Wrist pain and popping

May 31, 2013 3:39 PM

A while back, I did something totally normal like reaching into the back seat of my car, and my wrist popped and started hurting. I've tried a bunch of stuff and it's not getting better. The doctor says I'm supposed to immobilize it and come back in a month, at which point we can talk about surgery (!!!). I'm frustrated by this and tired of being in pain. Should I pursue other treatment, and if so, what kind?

Symptoms:
I'm in constant low-level pain (1 or 2 on scale of 10).
Ulnar knob is obviously swollen and tender to pressure along inner side of bone near wrist.
Popping noises and spiking pain on certain movements, especially twisting the wrist like turning a doorknob.
It's been like this for over a month now and it's not getting better by itself.

What I've tried: Ibuprofen, ice, immobilization and acupuncture. All have provided short-term relief.

I also did two treatments with a chiropractor, which did seem to help some, but she was treating me for free as a friend, and I was a bit loath to keep seeing her on that basis.

Last week I went to my PCP. She X-rayed it and sent me to a sports medicine specialist.. That doc said that the ulna is obviously somewhat out of place, and told me to immobilize it for a month. If it's still hurting we can talk then about surgery.

When I asked what happened, she said something vague about a ligament having gotten stretched. She also said it doesn't seem like carpal tunnel, and that there are signs of arthritis in the joint (I'm 52, no wrist pain before.) When I asked about non-surgical treatments, she said "let's talk about that in a month."

Is it likely that this will resolve with immobilization by itself if it hasn't already?
Would this type of injury respond well to chiropractic, and should I go back to my chiro for a longer series of treatments?
If not, what kind of doctor should I see to get a more specific diagnosis and a less laissez-faire treatment plan?

posted by ottereroticist to Health & Fitness (14 answers total)

How long has it been since the initial injury? And how seriously immobile have you gone? Be brutally honest with yourself; if it's only 90% immobile, it's not good enough.

For reference: I took a bad fall off a pair of tall shoes a couple of years ago and badly sprained my wrist. It was a good two months before I felt like it was improving at all... Frankly not until I took a hard line on "immobilize it" and put my whole arm in an actual sling as well as a wrist brace so I'd stop doing things like picking up coffee cups, brushing my teeth, signing field trip forms, etc.

Even after that, it was almost a year before my wrist felt totally OK. Soft tissue damage sucks.
posted by Andrhia at 3:51 PM on May 31, 2013 [1 favorite]

I went to an orthopedic surgeon, one that specialized in arm and hard surgeries, about a wrist injury that presented similar to yours.

While I thought the doc was using more than a little hyperbole, he told me that surgery wasn't an option because, "there's so much stuff going on inside your wrist, we don't even have proper names for all the tendons, ligaments and muscles in there." Meaning, it's all awesomely complicated and very difficult to fix correctly. Likely to do more harm than good.

He prescribed exactly what you got -- immobilization, rest and ibuprofen. It did eventually all go away.

Would this type of injury respond well to chiropractic, and should I go back to my chiro for a longer series of treatments?

You know what they say about chiropractors. You go in and they tell you that your back problem is caused by sitting on your wallet, so they offer to thin that wallet out for you.
posted by Cool Papa Bell at 4:05 PM on May 31, 2013 [1 favorite]

Physical therapist is what you want for this.

In the meantime, quit twisting your wrist! Buy a brace for it.
posted by yohko at 4:21 PM on May 31, 2013 [1 favorite]

I used to have a chiro I would trust for stuff like this but now I have physical therapist I trust for stuff like this. She told me about my shoulder the same thing Cool Papa was told about his wrist. And over a period of 3 months, got it fixed. Some insurance will let you self-refer to PTs. What I would do is: follow the doc's advice and rigorously immobilize for a month. Then see a good PT and do what they say.
posted by beagle at 4:25 PM on May 31, 2013

