TFCC Tear + Constant, Severe Pain

I underwent a wrist arthroscopy this past February (2011) for a TFCC Tear in my right wrist - which happens to be my dominant hand. They cleaned the area out and discovered that I was also missing some cartilage. I thought that after they did their magic my problem would be solved. Boy, was I totally wrong.

The pain only got worse, and now I've been seeing an Occupational Therapist (who specializes in the hand) for the last few weeks and haven't experienced any permanent pain relief. The ultrasound treatments only provide temporary relief, for the pain to only return a short time later. Stretching, weight, and constant bending/work/typing only make the situation worse. I can't do almost anything without swearing like a sailor.

Wearing a brace doesn't help the problem get any better, either. I've also been using BioFreeze and that alone only provides brief relief. I just wish I could keep my wrist permanently motionless!

Any tips? What are some further treatment options (if any) could I discuss with my surgeon when I go see him next week? I don't want to undergo another surgery and have the pain remain.

Any permanent options?

[S. Kaul, MD]

Hi there!

Arthroscopic debridement or repair of TFC injury provided has been shown to be useful in providing pain relief though the recovery may be slower in patients with in patients with ulnar-sided injuries. For better healing of an acute injury, placement of forearm in neutral rotation in long arm cast is usually helpful. Also marked pronation (backside up) should be avoided for the initial few weeks, while supination (palmar side up) with imperfect radial fragment reduction may result in palmar subluxation of the ulnar head. Aside these measures anti-inflammatory medications and steroid injection may be helpful in providing symptomatic relief. For severer injuries, cartilage replacement or open surgery may be considered. You may like to discuss the options with your doctor.
Hope this was useful.

Take care!