Chronic Wrist Pain (Scaphoid area)

I am a 28 year old male. I have been active and involved in sports and weightlifting for over ten years.

I fell on my outstretched left hand when I was 20 and went to the doctor. I had X-Rays done and they said I had a severe sprain and I needed to wear a brace for six weeks. I did that and it seemed OK after I took it off. I slowly eased back into weightlifting and sports, but it always hurt a little in awkward positions. I went back and had another few XRays done a few months later and they said that it was fine and it would just take a while to heal. It has never really felt 100% but it was bearable and it usually didn't bother me.

Flash forward to two years ago. It started hurting a lot more... if I did pushups or lifting heavy weight the next day the base of the bone that moves with the hand but is adjacent to the wrist (guessing scaphoid from diagrams) swells a small amount and hurts acutely. I have a fairly high threshhold for pain, but if I press against this somewhat swollen spot just under my wrist "pad" it feels like a knife being shoved into the bone.

I talked to some friends involved in the medical field and was told to visit an orthopedic surgeon. I went to him and after examination, he ordered X-Rays of the wrist. These showed a healthy, regular wrist so he sent me for a MRI. The MRI showed a small cyst, but he didn't think that it could be causing the pain I was experiencing.

This orthopedic referred me to a hand and wrist specialist and I took my X-Rays and MRIs to him. He did a much more thorough examination of the wrist that he still felt was inconclusive. After X-Rays which showed a normal wrist, he had me wear a brace for two months and stop all strenuous activities. He also gave me a cortisone injection. When I came back and took the brace off my wrist felt really good, no pain whatsoever and he told me to slowly start getting back into sports and weightlifting. No more than a few days into it the pain came back fully. I went back to him and he starting suggesting surgery etc and didn't really explain to me what was wrong.

I took my records and went to another hand and wrist specialist who I was referred to by a lot of people that have had sports related injuries treated. He ordered another MRI, X-Rays, etc. Same story, he couldn't pinpoint the problem. He had me wear another brace for another two months and the same thing happened. I came back with no pain whatsoever, but I explained to him what happened last time. He had me ease back into activities with the exception of anything that puts undue strain on the wrist (pushups, bench press, handstands, etc). The pain came back again and he recommened exploratory surgery to remove the cyst (which he did not think was causing pain) and to take a look inside and see what he could do. The plan was to fix it on the fly if he saw a problem.

After the surgery he told me he removed the cyst, cleaned up the ligaments (scraped them I believe he said), and closed up the two small incisions. He said I definitely didn't have CTS, there was no arthritic bones, everything looked good, etc. I wore a brace for about 12 weeks and did some rehab exercises for another couple months. Then I was told to ease into activities again... guess what? SAME PROBLEM

Now it has been about 6 months since the surgery and my wrist kills me if I put any undue strain on it and if I do not do anything for a week or so it feels fine. I don't know what else to do... I don't really trust any of these doctors and it kills me not to be able to do any of the activities I love.

EDIT:
EXAMPLE OF WHERE THE PAINFUL AREA IS: http://www.eorthopod.com/images/Cont...symptoms01.jpg
Specifically the bottom right section of the red area.

See Also: http://img229.imageshack.us/img229/360/handrp3.jpg

Hi,
Why don't you try 2nd opinion from a physio. Check this link below for more additional info. Who knows this might be the answer..'coz it works on me. Just sharing.:)

What lifts were the worst for your hand?
What kind of grip do you use when lifting (thumbless) ?

When you return to activity, did you return to everything at once?

Good Luck

OPI

Quote:

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Originally Posted by eshuro

Hi,
Why don't you try 2nd opinion from a physio. Check this link below for more additional info. Who knows this might be the answer..'coz it works on me. Just sharing.:)

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This was actually my third opinion :(

Quote:

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Originally Posted by opihiman

What lifts were the worst for your hand?
What kind of grip do you use when lifting (thumbless) ?

When you return to activity, did you return to everything at once?

Good Luck

OPI

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Straight bar or EZ Curl bar barbell curls
Bench press
Pushups on palms

Mostly exercises that put strain on my thumb/wrist.

No, I slowly eased into it and that is how I discovered that most exercises which hyperextend my wrist would cause extreme pain a day or two after.

I don't feel any pain during the lift.

It isn't just lifts, I could just be supporting myself on the floor on my palms and then next day I'll be in pain.

Thanks for the responses.

Anonuser - did you ever get an answer to this or find a way to make it better? I have the same problem and am equally frustrated as you! Please private message me if you do have any answers!

pain when palpating into the anatomical snuff box?? scaphoid fracture?? not visible immediatley on x-ray!!
Additional Comment I forgot:
malunion??scarring from the operation??? May require simple mobilisations initially then strengthing gradually anyone else have any other suggestions from expereince??

Hi, As an aging physio I have very similar symptoms and believe it to be carpal instability. The ligaments are lax so when you load the joint movement is abnormal and often painful. this does not often show on scan/xrays since it is only on loading that the abnormalities happen. I get some relief from using a powerball. Good Luck

We have almost the same problem. I enjoy the same activities as you and deal with a similar injury. It sounds like you have a scaphoid fracture. It is difficult to detect on x rays because of the lack of blood flow to the bone. Also, the lack of blood flow makes healing difficult and has the risk of forming a "Non Union". This can cause arthritis and a build up of scar tissue. My wrist is of the "non union" sort. I exercise 6 or 7 days per week and have never missed a workout due to pain. The key is to learn to work around the injury. I have found that what works best for me is to consciously lock my wrist prior to any lift and only allow flexion at the elbow and not the wrist. Bench Pressing is tricky. Lighter weight dumbells or bi lateral machines seem to work the best for me. The smith machine also is a good fit because you can focus on pressing the weight and not having to stabilize the bar. Basically... where there is a will there is a way if a guy with no legs can run a race in the Olympics... then you can lift weights