Global Health Asia-Pacific March 2022 March 2022 - Page 10

You Ask , They Answer

Q

: What ’ s the difference between sprains and strains and what are their telltale signs ?

A

: A strain occurs when a muscle or tendon becomes overstretched or torn . A sprain results from a ligament being overstretched or torn . Ligaments are tough fibrous tissues located around the joints , connecting bones to each other .
Symptoms of a strain include swelling , muscle weakness , muscle cramps , bruising , and difficulties moving the affected area .
A sprain , on the other hand , can cause limited movement around the joint , a ‘ popping ’ sound during the time of injury , pain , bruising , and swelling around the affected area .
However , it may sometimes be difficult to distinguish between the two . Sometimes a strain can also happen with a sprain , adding to the ambiguity .

Q

: Can patients with strains or sprains treat them at home ? If yes , what should they do ?

A

: Early treatment can be started at home with a simple protocol called R . I . C . E . Rest – Rest the affected area as much as possible . Ice – Apply a cold compress ( wrap the ice pack with a towel rather than applying it directly to skin ) to the affected area every 2 – 3 hours .
Compression – Reduce swelling by wrapping the affected area with a medical-grade elastic bandage . Seek medical attention if unsure about the right technique .
Elevation – Keep the injured area above the level of your heart to reduce swelling and pain . For example , if you ’ ve sprained your ankle , prop it up on one or two pillows .

Q

: Are there any cases when a doctor should be consulted ? If yes , should they see an orthopaedist or a general practitioner ?

A

: In certain scenarios , one should seek medical attention , be it from a general practitioner or an orthopaedist :
1 . Inability to bear weight on a joint , e . g ., the foot , ankle , or knee , may indicate a more severe injury , like a fracture .
2 . Persistent pain despite RICE therapy and pain medications . Most strains and sprains get better within a week . So if pain persists beyond that , one should seek medical help .
3 . Inability to move or bend a joint . This may suggest a more serious underlying problem , like a meniscus tear in the knee or a tendon rupture .
4 . Significant swelling or deformity . This may be caused by an underlying fracture or dislocation .
5 . Recurring pain .

Q

: How long does it take for patients to recover ?

A

: This depends on the severity of the strain or sprain . Most soft tissue musculoskeletal injuries ( i . e ., with no bony involvement ) take anywhere from a few days to up to six weeks to heal .

Q

: When is additional treatment , like physiotherapy , recommended ?

A

: A specialist orthopaedic surgeon will typically first conduct a thorough clinical assessment , which may include imaging , such as x-rays and MRI scans . Depending on the final diagnosis , treatment can be conservative , e . g ., medications , rest , physiotherapy , orthotics , or other therapy . If conservative treatment is insufficient , surgery can be performed via the “ keyhole ” minimally-invasive method or open method , depending on the condition to be treated .
Dr Koo Oon Thien Kevin
Dr Koo Oon Thien Kevin is an orthopaedic surgeon at Mount Elizabeth Hospital in Singapore .
8 MARCH 2022 GlobalHealthAsiaPacific . com