Dear Doctor: Wrist injury still painful days later

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Question:

I thought I just sprained my wrist several days ago, but it still really hurts. Should I have a doctor examine my wrist or will the pain eventually go away?

Answer: Fall and winter is a busy time for doctors caring for wrist problems. Many sports often lead to wrist injuries. The simple sprain is sometimes not so simple. When the wrist is bent backward, two things can happen: A bone can break or a ligament can tear.

The difference between a sprain and a more significant injury is usually the amount of pain you experience and the degree of swelling. Interestingly, bruising is uncommon unless you've struck the top side of the hand or there is a break to one of the bones outside of the wrist.

Two problem injuries inside the wrist are the scaphoid fracture and the scapholunate ligament tear.

The scaphoid is on the thumb side of the wrist. It is a bone with a poor blood supply. Due to this an untreated scaphoid fracture may fail to heal. This leads to chronic wrist pain and arthritis. Early recognition and treatment can increase the chance of healing and decrease the chance of painful arthritis.

The scapholunate ligament is an important ligament in the center of the wrist that holds the scaphoid bone attached to the lunate bone. Injury to this ligament is characterized by wrist pain with tenderness on the top and center of the wrist. The ligament can be partially or completely torn. Partial tears can heal with splinting or casting. Complete tears cannot heal without surgery and if untreated can lead to wrist arthritis. Injury to the scapholunate ligament is another hidden wrist injury that does best with early treatment.

If you injure your wrist and it does not feel better within five to seven days, have your wrist examined by a physician. An X-ray may be administered to determine the level of damage done to the wrist.

Mark Baratz, M.D.
Orthopedics,
Hand and Upper Extremities


Write to ???Dear Doctor,??????Allegheny County Medical Society, 713 Ridge Ave., Pittsburgh, PA 15212, or e-mail acms@acms.org . Individual responses will not be provided. This column acts as an overview; see your physician for diagnosis.


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