Seeking a Third Opinion on My Scaphoid: Am I Overreacting?
28-year-old male. I consume alcohol socially, but I do not smoke or use recreational drugs. Medication: Daily intake of 30mg Vyvanse. Back in January, during a rugby match, I extended my arms and unfortunately ended up injuring my wrists. At first, I assumed I merely sprained both wrists since I had previously fractured a wrist and this didn’t seem nearly as painful. I continued playing despite the discomfort until I aggravated the injury again in May, leading me to seek medical attention. X-rays revealed an ulnar styloid fracture, but no major concerns, and I was prescribed a splint. A month later, a CT scan brought up inconclusive results, yet I was fitted with a removable thumb spica cast that I wore for another month. After a lengthy wait, I finally advocated for an MRI, which occurred eight months post-injury. The MRI indicated a “chip” in the distal pole of my scaphoid, according to the surgeon; however, no further actions were taken, with the orthopedic hand surgeon informing me that I would likely endure discomfort for several more months before regaining normalcy. This situation occurred nearly a year ago and I still experience significant pain frequently enough to seek a second opinion from another hand surgeon. He evaluated my existing scans and conducted a new x-ray, which confirmed the earlier fracture but found no signs of nonunion. I received a steroid injection, which provided substantial relief, eliminating pain for several weeks, and I felt reassured during the follow-up consultation a month later. Yet, now several months have passed, and my pain has returned to its previous intensity, leading me to question if the discomfort might be psychosomatic or if I am merely being overly anxious. Regardless, the frustration is palpable. I can’t shake the fear that a nonunion or avascular necrosis may have been overlooked, and considering I rely heavily on my right hand, avoiding a SNAC wrist or potential arthritis is crucial. I wonder if that possibility has already passed. Is pursuing a third opinion warranted? Or am I simply overreacting?
Answers (1)
8/10/2025, 4:50:49 PM
OpenHealth AI
It’s understandable to feel frustrated and anxious when dealing with persistent pain, especially after a sports-related injury. Based on your experiences, it's clear you've been proactive in seeking care. Here’s a summary of important points regarding your scaphoid injury and the potential need for a third opinion.
Main Points:
- Persistent Pain After Injury: It's common for pain to linger after a wrist injury, especially if complications like scaphoid fractures are involved.
- Concerns About Nonunion/Avascular Necrosis: Your worries about potential complications are valid, given the importance of the scaphoid bone in wrist function.
- Considering a Third Opinion: Seeking further evaluation can provide peace of mind and possibly different treatment options.
Explanation:
Scaphoid fractures can be tricky because they can lead to complications like nonunion (where the bone doesn't heal properly) or avascular necrosis (when the blood supply to the bone is interrupted). Given your ongoing pain and the previous inconclusive imaging, it's natural to question whether all potential issues have been thoroughly explored.
The steroid injection temporarily alleviated your pain, suggesting inflammation may still be contributing to your symptoms. It's common for these injuries to be frustrating and for healing to take longer than expected. Psychosomatic concerns can arise from chronic pain, but given your long history and objective findings, it’s equally important to consider that physical issues may still be at play.
Next Steps:
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Consider a Third Opinion: If it provides reassurance and you still feel pain, pursuing a third opinion—especially from a specialized orthopedic hand surgeon—can be a reasonable step. Ensure this provider is familiar with complex wrist injuries.
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Discuss Imaging Options: During your next visit, discuss the possibility of advanced imaging (e.g., repeat MRI or specific MRI sequences) to assess the scaphoid in more detail, looking for any signs of nonunion or avascular necrosis.
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Pain Management Strategies: In the meantime, consider physical therapy to strengthen and stabilize the wrist, incorporate range-of-motion exercises, and possibly explore additional pain management alternatives if ongoing pain persists.
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Monitor Symptoms: Keep a detailed log of your pain, including triggers and the intensity. This information can be valuable for your next consultation.
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Seek Support: Given the emotional toll of chronic pain, consider talking to a mental health professional to help manage anxiety related to your injury and ongoing discomfort.
Remember, advocating for your health is essential, and pursuing a third opinion when you have concerns is a proactive step toward finding relief and regaining function.
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