Chronic wrist pain

[taylorquest]

my 17 yr old daughter had a wrist injury 6 weeks ago - all radiographs are coming up negative for fracture (bone scan showed hot spots and MRI was inconclusive so was referred to have a CT scan - no results for CT received as yet).  Originally was diagnosed as possible scaphoid fracture but now as these tests are coming back negative the doctor thinks it is likely just a soft tissue injury and she needs to work through the pain at physio and try harder.  Her current physiologists have much experience with scaphoid fracture patient and are convinced there is something there as she is still having extreme pain on movements and some swelling/throbbing - more after MD manipulation.  they are doing some U/S stimulation and heat/ice.  If this is not a fracture has it somehow turned into a chronic pain issue?

Appreciate any feedback....

[jeric]

Can you pinpoint what movement/activity of the wrist causes the pain? For example, if picking up a book causes the pain, you can ask the doctor to do an x-ray while she picks up a book and holds it. I read this somewhere (sorry I don't remember where) a long time ago but it helped in locating the cause of the pain, because it was only visable while they were doing what ever cause the pain.

It's worth talking to/suggesting the idea to your dr.

Good luck!!

[BOK2Bjan]

Hi,

I can't pretend to know the answer to your question, but I will give you feedback based on my experience with soft tissue injury and pain.  It is very difficult to image this type of injury.  She could have a torn tendon or ligament and it wouldn't show up.  The reason they show up on some MRIs etc. is that they pull some bone off when they tear and the image shows the misplaced bone.  If the injury is only to the tendon, it would only show up as "hot spot" or even nothing.  Inflammation might be up, but otherwise it's difficult to diagnose except clinically.  I think the physiologist is right, that there is a definite injury.  It's just not bone.  That doesn't mean it's not painful.  They can take a long time to heal and should be immobilized - not put through the paces.

Again, that's just an opinion.  BUT, anytime there is sharp intense pain when there's movement - there's likely an injury.  Chronic pain takes a bit longer to develop and wouldn't cause the swelling, nor the increase in blood flow, which is what is causing the throbbing.  I would try immobilization in a wrist brace until it's had more time to heal.  I wish her well, and would love to hear what happens.

Blessings, Jan