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Need urgent help with wrist pain not going away7

 

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22 year old needs help with wrist pain not going away

A sincere request to an experienced doctor to take my case.
I am 22 year old young man. Injured my left wrist while playing basketball in November 2016. It's been 15 months now and it still hurts. Whenever I type on computer or twist my hand, it is hurting. Also hurts to bend wrist forwards or backwards. Hurts to twist doorknobs. Doesn't hurt when wrist is not being used or is resting. Only hurts when in use. It can't support much weight (carrying a plate of food or backpack hurts) and feel pain when grabbing or twist in particular direction.

Took left wrist MRI & MR Arthrogram in March 2018. Please see the MRI findings below. There's a very small TFCC tear. Doctor said that there is 1 very small ligament tear and 1 cartliage tear. He said that the tear is very small, so it should fix with time, and no surgery is needed. Patient should try not to strain it and wear the brace.
Ligament tear- is causing the Pain, takes longer to heal around 3-6 months.

But it still hurts. So, went to orthopedic doctor in Jan 2019. After examination, he said that there is pain in volar aspect of left wrist and ulnar side of left wrist, dull and mild pain. He put my wrist in cast for 4 weeks after a steroid injection for immobilization . After 4 weeks, cast was removed and doctor said to continue using wrist less and don't strain it to let it heal internally. consult again in a few weeks to determine whether surgery is required. But still no change and it hurts the same.

So far have taken Belis per Q, Rhus Tox 200, but no change at all in the pain.

Can someone please take the case urgently and prescribe what medicine to take to fix the pain. Can this be cured by homeopathy or surgery has to be done. Please advise.

Thanks so much for the prompt response.

MRI results-
FINDINGS:
A poorly defined pinhole tear is present through the radial margin of the central TFCC disc seen best on coronal image #9 and 10 series 5 and 6. The ulnar aspect of the ligament demonstrates mild irregularity along the distal volar margin coronal image #8 and 9 consistent with a partial tear. The extensor carpi ulnaris tendon is intact without altered signal, position or surrounding fluid. No significant ulnar positive or minus variance. The distal radioulnar joint is normal in position with contrast extending into the joint through the TFC tear discussed above.
The radiocarpal, midcarpal and carpometacarpal joints are normal in position without fracture or marrow edema. The scapholunate and lunotriquetral ligaments are intact without altered signal. The carpal tunnel, flexor tendons and median nerve are normal in appearance. Extensor tendons remain intact without altered thickness, signal or tenosynovitis.

IMPRESSION:
1. Small pinhole central TFC tear about 1 mm from the radial insertion (Palmer Class IA injury).
2. Mild partial tear volar ulnar aspect of the ligament.
3. No evidence of a scapholunate or lunotriquetral ligament tear, tendinopathy or fracture.
 
  suna711 on 2019-02-25
This is an internet forum. Assume posts are not from medical professionals.
Very well explained. Please try a mixture of 12 tissue salts. Ask homeopathic pharmacy to give you a mixture of all 12 tissue salt remedies. ((Not five phos)) 2-4 pellets 3 times a day for 10-15 days only.

Don't eat or drink anything before and after taking the medicine. Don't take this during diarrhoea.

==================================================

How long you got this accident ? And what experts say about it ?

ANSWER THE FOLLOWING QUESTIONS TO KNOW REMEDY SUGGESTIONS
========================

Answers below ones as well .........
A) constipation history. B) headache if any. C) must select one option, weakness or restlessness, which is more.
D) your detailed daily routine, like active or sadantry life style etc If possible hourly basis details required .. E) is it a reoccurring problems F) you were physically active or inactive just before this condition ? G) do you feel more thirsty or thirstless ? H) do you feel cold in body or hot mostly ? If you like click my name to remind me only if I'm not replying.
[Edited by Ibrahim3 on 2019-02-25 04:25:42]
 
Ibrahim3 2 months ago

Thanks for the response.
I have most of the 12 individual tissue salts. Will start taking those. That will be 48 pellets 3 times a day.

This accident happened in Nov 2017. So, it has been 15 months now.

In March 2018, the doctor, radiologist & chiropractor said that it is a very small Ligament tear and Ligament tears take longer to heal and it will take 3-6 months and surgery is not needed. He's been wearing a brace.
In Jan 2019, the orthopedic said that surgery is the last resort. He felt that steroid injection would help, but there was no change.

A) No constipation
B) No headache
C) Weakness
D) class from 11am-4:30pm, exercise 3-4 days a week around class, lunch 12, dinner 5:30, work after 7pm
E) Yes for a year
F) Physically active
G) Neither
H) Neither cold nor hot

Please advise. Thanks.
 
suna711 2 months ago

You understood absolutely WRONG ... there is a product which consists of a mixture of 12 tissue remedies.

Means each pellet costs of a mixture of 12 tissue salts.

You don't need to take 4 pellets of each salt individually. It is wrong.

Just ask the pharmacy to give you a product ((remedy)) in which each tablet costs of 12 tissue remedies.

And total number of pellets now will be 6 .. 2 Pellets in the morning, 2 in the afternoon and 2 at night. Total 6 pellets a day. I hope you can understand. If I'm not replying you can click my name below to give me a quick reminder
 
Ibrahim3 2 months ago

Just take one dose of arnica CM and Ruta G CM
One in the morning and other in the evening
 
Kapsdquack 2 months ago

Is there Anyone who can tell the forum rules ?
 
