Wrist Issues: Recovery and Treatment Options After Injury - Orthopedics

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Hello! It sounds like you've been through quite a challenging time with your wrist injury. Based on your description, it seems that you sustained a wrist injury from a fall while riding your bike, which resulted in a partial dislocation of the distal radioulnar joint (the joint between the radius and ulna bones in your forearm) and possibly some ligamentous injury. Even though your X-rays showed no fractures, the ongoing symptoms you’re experiencing—such as pain, discomfort, and numbness—are not uncommon after such injuries.


Understanding Your Symptoms
1. Partial Dislocation and Ligament Injury: The term "partial dislocation" indicates that the bones in your wrist may not be aligned properly, which can lead to instability in the joint. This instability can cause pain and discomfort, especially during certain movements or when pressure is applied to the wrist. Ligament injuries can also contribute to these symptoms, as ligaments are crucial for stabilizing joints.

2. Nerve Compression: The numbness you experience upon waking could be due to nerve compression, possibly from swelling or improper positioning of your wrist while you sleep. The median nerve, which runs through the carpal tunnel in your wrist, can be affected by inflammation or swelling, leading to symptoms similar to carpal tunnel syndrome.

3. Rehabilitation and Recovery: It’s important to understand that recovery from wrist injuries can take time, especially if there was any ligamentous damage or joint instability. The "golden period" for treatment often refers to the initial weeks following an injury when the most effective interventions can be applied. Since you mentioned that you are past this period, it’s crucial to focus on rehabilitation to regain strength and mobility.


Treatment Options
1. Physical Therapy: Continuing with physical therapy is essential. A physical therapist can provide specific exercises to strengthen the muscles around your wrist and improve stability. They can also help with manual therapy techniques to improve joint mobility and reduce pain.

2. Shockwave Therapy: You asked about shockwave therapy (also known as extracorporeal shock wave therapy). This treatment can be beneficial for chronic pain conditions and may help stimulate healing in soft tissues. It’s worth discussing with your healthcare provider to see if it’s appropriate for your specific situation.

3. Pain Management: If you experience pain, over-the-counter pain relievers (if not contraindicated) or topical analgesics may help. If your pain persists, your doctor might consider other options, including corticosteroid injections.

4. Bracing: Depending on the severity of your symptoms, a wrist brace may provide support and stability, especially during activities that exacerbate your pain. However, if wearing a brace causes discomfort, it’s important to communicate this to your healthcare provider.

5. Surgical Options: If conservative treatments do not alleviate your symptoms and if there is significant instability or pain, surgical intervention may be considered. This would typically involve stabilizing the joint or repairing any damaged ligaments.


Conclusion
In summary, the symptoms you are experiencing could indeed be related to the initial injury and subsequent instability or nerve involvement. It’s essential to maintain open communication with your healthcare provider about your symptoms and treatment options. If you feel that your current treatment plan is not effective, seeking a second opinion or discussing alternative therapies, such as shockwave therapy, could be beneficial. Remember, recovery can take time, and it's important to be patient with your healing process.