Diagnosis–TFCC Tear in My Left Wrist
After weeks of pain, my Doc is confident my pain is due to a tear in my TFCC, better known as the Triangular Fibrocartilage Complex. It’s a collection of ligaments and cartilage on the outside of your wrist that allows for mobility of the joint and helps hold everything together.
http://www.youtube.com/watch?v=tM_O2cnlgh8
I had a bit of swelling along with bouts of going numb in my pinkie and ring finger that would sometimes go up my arm like someone smacked my funny bone. So just to be safe, the Doc sent my to a neurologist to see if I had Ulnar nerve entrapment. But my test was normal.
So my ortho did one more test with me after I told him exactly where the pain was. He grabbed my ulna and radius and moved them back and forth, opposite of each other. OMG what a weird combination of strange, creepy and tickly. I could feel the weakness in there. He did it to my right wrist and everything felt fine. That cinched the diagnosis for him.
He told me I had two options. One is to get a full arm cast for four weeks followed by physical therapy afterward. The other was to go to the hand surgeon, get a painful dye injected into my wrist to see where the tear was on an MRI–then get casted for four weeks followed by physical therapy. LOL Well, since I didn’t want to go any longer without what seemed to be the only form of treatment, I decided to get a cast. Talk about a shock! I totally wasn’t expecting that.
So as you can see, I decided to have fun with it. I got the pink, and the lady was nice enough to give me spray-on glitter! Figured the only way to stay positive with a full arm cast where my arm is bent for 4 weeks on top of a small baby, 4 other kids and a house to take care of (not to mention my writing) was to have a little levity with the situation.
Now we’ve got to get used to the adjustment. When I broke my wrist as a kid, I had a full cast for 4 weeks then too. I remember getting it off and not being able to fully extend my arm for maybe a week after that. It was painful. I also remember the pain of bending my wrist for the first time. Doc said, “Yeah, you’re not 13 any more.” Hence the PT I’ll need. **shudder** But it’s not just because of the cast, the PT is also to help the TFCC strengthen and regain mobility. Not looking forward to that.
I’m hoping this mode of treatment works. The only other treatment is surgery to suture the tear. Now, it’s an out patient procedure, but it still hurts like hell and can take weeks/months to recover from. DO NOT WANT!
So, that’s the news from this end. No writing for me for awhile.
How did I injure myself, you ask? Well, I don’t really know. It’s been hurting since early December. The only thing I can think of is when I pushed myself off my couch three or four different times and felt something in my wrist like someone plucking on a guitar string. It didn’t hurt at the time, just felt odd. Shortly thereafter my pain began. That may or may not be how it happened, but it probably was.
However, good news! Champagne Books just bought BLACK ANGEL! That’s my fantasy novella about the hero with obsidian black skin and wings! I love that story and will be proud to see it with Champagne! Woohoo! 
~~Becka
Wow, a cast! Sorry to hear that, but glad your pain is being treated. I went through hand/wrist therapy about three years ago. Although some of the therapy is painful, a lot of it is soothing – like the hot wax treatments and the electro shock thingys – they tingle and make the muscles where they are applied contract, but your hand/wrist feels so much better after treatment. My point is to not dread the therapy too much – it was really beneficial to me. You’re in my thoughts. Love you.
Keep the positive and I hope the pain ends for you soon! Luv ya tons sweetie!
Hugs
Donica
Well, either the nerve test or the fact I’m no longer wearing my wrist brace has seemed to eliminate the numbness I was having. Perhaps I was wearing the brace too tightly. I did strap it down pretty good. Still hurts like an SOB tho. Now that I can’t move my wrist to compensate, I can definitely feel the weakness in my fingers when trying to do simple tasks–like taking the lid off the milk jug or screwing on the nipple of the baby’s bottle.
~~Becka
THE PAIN!! OMG the pain… **sobs** Went to the store for a few things today and thought I was going to die. Asked Doc for diff. med. that Aleve — wasn’t working for me — told me to use ibuprofen instead (not *with* the Aleve) with some Tylenol here and there to “take the edge off”.
Don’t know why it hurts so much but over the weeks since I first noticed it, seems to be getting worse. Even since I got the cast. What’s the deal with that? The weight of the thing making my ligaments work to hold it up? It is a heavy cast. Don’t have a sling, tho… :’(
I hate this. I’m not one to complain hardly ever and I feel like I’m a whiny baby about this. I’d say almost hurts more than any of my previous broken bones.
~~Becka
hi i have a tfcc diagnois from two mri’s and the doc has put me in a cast but only up my arm not my elbow as a method to prevent surgery and i have more pain with the cast then with the brace and is this casting theraphy goona work or is it a waste of my time
Kel,
From my experience and the experience of others, it would seem casting does not work on bigger tears. However, casting is used for smaller tears, as immobilization from a cast could bring down the inflammation enough so that the pain goes away.
But if you have bigger tear, this won’t work, as the TFCC pretty much cannot heal on it’s own due to its poor blood supply. Only a peripheral tear (on the side of the disc) can heal, but not a tear in the middle.
