Hand Pain -- No medications

Hello everyone. I am currently in the waiting period for an MRI of my wrist/hand to check for soft tissue damage from an old injury. However, since being placed in a brace the pain has been unbearable when it is out of the brace. Even in the brace, it is still very painful at times.

The brace was given to me as a tool for pain management and my ortho does not want to prescribe me any pain meds. I dont even want narcotics, but OTC NSAIDS are not doing anything. I have also tried the Salon Pas patches and I was desperate enough to try my TENS unit.

Does anyone have any recommendations?

Motox:
You have mentioned that you are being evaluated for a possible tear of the TFCC - thus, the pending MEI.

That you have been provided with a firm wrist splint is an appropriate intervention by your orthopedic/pain physicians while you wait a definitive diagnosis. If you do indeed have a TFCC year, immobilization is the first line of treatment. Immobilization in a cast is usually for 4-6 weeks.

That you have increased pain when out of the splint would be expected with a FTCC tear. This injury can be especially painful along the pinky side of the wrist when the wrist is moved (especially with flex ion and ulnar deviation, sideways gliding movement toward the pinky). Keeping your wrist in the splint will help minimize sharp increases in pain.

The TFCC is a fibrocartilage triangle-shaped buffer that serves to cushion the wrist at the distal radius and ulna at the junction of the carpal bones at the pinky side of the hand.

Blood flow to this region of carpal bones is less than robust. Tears to the TFCC can be acute (a fall on an outstretched hand) or degenerative (occurring years after a prior wrist injury, analogous to deferarive arthritis). The restricted blood flow can mean a slower recovery than a similar soft tissue injury elsewhere in the body with better blood flow perfusion. Patience with longer time frame for healing is necessary.

Bottom Line: Avoid overly moving your wrist when out of the splint pending the MRI findings. Susie/Straydog has offered good suggestions for ways to ease some of the pain you are dealing with. Alternating ice and a warm compress (this serves to stimulate blood flow and healing); topical analgesic cream with lidocaine available OTC; keeping your hand/wrist supported and upright, minimizing downward dangling.

I hope the upcoming MRI gives you a definitive diagnosis of what is ailing your wrist. Make no mistake, a tear of the fibrocartilage of the wrist is painful. The good news is that it is a very treatable orthopedic condition. The standard of care is first casting/immobilization for 4-6 weeks; secondarily surgery if immobilization is not sufficient.
Karen