Same experience as above. I picked up something and felt a pop in my elbow, not my wrist. I couldn't lift my arm, it hurt so much. I was skeptical about immobilization and NSAIDs. I had two cortisone shots, which didn't really help. In the end, I had to have a cast put on my elbow to completely immobilize it. I had a course of physical therapy. It took a full year to heal, but it did heal, and it hasn't given me trouble since. This was more than a decade ago. Patience, immobilization and NSAIDs cure a lot of things.
posted by clarkstonian at 4:29 PM on May 31, 2013

Different limb, but same priniciple: I had a foot injury last year which required that I wear an air cast/walking boot for 5 weeks. The podiatrist told me that if I took off my air cast and took a single step at any time during the 5 weeks, my healing period would be reset to zero, and I'd have to start counting the 5 weeks all over again.
posted by lulu68 at 4:30 PM on May 31, 2013

Just for peace of mind, consider that Major League pitchers, whose arms are worth millions of dollars and have essentially unlimited medical resources at their disposal, are prescribed the same course of treatment when they have pain in their forearms/elbows/shoulders: rest and physio first and if that fails surgery. There's no shortcuts for this type of thing yet.
posted by no regrets, coyote at 5:05 PM on May 31, 2013

FWIW, I've screwed up both wrists, and a $5-10 wrist brace from the drug store does wonders for helping immobilize it *and* keeping it warm, which supposedly encourages healing.

Go find a physical therapist, whose full-time job is to fix things like that without surgery.
posted by talldean at 5:45 PM on May 31, 2013

I made a small gesture during a conversation one day and there was a pop in my wrist and then pain. I went to the doctor after a week of continuing pain and he explained that my wrist was sprained. He said it was the pop that made him sure of it. It even has a specific name, but this happened over 10 years ago and I don't remember the name (I'm so sorry). My memory of it was that the pop wasn't about it being a sprain versus a fracture; the pop made him think "Oh, it's that kind of sprain".

The thing with sprains is that you have to keep the area immobilized for the entire length of time recommended, even if it isn't actively hurting. Most people just do it until the pain goes away, and then start to gently use the wrist or ankle again, but the injury is still there and still needing to heal. Basically, if you do this, what you are doing is re-spraining the wrist over and over again.

You haven't described your immobilization, but you really need something that keeps your wrist from moving at all. And you need to wear it constantly for a month or so. Not in fits and starts. If you follow those directions, a sprain will heal itself and not cause you constant pain.
posted by Brody's chum at 10:43 PM on May 31, 2013

Response by poster: I'm wearing a neoprene brace with a metal splint sewn into the palm side. It wraps around the thumb and goes up to mid-arm, tightening with Velcro. It provides support and compression, but I can still use my hand in a near-normal way. This is my dominant hand -- obviously not using it AT ALL for a month would be a significant impairment to daily life and livelihood. Should I be wearing a sling as well? Should I go back to the doctor and ask for a cast?
posted by ottereroticist at 8:05 AM on June 1, 2013

Response by poster: I should add: the brace does help prevent the twisting movement that causes pain. But I still can and do use my hand.
posted by ottereroticist at 8:41 AM on June 1, 2013

It is important to remember that the wrist is unusual. There is no socket. It can't dislocate the way joints can. What you have is probably swelling displacing bones. I jammed my wrist once playing football. Hurt like hell. Swelled up badly and basically pushed everything to weird places. The only cure was stop using it and to wait for the swelling to go down. It took a long time. Every time you use your hand you are moving tendons through the region that is swollen and likely irritating it. You probably need to stop using your hand if you want the swelling to go away faster.
posted by srboisvert at 1:01 PM on June 1, 2013

I feel your pain (literally.) My sprain was my dominant hand, too, and not using it really and truly sucked, especially because my younger daughter was still at a pick-me-up and push-the-stroller age. but it was necessary for it to begin to heal. Even if you do go with a surgical option eventually, you'd need total rest to heal from that surgery, too. Losing the use of your dominant hand for a few weeks sucks a whole lot less than losing mobility and strength for life because you couldn't commit to rest.
posted by Andrhia at 2:54 PM on June 1, 2013

It sounds like you are still using it for small things. I think you might want to ask about having a cast put on it to take away the temptation. Having a cast sucks but a month is not forever and you will really need to stop using the hand too.
posted by saradarlin at 8:53 PM on June 1, 2013