronic pain or postoperative recovery period.
Ultrasound therapy
Function: Promote tissue repair through thermal and mechanical effects and relieve deep pain.
Third, rehabilitation exercises
Early passive activity
Objective: To prevent joint stiffness and promote blood circulation.
Method: Perform passive movements such as joint flexion, extension and rotation under the guidance of a doctor.
Gradual active activities
Principle: Gradually increase the amount of activity according to the degree of pain tolerance.
Isometric muscle contraction training began two weeks after the operation, and partial weight-bearing was attempted four weeks later.
Functional training
Objective: Restore the ability to perform daily activities and reduce pain caused by compensatory postures.
Fourth, psychological intervention
Cognitive Behavioral Therapy (CBT)
Method: Reduce pain perception by adjusting patients’ cognition of pain and coping styles.
Effect: Research shows that CBT can significantly improve the psychological state and functional level of patients with chronic pain.
Relaxation training
Techniques: Deep breathing, progressive muscle relaxation, etc.
Mechanism: Reduce the excitability of the sympathetic nerve and relieve anxiety related to pain.
Fifth, lifestyle adjustment
Sleep management
Suggestion: Keep a regular schedule and use a mattress and pillow that are neither too hard nor too soft.
When the pain is obvious, sleep aid drugs can be used for a short period of time.
Nutritional support
Key nutrients: Protein (promoting tissue repair), vitamin C (collagen synthesis), calcium (bone health).
Dietary advice: Increase the intake of lean meat, fish, and fresh fruits and vegetables.
Pain Diary
Function: Record the onset time, intensity and influencing factors of pain, providing a basis for doctors to adjust treatment plans.
Sixth, other intervention measures
Nerve block
Indications: Local neurogenic pain.
Method: Inject local anesthetics or glucocorticoids under image guidance.
TCM (traditional Chinese medicine) therapy
Acupuncture: It regulates the circulation of qi and blood by stimulating acupoints.
Massage: Relieve muscle tension, but avoid the area where the bone plate is fixed.
Multidisciplinary collaboration
Composition: Orthopedic doctors, pain specialists, rehabilitation therapists, psychologists, etc.
Advantages: Develop individualized comprehensive treatment plans to enhance therapeutic effects.
Precautions
Seek medical attention promptly: If the pain continues to worsen or is accompanied by symptoms such as fever and redness, be alert to infection or loosening of the bone plate.
Avoid excessive reliance on medication: Long-term use of painkillers may lead to liver and kidney damage or drug tolerance.
Regular follow-up: Adjust the rehabilitation plan based on the recovery situation to ensure safety and effectiveness.
Through the reasonable combination of the above strategies, the pain after bone plate fixation can be significantly improved and the functional recovery of patients can be promoted. The specific plan needs to be formulated by professional doctors based on the patient’s condition.