<s>[INST] I fell backward landing on both hands and butt. I had serious pain in my right elbow and back that passed after few minutes. Mr right elbow has intense pain depending on how it moves. i don y see any bruise and my hand functions. I have been icing it for 8 hours and i still get intense pain when i move some directions. At wha point do i stop ice and see a doc. I have a high pain threshold, but when it flares i can t use my arm [/INST] Hi,Thanks  for  your query.An initial xray of the injured part is mandatory to rule out any bony injury (fracture). If the xray is negative for a fracture, then the other possibility is soft tissue injury either to the ligaments, tendons etc.The initial management for your condition is as follows -- Give adequate rest to the injured part and avoid any movements that produces pain- Apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day- Compress or bandage the injured area to limit any swelling and movement that could damage it further. You can use a crepe bandage or a simple elastic bandage - Keep the injured area raised and supported on a pillow to help reduce swelling. - Gentle massage with a pain killer cream over the injured area might be helpful If your symptoms are still persisting after the above measures, consult an orthopedic surgeon for further evaluation and management.I do hope that you have found something helpful and I will be glad to answer any further query.Take care </s>