Managing Chronic Wrist Pain: Non-Surgical Options and Insights

Wrist issues

Hello Doctor, I have been experiencing pain in my left wrist for over six months.
Sometimes it hurts when I check the time on my watch, and I feel weak when lifting heavy objects.
Initially, I consulted a doctor who took X-rays and mentioned a subluxation of the distal radioulnar joint, indicating that the two bones were somewhat separated, but surgery was not recommended.
Later, I saw another doctor who suggested a "distal radioulnar joint button reconstruction surgery." After further evaluation, including an MRI, it was found that there is also nerve damage.
However, due to my work situation, I may not be able to undergo surgery.
Are there any other options available? Thank you, Doctor.

Kuo, 30~39 year old female. Ask Date: 2016/10/13

Dr. Shi Guozheng reply Orthopedics

Wearing a wrist brace to reduce the intensity and frequency of use, taking some anti-inflammatory medication, and observing for a period of time to see if there is improvement.
If there is no progress, then consider undergoing surgery.

Reply Date: 2016/10/13

More Info

Managing chronic wrist pain, especially when it has persisted for over six months, can be challenging, particularly when surgery is not an option due to work commitments or other factors. Given your situation, it is essential to explore non-surgical options that can help alleviate your symptoms and improve your wrist function.

Understanding Your Condition
From your description, it appears that you have been diagnosed with a partial dislocation of the distal radioulnar joint and possibly some nerve damage. The distal radioulnar joint is crucial for wrist stability and function, and any issues here can lead to pain, weakness, and limited range of motion. The presence of nerve damage can further complicate your symptoms, leading to pain, numbness, or weakness in the wrist and hand.

Non-Surgical Management Options
1. Physical Therapy: Engaging in a structured physical therapy program can be highly beneficial. A physical therapist can design a personalized exercise regimen focusing on strengthening the muscles around the wrist, improving flexibility, and enhancing overall function. Techniques such as manual therapy, ultrasound, and electrical stimulation may also be employed to reduce pain and inflammation.

2. Bracing and Splinting: Using a wrist brace or splint can provide support and stability to the wrist joint, especially during activities that exacerbate your pain. A brace can help prevent movements that might lead to further injury and allow the wrist to rest and heal.

3. Activity Modification: It is crucial to identify and modify activities that trigger your pain. For instance, if checking your watch causes discomfort, consider adjusting your wrist position or using a different method to check the time. Gradually increasing the weight of objects you lift can also help your wrist adapt without causing excessive strain.

4. Pain Management Techniques: Over-the-counter pain relievers such as NSAIDs (e.g., ibuprofen or naproxen) can help manage pain and reduce inflammation. Additionally, topical analgesics or patches may provide localized relief. If your pain is severe, discussing prescription options with your doctor may be warranted.

5. Corticosteroid Injections: If your pain persists despite conservative measures, corticosteroid injections into the wrist joint may provide temporary relief by reducing inflammation. This option should be discussed with your healthcare provider, considering the potential benefits and risks.

6. Alternative Therapies: Some patients find relief through alternative therapies such as acupuncture, chiropractic care, or massage therapy. While the evidence supporting these treatments can vary, they may provide symptomatic relief for some individuals.

7. Ergonomic Adjustments: If your work involves repetitive wrist movements or heavy lifting, consider ergonomic adjustments to your workspace. Using tools designed to minimize strain on the wrist, such as ergonomic keyboards or lifting aids, can help reduce discomfort.

8. Monitoring and Follow-Up: Regular follow-up with your healthcare provider is essential to monitor your condition. If your symptoms worsen or new symptoms arise, further evaluation may be necessary to reassess your treatment plan.

Conclusion
While surgery may be a consideration in the future, there are numerous non-surgical options available to manage chronic wrist pain effectively. A combination of physical therapy, bracing, pain management strategies, and lifestyle modifications can significantly improve your quality of life. It is essential to work closely with your healthcare provider to develop a comprehensive treatment plan tailored to your specific needs and circumstances. Remember, addressing wrist pain early and proactively can prevent further complications and enhance your overall wrist function.

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