QUESTION: A 32 year old man is experiencing pain on the back of his wrist when doing push ups. Strong gripping and lifting objects also aggravates his pain. He remembers falling on his wrist a few weeks ago, straining it What should he do?
What is it?
The scapholunate ligament is a ligament that connects the scaphoid and lunate carpal bones together. It is an important stabiliser of the wrist when under load such as gripping and weight bearing. It can be torn from high energy injuries or falling on the wrist. Pain is felt at the back of the wrist on the radial side (thumb side). A tear to the ligament can cause widening of the joint and altered wrist kinematics and may lead to arthritis over time if left untreated.
A X-Ray or MRI may be appropriate. Your hand therapist will let you know if this is required.
Hand splints and exercises can help to improve stability and reduce pain. There are different types of hand splints available depending on the needs of the patient and how much support is required. You will also be provided with:
- Pain management techniques and activity modification
- Provision of a splint, if appropriate
- Graded strengthening and proprioception exercises to help improve stability, coordination and strength in the hand and wrist
Surgical review may be required if there is substantial laxity in the wrist and if pain and symptoms are not resolving. Your therapist will be happy to discuss with you and your GP whether referral to a hand surgeon is appropriate.