When the blood supply to the lunate, the small wrist bone, is disrupted or completely cut off, the bone can die, causing severe discomfort, pain, and limited movement.
This is what is known as Kienbock’s disease, or Kienbock’s wrist.
In this post, we explore some of the most commonly prescribed non-surgical treatments for Kienbock’s, as well as recovery periods, and how we can help.
Kienbock disease
One of the 8 bones in the wrist, the lunate, a carpal and crescent-shaped bone, is a key bone in helping the hand and wrist to move.
The bones in our body are living tissue, which means they require a regular supply of blood for nourishment to stay alive.
This means when there is no blood supply to the bone, it can soon begin to lose its structural support, leading to its collapse and causing a painful or stiff wrist, as well as:
- Limited range
- Decreased grip strength
- The wrist is sore to the touch, tender.
It is also common for Kienbock’s disease to lead to arthritis in the wrist. However, this particular condition progresses slowly over months, if not years.
Causes of Kienbock
Kienbock’s disease often starts slowly with wrist pain and swelling building as the deterioration of the bone continues.
The main cause of Kienbock’s disease is trauma to the wrist from a fall onto an outstretched hand and wrist, or unwanted contact to the wrist.
Other causes include:
Different length bones in the forearm (the radius and the ulna). This difference in bone lengths can put pressure on the lunate, which, over time, can lead to a compromise in blood flow to the lunate, leading to Kienbock’s disease.
Benefits of non-surgical treatment
The major benefit of non-surgical treatment is that often these treatments, such as the NSAIDs, can provide a positive effect within hours, reducing pain and swelling.
In addition to providing instant relief (to some degree), non-surgical treatments, in particular physical therapy can also prevent further deterioration, slowing progression of the disease down.
Kienbock disease non-surgical treatment
Non-surgical treatments allow us to manage pain and swelling while monitoring your condition and how treatment is progressing.
However, it is important to note that non-surgical options will not cure the condition completely, but they will help to slow the disease down while alleviating the pain felt.
Some of the most prescribed non-surgical treatment Kienbock disease include:
Non-steroid anti-inflammatory medication
Anti-inflammatory drugs (non-steroid) help to reduce swelling and ease the pain you’re experiencing often within a few hours.
Available as tablets (most common), creams and gels (prescribed), and even available in injection form, this type of drug works by temporarily blocking the elements that are causing swelling and pain in the wrist.
However, this is a temporary solution and not a long-term recommendation.
Note: It’s important to be aware of the side effects of NSAIDs, such as rashes, changes in blood pressure, swelling, stomach problems, headaches, drowsiness, and any signs of allergic reaction.
Steroid medication
Corticosteroid injections and medication can be given directly into the wrist, alleviating pain and reducing swelling. This type of medication, and indeed injections, can provide longer-lasting pain relief but are not a permanent solution.
Physical therapy
Physical therapy is essential both as a form of Kienbock’s non-surgical treatment as well as post-surgery.
With dedicated, tailored exercises designed around your needs and the stage and severity of the disease, physical therapy helps build movement and allows patients to resume everyday activities without pain.
Helping to reduce stiffness, pain, and boost overall mobility.
Splinting or casting
Immobilising the wrist for between 2 to three weeks can help to relieve pressure, reducing swelling, and protecting the wrist further.
Casting can involve a soft cotton first layer that covers the hand and wrist, followed by the second layer, which is a harder shell that helps protect the bones.
Effective in their support, splints and casts help to manage and ultimately reduce the pressure on the lunate bone, supporting a better flow of blood to the hand and wrist.
Kienbock’s non-surgical
Every patient and individual responds to treatment differently, and with any Kienbock treatment, it is essential that patients have post-treatment follow-up, allowing us to monitor progress so changes and adaptations can be made appropriately.
It’s also important to know that you may need Kienbock surgery if none of the non-surgical procedures work, and one of our consultants will talk through all of your options with you.
At Ladan Hajipour, we understand the importance of keeping your hands and wrists mobile to allow you to carry out your everyday activities.
We also know that your ligaments, tendons, muscles, joints, and bones must work harmoniously together in order to achieve this.
That’s why all our team members are compassionate in their approach and use our years of experience to ensure the correct diagnosis and Kienbock treatment plan for our patients.
Offering high-quality patient outcomes, we specialise in a whole host of wrist and hand conditions and injuries, providing unique treatment plans tailored to you.
Whatever your hand or wrist condition, our team can help.
Get in touch and book your appointment with us today.
Check out this article, it might interest you: What is the Long-Term Outlook for Kienböck’s Disease?