Wrist Pain from Push-Ups: Causes and Treatment Options - Orthopedics

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Wrist pain, particularly in the context of performing push-ups, can be attributed to several underlying causes, including ligament injuries, tendonitis, or even issues related to the carpal bones. Given your description of pain at the junction of your palm and wrist, it is plausible that you are experiencing a ligament injury or a form of tendonitis, especially if the pain has persisted despite physical therapy.


Q1: Is it truly a ligament injury, and should I get an X-ray?
Based on your symptoms and the history of your injury, it is indeed possible that you are dealing with a ligament injury. Ligament injuries in the wrist can occur due to repetitive stress, especially in activities like push-ups that place significant strain on the wrist. Common ligaments that may be involved include the scapholunate ligament and the triangular fibrocartilage complex (TFCC), both of which can be injured during activities that involve wrist flexion and extension.

While physical therapists can provide valuable insights and treatment, if your pain persists or recurs, it may be prudent to seek further evaluation from an orthopedic specialist. An X-ray can help rule out any fractures or bony abnormalities that might be contributing to your pain. If the X-ray is inconclusive and your symptoms persist, your doctor may recommend an MRI to assess soft tissue structures, including ligaments and tendons, more thoroughly.


Q2: Should I consider prolotherapy?
Prolotherapy, or dextrose prolotherapy, is a treatment option that involves injecting a solution (often dextrose) into the affected area to stimulate healing. This treatment is thought to promote tissue repair and may be beneficial for chronic ligament injuries or tendonitis. However, the evidence supporting its efficacy is mixed, and it is generally considered after conservative treatments, such as physical therapy, have failed.

Before proceeding with prolotherapy, it is essential to have a clear diagnosis. If your pain is indeed due to a ligament injury, prolotherapy might be a viable option, but it should be discussed with your healthcare provider. They can help you weigh the potential benefits against the risks and costs associated with the treatment.


Additional Considerations
1. Rest and Activity Modification: It’s crucial to allow your wrist to rest and avoid activities that exacerbate the pain. Modifying your push-up technique or using wrist supports may help alleviate stress on the wrist.

2. Physical Therapy: Continuing physical therapy focused on strengthening the wrist and improving flexibility can be beneficial. Your therapist may also employ modalities such as ultrasound or electrical stimulation to aid in recovery.

3. Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help manage pain and inflammation. However, consult with your healthcare provider before starting any medication.

4. Gradual Return to Activity: Once your pain subsides, gradually reintroduce push-ups and other wrist-intensive activities. Consider starting with modified versions, such as incline push-ups, to reduce the load on your wrists.

5. Consultation with a Specialist: If your symptoms persist despite conservative management, a consultation with an orthopedic surgeon specializing in the wrist may be warranted. They can provide a more comprehensive evaluation and discuss potential surgical options if necessary.

In summary, while it is possible that you are dealing with a ligament injury, further evaluation through imaging may be necessary to confirm the diagnosis. Prolotherapy could be an option, but it should be considered after a thorough assessment and discussion with your healthcare provider. Prioritize rest, modify activities, and continue with physical therapy to enhance your recovery.