What options do I have for wrist pain?

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Q: I've had six years of wrist pain that has been manageable but now starting to interfere with work. Over-the-counter pain relievers and antiinflammatories aren't doing the trick. Neither is the wrist splint I've been wearing. Are there any other options?

A: Much of treatment for painful wrist conditions depends on the underlying cause. Treatment may vary depending on the location and severity of symptoms or type of damage present (if there is any).

One of the most common causes of chronic wrist pain is osteoarthritis. This could be from a previous trauma or a progressive degenerative process associated with aging. There are other diagnoses such as rheumatoid arthritis or Kienböck disease (loss of blood supply to a wrist bone).

Depending on your diagnosis, there may be some other things you can try. The first thing is to go back to your primary care physician or orthopedic surgeon (whoever has been treating you) for a re-evaluation. It's possible all you need is a revision of your medications or review of activity modifications.

Perhaps it's time for an updated splint or even a more concentrated rehab program. A program of conservative (nonoperative) care is always advised for at least three to six months before considering surgery. And alternative approaches like acupuncture or relaxation techniques might be helpful.

Local injection of a numbing agent into the wrist might give you some temporary pain relief. This procedure is also a way to find out if surgery to cut the sensory (pain producing) nerves might be helpful.

So you see, there are options but in order to know which one is best for you, an examination is really the next step. It is often the case that specific treatment based on the underlying etiology (cause) is the most effective over the long-term.

Reference: Jefferson Braga-Silva, MD, PhD, et al. Wrist Denervation for Painful Conditions of the Wrist. In The Journal of Hand Surgery. June 2011. Vol. 36A. No. 6. Pp. 961-966.

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