Ibrahim3 2 months ago

Dear Ibrahim3
May I request you to please fwd me link to the forum rules so that you do not have to request this forum for the same
Also if unknowingly I have constrained you to post this on the forum I sincerely apologise for the same
All the very best for your efforts
Regards
 
Kapsdquack 2 months ago

As I don't have the mixture of 12 tissue salts, can I take each separate or is it not the same. Else I will order them.

Also, we had a second opinion from a doctor over the phone.
His findings are as below. Please review and share your thoughts and opinions and advise what to take next.

Current Diagnosis:
22-year-old male with left wrist pain. This began in November 2017. Of note, patient had a prior fracture in the proximal he seventh grade. Patient had initial consultation in January 2018, given the diagnosis of FCU tendinitis, and splinted. Hand surgery consultation in January 2019 diagnosed with TFCC tear. Patient was given an injection of Celestone and placed in a short arm cast for approximately 4 weeks. Cast was removed on 1/31/19.He has persistent and significant pain with most forceful activities. No significant improvement after splinting and cortisone injection. He has no subjective instability to his wrist.
MRI dated 3/21/18 shows evidence of a punctate TFCC tear.
Pain on the ulnar side of the wrist is quite common. I treat on average 2 or 3 patient’s daily for this pain. The majority of the time, this pain can be treated with nonoperative treatment options. Most important in making the correct diagnosis is the exact location of the pain that patients are experiencing. Pain that is on the small finger side of the wrist, also known as the ulnar side of the wrist, is what we will go over now.
There are several specific diagnoses that cause ulnar-sided wrist pain. Some of these include tendinitis, tears of the small cartilage of the ulnar side of the wrist, ulnar impaction syndrome, and synovitis on the ulnar side of the wrist. The typical initial treatment I provide is rest, activity
modification, and, most importantly, splinting. The type of splint used is very important. A typical off-the-shelf volar wrist resting splint does not usually immobilize the wrist well enough to improve symptoms in my opinion. An ulnar gutter splint, a splint that provides rigid support on the ulnar side
of the wrist, is necessary to achieve enough stability to improve pain. Regardless of the underlying diagnosis, the appropriate type of splint will often improve symptoms dramatically, sometimes even entirely. I typically have our hand therapist make a thermoplastic ulnar gutter splint as I have not found an over-the-counter version that works quite as well. I recommend wearing the splint essentially full-time, roughly 23.5 hours per day off only for bathing, for a total of 6 weeks. We will often follow with 4 additional weeks of nighttime splinting following this full-time splinting regimen. You were casted, which is appropriate, but only for 4 weeks. Although this difference is small, this may make an impact into improvement in pain.
If this does not improve symptoms, at this point I would typically recommend an MRI, which you have already had. For many patients I would recommend a Second cortisone injection as a next step.
If patient’s do not respond to either splinting or cortisone injection, surgery is a reasonable option. For patient’s who are ulnar neutral or ulnar negative, a wrist arthroscopy to both evaluate the source of the ulnar-sided wrist pain (such as to confirm a tear of the TFCC) and treat that pathology is often
warranted.
Although certainly not exhaustive, one additional alternate potential diagnosis is subtle instability at the distal radioulnar joint due to his previous malunion of the distal third of the radius. The pain at the palmar ulnar aspect with pressure to the hand is consistent with subtle instability. Insight can be
gained by clinical evaluation, full length forearm x-rays of both sides, and possibly CT scans of both forearms.
Careful clinical evaluation and examination is critical to identifying the correct diagnosis.It should be emphasized that I cannot make a clinical determination for him specifically without direct examination.
 
suna711 2 months ago

Ibrahim- everytime you post a reply , there is a box
To the right, that says “I agree to forum rules”
Click forum rules and you will see them.

Many people who ask for advice - think wrongly that
They are entering into some private dr office with
The prescriber and get angry if anyone else posts
On the thread. Others think wrongly that prescribers
Collaborate on their case and get very confused.

Any member is allowed to post on any thread.
However, if someone is taking the time to study
A case and someone else pops in- just ask
The patient who they want to follow.
 
simone717 2 months ago

Dear Suna711
Thank you for the detailed history of your wrist pain
This thread has gone on Tangent due to me breaking the rules of this forum
The most important fact which is needed by a lover of homeopathy is how did you get injured.
Did you bend your wrist beyond normal or did you bang your wrist, when you were injured
To tell you that even if you get rid of the pain by homeopathic medicine the TFCC tear may still be there.
As I shud not write any medicine since others are working on it.
I can tell you the dos and don’ts about your wrist
Do not keep massaging or rubbing or pressing the painful part as it aggravates the tear. Do hot water fermentation it improves the feeling
I assure you that it is treatable without surgery
[Edited by Kapsdquack on 2019-03-07 03:37:43]
 
Kapsdquack 2 months ago

K-quak I mean 'kapsdquak" you can Take this case. As you seems too much interested in it. You can start suggesting whatever you read.
[Edited by Ibrahim3 on 2019-03-08 19:18:20]
 
Ibrahim3 2 months ago

Thanks you can refer to as Kaps
Please bear with me that the person is in pain for more than a year and it was this that prompted me to interven in the first place and I am not giving up on this so let’s start afresh
I have questioned the patient let’s saa if he still has the faith
Thanks once again
 
Kapsdquack 2 months ago

It's sad that I got caught into all this. This is a professional organization, so my hope is that we can come out of it. As this is a complex case, I really need more experienced doctor in this field.
Please advise who will take the case - anybody in the forum also - please come forward. I need your help on how to proceed further and what to take.
Thanks.
 
suna711 2 months ago

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