Health Q&A: continuing pain after an injury and the loss of smell and taste

Dr David Roche / 23 May 2013

Saga Magazine's Dr Roche answers questions on continuing pain after a golfing injury and the loss of smell and taste

Question: Two years ago I was hit on the lower shin by a golf ball; my leg was black and blue all the way up to the knee. I have been to the doctor several times as, although the bruise has reduced in size to that of a golf ball, it is still very painful all around that area. Shouldn’t the bruise and pain have gone by now? I’m 70 and know that I will not heal as well as when younger. I had a blood test and that was fine. My GP seems to suggest that if it hasn’t gone by now, that’s as good as it’s going to get. Recently I have also developed really painful sciatica and get excruciating cramp all down that one leg. Is this just a coincidence, do you think?

Dr Roche writes: In the front of the lower shin, the bone is close to the surface so an injury there often results in a collection of blood close to or including the surface of the bone. When the blood collection can be felt as a distinct swelling it is called a haematoma.

As it heals, some new bone can form in the bruise and they often stay sore for a very long time. All scars, particularly deep ones, have the potential to cause long-term pain, particularly if nerve tissue has been badly damaged, and I suspect this may apply in your case.

In other cases you can expect the pain to settle fully but there may always be a swelling present. Football and hockey players, who often injure their shins, can have quite a collection of lumps! Of course the lump should not be enlarging or getting more painful – you need a medical opinion if it is.

The sciatica is just a coincidence. The injury causing that is in the base of your spine; the pain just happens to radiate into the affected leg.

Loss of smell and taste

Question: I’ve had no sense of smell or taste for years. I’ve had two operations for the removal of polyps in my nose, one of which did bring back my senses of taste and smell for a week or two. I am going on holiday shortly and would love to be able to taste the food. Is there anything I can take to help?

Dr Roche writes: Loss of smell and taste is very frustrating. Testing often reveals that some taste is preserved, though loss of smell is often complete, and the two sensations are interdependent to some extent. The commonest causes are nasal polyps and sinus disease, and addressing these problems can help matters, but doesn’t always work. Nerve receptors for smell are confined to a small area in the roof of the nose and are prone to injury. And if smell has been lost for years it is unlikely to return. Some drugs interfere with smell, so this is worth exploring if you are on medication. Occasionally, strokes, Parkinson’s disease or multiple sclerosis can be responsible. Taste passes through several different nerve pathways to the brain and taste receptors cover a wide area of the tongue, so damage to taste is unlikely to be complete.

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