Persistent Wrist Pain After Injury: Seeking Effective Treatment Options

Q: Persistent Wrist Pain After Injury: Seeking Effective Treatment Options

Hello： First, it is important to determine the location of the fracture and the healing status. <br>If it is a wrist bone fracture, the healing status and potential complications need to be carefully monitored. <br>Thank you!

Wrist issues

Hello, doctor.
I fell and landed on my right hand, resulting in a wrist injury.
For the first three months, I visited an orthopedic clinic and a rehabilitation center, where the diagnosis was inflammation.
After treatment, there was no improvement.
I then went to National Taiwan University Hospital, where the doctor mentioned that the bone should have healed by now and recommended an ultrasound examination.
The result indicated a fracture, but he did not specify which bone was fractured and advised me to wear a wrist brace.
Now, entering the fifth month, my wrist issue still hasn't improved.
I don't have much time to see a doctor and I'm unsure where to seek appropriate treatment.
What should I do? Thank you.

Qiu, 20~29 year old female. Ask Date: 2016/05/21

Dr. Wang Shouji reply Orthopedics

Hello: First, it is important to determine the location of the fracture and the healing status.
If it is a wrist bone fracture, the healing status and potential complications need to be carefully monitored.
Thank you!

Reply Date: 2016/05/21

More Info

Persistent wrist pain following an injury can be quite challenging, especially when initial treatments do not yield the expected results. Based on your description, it seems that you have been dealing with this issue for several months, and the diagnosis has evolved from inflammation to a potential fracture that was not initially identified. Here’s a comprehensive approach to understanding your situation and exploring effective treatment options.

Understanding Your Condition
1. Initial Injury and Diagnosis: When you fell and landed on your wrist, the immediate concern would typically be soft tissue injuries (like sprains or strains) or fractures. It’s common for fractures to be missed in initial evaluations, especially if they are non-displaced or hairline fractures.

2. Persistent Pain: The fact that you have been experiencing pain for five months suggests that there may be underlying issues that have not been fully addressed. This could include:
- Undiagnosed Fracture: If a fracture was indeed present and not properly treated, it could lead to ongoing pain and dysfunction.

- Tendonitis or Tenosynovitis: Inflammation of the tendons around the wrist can cause persistent pain, especially with certain movements.

- Carpal Tunnel Syndrome: Sometimes, wrist injuries can lead to swelling that compresses the median nerve, resulting in pain, numbness, or tingling in the hand.

- Complex Regional Pain Syndrome (CRPS): This is a rare but serious condition that can develop after an injury, characterized by prolonged pain and changes in the skin.

Diagnostic Steps
1. Imaging Studies: Since the ultrasound indicated a fracture, it may be beneficial to get further imaging, such as an MRI or CT scan, to assess the soft tissues, ligaments, and any subtle fractures that X-rays might miss.

2. Physical Examination: A thorough examination by a hand specialist or orthopedic surgeon can help identify specific areas of tenderness, range of motion limitations, and functional impairments.

Treatment Options
1. Rest and Immobilization: If a fracture is confirmed or suspected, immobilizing the wrist with a splint or brace is crucial. This allows the bone to heal properly and reduces pain.

2. Physical Therapy: Engaging in a structured physical therapy program can help restore strength and flexibility to the wrist. Therapists can provide targeted exercises to improve range of motion and reduce pain.

3. Pain Management: Over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) can help manage inflammation and pain. If these are insufficient, your doctor may prescribe stronger medications.

4. Corticosteroid Injections: If inflammation is significant, corticosteroid injections into the wrist joint may provide relief.

5. Surgery: In cases where conservative management fails, surgical intervention may be necessary to repair any structural damage, such as a fracture or ligament tear.

Seeking Appropriate Care
Given your busy schedule, it’s essential to find a healthcare provider who can efficiently address your concerns. Here are some suggestions:
- Hand Specialists: Look for an orthopedic surgeon specializing in hand and wrist injuries. They have the expertise to diagnose and treat complex wrist issues.

- Pain Management Clinics: These clinics can offer a multidisciplinary approach, combining physical therapy, pain management, and possibly interventional procedures.

- Telemedicine Options: If visiting a clinic is challenging, consider telehealth consultations, where you can discuss your symptoms and treatment options with a specialist remotely.

Conclusion
Persistent wrist pain after an injury can stem from various causes, and it’s crucial to pursue a thorough evaluation to identify the underlying issue. Given the duration of your symptoms, seeking a second opinion from a hand specialist or orthopedic surgeon may provide you with the clarity and treatment plan you need to recover fully. Don’t hesitate to advocate for yourself and ensure that you receive the appropriate care for your wrist injury.

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