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Medical Forum / General / General / June 2007acute wrist tendonitis
I'm 62 year old female. Woke up yesterday with horrible pain in top of my wrist. I thought it was broken but ortho said it was tendonitis. He gave me a splint and said if it wasn't better in a week to return. Does this sound right? I did not injure my wrist. I just woke up that way. I sleep on my back so I didn't do it sleeping. He said this can start suddenly with no apparent cause. For someone my age how long should I expect to be like this? I usually swim a mile every day but can't now. I have severe back and knee problems and can"t do much else. Overuse of the wrist for long time my cause this Tendonitis(DeQuervain's Tendonitis), and for someone your age it is expected. Everyone recovers from at a different rate and There is three stages of treatment: 1st: split + pain killers + physiotherapy. 2nd: split + local injection of DEPO-MEDROL + physiotherapy. 3rd: Tendoscopy or open surgery (rare). wrist brace alone is not enough. you need medication. thank you for writing and best regards Dr. Haiyan On Jun 6, 5:57 pm, "drhai...@gmail.com" <drhai...@gmail.com> wrote: > Overuse of the wrist for long time my cause this > Tendonitis(DeQuervain's Tendonitis), and for someone your age it is [quoted text clipped - 11 lines] > > Dr. Haiyan Hi Dr. Haiyan I noticed this article in the BMJ : BMJ 2002;324:626-627 ( 16 March ) Editorials Time to abandon the "tendinitis" myth Painful, overuse tendon conditions have a non-inflammatory pathology "Tendinitis such as that of the Achilles, lateral elbow, and rotator cuff tendons is a common presentation to family practitioners and various medical specialists.1 Most currently practising general practitioners were taught, and many still believe, that patients who present with overuse tendinitis have a largely inflammatory condition and will benefit from anti-inflammatory medication. Unfortunately this dogma is deeply entrenched. Ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs for treating painful conditions like Achilles and patellar tendinitis despite the lack of a biological rationale or clinical evidence for this approach. 2 3 Instead of adhering to the myths above, physicians should acknowledge that painful overuse tendon conditions have a non-inflammatory pathology. Light microscopy of patients operated on for tendon pain reveals collagen separation4-6thin, frayed, and fragile tendon fibrils, separated from each other lengthwise and disrupted in cross section. There is an apparent increase in tenocytes with myofibroblastic differentiation (tendon repair cells) and classic inflammatory cells are usually absent.4 This is tendinosis and it was first described 25 years ago,6 but this fundamental of musculoskeletal medicine has not yet replaced the tendinitis myth."... The article guestions the value of several commonly used agents . The link is here http://www.bmj.com/cgi/search?fulltext=tendinitis&x=14&y=9 please any insight you offer would be appreciated. A personal note at one time a had tennis elbow it took almost a year to resolve. Perhaps this is not uncommon as the tendonosis model perhaps expects this time frame. I'd appreciate any comment you might have. Thanks Vince On Jun 6, 5:57 pm, "drhai...@gmail.com" <drhai...@gmail.com> wrote: > Overuse of the wrist for long time my cause this > Tendonitis(DeQuervain's Tendonitis), and for someone your age it is [quoted text clipped - 11 lines] > > Dr. Haiyan I am unable to take NSAIDS. I already take tramadol for my back pain. > On Jun 6, 5:57 pm, "drhai...@gmail.com" <drhai...@gmail.com> wrote: > [quoted text clipped - 15 lines] > > I am unable to take NSAIDS. I already take tramadol for my back pain. The tramadol should help with the pain and you can try ice packs for the swelling. You should call up your doctor and ask which anti- inflammatory you can use with your current other medications. If worse comes to worse he can give you a cortisol shot for the inflammation. (depending on the other medications your on of course) Hope that helps... > On Jun 6, 5:57 pm, "drhai...@gmail.com" <drhai...@gmail.com> wrote: > [quoted text clipped - 15 lines] > > I am unable to take NSAIDS. I already take tramadol for my back pain. Tramadol is an opioid which is a centrally acting Analgesic - it well relief pain but has no action on the pathology in the tendon you can take : paracetamol+Tramadol=(Ultracet or Tramacet) this well be better. Dr. Haiyan On Jun 6, 9:28 pm, "drhai...@gmail.com" <drhai...@gmail.com> wrote: > > On Jun 6, 5:57 pm, "drhai...@gmail.com" <drhai...@gmail.com> wrote: > [quoted text clipped - 22 lines] > > Dr. Haiyan Ultracet appears to be tramadol plus tylenol. can't i just take tylenol with the tramadol? I didn't think tylenol did anything other than symptomatc relief? On Jun 6, 5:57 pm, "drhai...@gmail.com" <drhai...@gmail.com> wrote: > Overuse of the wrist for long time my cause this > Tendonitis(DeQuervain's Tendonitis), and for someone your age it is [quoted text clipped - 11 lines] > > Dr. Haiyan I just read about DeQuervain's Tendonitis and it foesn't sound like what I have. True moving my thumb back causes great pain in my wrist, but on the opposite side of the front of the wrist, not the thumb side. Also I can grasp things without a problem. The pain seems to be totally associated with moving the thumb back. |
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