Transitioning from hurting to healing: self-management after distal radius fracture

Abstract

Purpose

Chronic pain and disability after musculoskeletal trauma support the need for non-biomedical perspectives to frame experiences of recovery. Self-management is a specific holistic lens with implications for improving health outcomes. This qualitative study explored how adults made meaning of self-management after distal radius fracture (DRF).

Methods

Thirty-one individuals aged 45–72 with a unilateral DRF participated in a semi-structured interview 2–4 weeks after discontinuing full-time wrist immobilization. Interviews were audio-recorded and transcribed, and constructivist grounded theory techniques were used to analyze the data.

Results

Participants made meaning of self-management as a process of “transitioning from hurting to healing,” which occurred via three underlying processes. “Learning because of my injury” included gaining information for empowerment and understanding by physically living through the experience. “Working and hoping toward healing” involved taking active steps to recovery in the face of uncertainty. “Getting back to my normal self” comprised reconnecting to one’s body and identity after injury.

Conclusions

Participants’ lived experiences overlapped with those of self-managing chronic conditions, highlighting the need to consider how individuals actively engage in their recovery after DRF. Findings suggest using supportive interventions to facilitate patients’ understanding, activation, and engagement in meaningful activity after DRF.

Implication for rehabilitation

• To maximize health outcomes after distal radius fracture, clinicians should move beyond impairment remediation to supporting multiple dimensions of recovery, including emotional distress and functional limitations.

• Clinicians should routinely provide early and ongoing information, such as expected symptoms and recovery time frames, to minimize loss of control related to uncertainty.

• Clinicians should emphasize active interventions, such as collaborative goal setting and functional tasks, that engage patients in their own healing.

• Clinicians should support patients’ early return to meaningful activity to maintain or restore connection to the body and identity.

Keywords:

• Hand injuries
• health behavior
• lived experience
• orthopedics
• qualitative
• wrist

Acknowledgements

We gratefully acknowledge the participants who shared their stories and clinicians who assisted with recruitment. This article is based on research conducted by BZS in partial fulfillment of the requirements for the Doctor of Philosophy degree in Occupational Therapy at New York University, May 2020.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This study was supported by the Burkhalter New Investigator Grant from the American Hand Therapy Foundation and an NYU Steinhardt Doctoral Research and Travel Grant. Support for BZS’s time for manuscript development was provided by a Grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (#90ARHF0003, PI: Allen Heinemann).