I believe doctors go through a list of treatments before surgery to weed out the people who “really need it”. I’ve come across some people whose tears were so bad doctors operated right away. But for people like me, it was more like, “Okay, let’s try casting. Well, that didn’t work. Let’s try physical therapy. Hmm. A splint? No? Okay, what about a cortisone shot?”
I’m at the end of all of the above. I see the doctor again on May 27th to discuss the “results” of my cortisone shot. Oh, it brought down my inflammation, all right. Cortisone did it’s job. BUT (Oh, and it’s a BIG but… LOL), NOW, my wrist is tender to the touch when it wasn’t before. I was never able to give the doctor an exact spot where I felt the pain, it was always diffuse, an all-over ache. NOW, however, it’s pretty much, “MY PAIN IS RIGHT EFFING THERE!”
Doc said to give the cortisone 6 weeks before ruling it a failure, as some people respond differently than others. I have just over two weeks left of “waiting it out”. I can tell you right now it isn’t going to magically fix a damn thing. I’m going to need the surgery.
Of course, my doc hasn’t said this, but I know. I know my body and what it’s telling me. If there’s one thing I’ve learned about this ordeal is a TFCC tear is full of a lot of red tape and a lot of waiting. I’m sorry, hun, wish I had better news for you…
~~Becka
Hi, thanks for your input. We are both in red tape hell. My injury is from April 5th and since then I have had a mri with dye and without dye and the results were a tear and have been in a brace/cast and now another brace and out of work because I am a flight attendant. This is piss poor medical care and I am going to scream at my re-check on the 22nd…..I have made zero progress in this treatment plan….WTF…..any suggestions ????
As far as I know, some people have requested the surgery. If you are just honest with the doctor, maybe he/she will cave. A lot of us patients follow the doctor’s orders because well, he’s the doctor, he knows best, right?
Well, surgery is the most expensive option. Also, some insurances don’t cover it. But, if your insurance does and you feel nothing will work, I’d request it. Otherwise the next step is a cortisone shot and another few weeks of waiting that treatment out.
Cortisone works differently for different people. Some people it’s a miracle, others, it didn’t do anything. So your doc might try to talk you into that. And maybe the doc has a valid reason not to jump into surgery right away.
But if it’s just for simple debridement like hopefully mine will be, recovery time (according to my doc) is 3-5 days. That’s nothing! Assuming you don’t need your ulna shortened or pins put in to stabilize things (for which you’d need the surgery anyhow).
Just go in on your appointment day and ask for a surgery. That’s my advice. Mention the red tape. Tell them you know your body and you’re not getting any better. I have been cynical throughout all of this and it ended up I was right all along. You probably will be too.
~~Becka
I was diagnosed with a slightly ill defined horizontal tear of the triangular fibrocartilage violating the mid ulnar surface extending through the periphery. Dorsal and volar radioulnar ligaments are intact.
I have been out of work for 14 weeks.. this has been hurting for 3 months at least and just went to the dr 3 weeks ago and got this dreaded diagnosis. I think I did it while pulling weeds while trying to keep myself busy in the yard while out of work. I’m supposed to go back on 7-6-10 but find out next week if I have a job and will be having a 2nd interview. I’ve been in a velcro splint for 3 weeks and wear it most of the time. It still hurts. He mentioned casting it. I CANNOT START A NEW JOB OR TRY TO FIND A JOB WITH A DAMN CAST. What am I going to do? I am just sick. Is this something that I can try and live with for a while and if it doesn’t heal, then proceed? I’m tempted to cancel my appt on Tuesday and just wait this out. This could not be coming at a worse time. This is my right – dominant arm.
12 years agoI had Keinbock’s Disease and had to have a bone removed and then an 8 in metal rod and 7 screws put in so I know about arm surgery but being my dominant arm is another story. I’m grateful this is not Keinbock’s again.
Can I even drive with a cast? I am so down.
Have any of you tried the wrist widget?
I am having tfcc w/ulnar shorting surgery in 2 weeks. : (
had my surgery tfcc w/ulnar shortning and got a short cast yepeee..it hurt for 4 days but now i am shopping and reading by the pool
Thanks for writing about your injury. I go to see my orthopedic this week and all they told me was I had a small tear concerning the TFCC in my right wrist and the nurse mentioned an injection or surgery. Your story gave me a better perspective of what I could possibly expect to happen. Just wish I knew which plan of action they want to take.
By the way, the ink injection into the wrist does hurt even with the lidocaine injection for an MRI. Also, why did your doc not decide to do surgery?
Thanks again.
Gaylen
Well, Gaylen, I don’t know if you read my entire story. I did get my surgery – eventually – on July 16th. Helped CONSIDERABLY. Most of my pain is gone and I’d do it again in a heartbeat.
I had my MRI in March, and I actually didn’t feel the ink go in after my numbing injection, other than feeling like my hand was inflating like a water balloon. I guess everyone is different.
I was first casted, then I got the cortisone shot (which did nothing), then I got my surgery, so it was a process. I think it’s because the health insurance wants to “make sure” you don’t have something that could have easily been fixed with some other treatment, since surgery is expensive.
I’m just glad it’s (mostly) over with. I still have some pain. You can look up my TFCC Tear Treatment tag on my blog to find all the posts regarding my wrist saga.
~~Becka