Wrist Pain and Scaphoid Discomfort: Treatment Options and Recovery Time

Wrist pain when bearing weight and pain in the scaphoid bone of the wrist?

Hello, doctor.
About a month and a half ago, I started feeling a clicking sensation in my right wrist.
During my training, whenever I perform push-up movements, I experience pain in the dorsal side of my hand, specifically in the extended positions of my index and middle fingers, and my wrist feels swollen and stiff.
Now, in addition to the pain in those areas, I also feel pain in the scaphoid bone of my wrist.
A couple of days ago, I consulted a traditional Chinese medicine practitioner who said that the cartilage between the bones is misaligned and that my wrist joint is relatively loose.
He provided manual therapy, topical medication, and a brace, but my wrist is still swollen.

Could you please advise whether I should continue seeing the traditional practitioner, or should I consider acupuncture, physical therapy, or shockwave therapy instead? Additionally, how long might it take for my wrist to heal? Is a full recovery possible? I have a physical fitness test in a month, so I would like to know if it’s feasible to recover by then.
Thank you.

Tong, 20~29 year old female. Ask Date: 2020/07/13

Dr. Shi Guozheng reply Orthopedics

It is best to consult an orthopedic physician, who will need to take X-rays to determine if there are any fractures.
A correct diagnosis is essential to understand how to treat the condition and how long it will take to heal.

Reply Date: 2020/07/13

More Info

Wrist pain, particularly in the area of the scaphoid, can be quite challenging, especially for someone actively engaged in sports or physical training. Based on your description, it seems that you are experiencing discomfort and swelling in your wrist, particularly during weight-bearing activities like push-ups. The sensation of "catching" or "locking" in the wrist, along with pain in the area of the scaphoid, suggests there may be an underlying issue that needs to be addressed.

Understanding Your Condition
The scaphoid bone is one of the small bones in the wrist that plays a crucial role in wrist stability and movement. Injuries or conditions affecting the scaphoid can lead to pain, swelling, and functional limitations. Common causes of scaphoid pain include:
1. Scaphoid Fracture: Often occurs from a fall onto an outstretched hand. Symptoms include pain in the wrist, particularly in the anatomical snuffbox (the area at the base of the thumb).

2. Scapholunate Ligament Injury: This ligament connects the scaphoid and lunate bones. Injury can lead to instability and pain.

3. Osteoarthritis: Degenerative changes in the wrist joint can lead to pain and swelling, particularly in older individuals or those with a history of wrist injuries.

4. Tendonitis: Inflammation of the tendons around the wrist can cause pain, especially during movement.

Treatment Options
Given your symptoms and the initial treatment you've received, here are some options to consider:
1. Continued Conservative Management: If you have not yet had imaging studies (like X-rays or an MRI), it may be beneficial to obtain these to rule out fractures or significant ligament injuries. If a fracture is suspected, immobilization in a cast or splint may be necessary.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the wrist, improve range of motion, and reduce pain. A physical therapist can provide specific exercises tailored to your condition.

3. Pain Management: Over-the-counter anti-inflammatory medications (like ibuprofen) can help reduce pain and swelling. However, consult with your healthcare provider before starting any new medication.

4. Alternative Therapies: Acupuncture and chiropractic care may provide relief for some individuals, but it's essential to ensure that any practitioner you see is experienced in treating wrist conditions.

5. Shockwave Therapy: This is a non-invasive treatment that can help promote healing in chronic tendon injuries and may be beneficial if conservative measures do not yield results.

Recovery Time
The recovery time for wrist injuries can vary significantly based on the specific diagnosis and the severity of the condition. Generally, minor sprains or tendonitis may take a few weeks to heal, while fractures or significant ligament injuries can take several months.
If you are preparing for a physical fitness test in a month, it is crucial to communicate this timeline to your healthcare provider. They can help set realistic expectations and may adjust your treatment plan to optimize recovery within that timeframe.

Conclusion
In summary, it is advisable to consult with a healthcare professional who specializes in musculoskeletal injuries, such as an orthopedic surgeon or a sports medicine physician. They can provide a thorough evaluation, including imaging studies if necessary, and develop a comprehensive treatment plan tailored to your needs. While many wrist injuries can heal completely, the key is to ensure proper diagnosis and treatment to avoid long-term complications. With appropriate care, you can work towards a full recovery and be ready for your upcoming physical fitness test.

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