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Severe pain top of hand, X-ray says not broken. Why can't I grip anything?

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Orthopaedic Surgeon
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severe pain top of hand. x-rays say not broken. Ican grip anything without going into severe pain.
Posted Sat, 5 May 2012 in Bones, Muscles and Joints
 
 
Answered by Dr. Atul Wankhede 1 hour later
Hello,
Thanks for posting your question.

The information you gave is not adequate to reach a diagnosis. We will try to establish a few differential possibilities though.

As you said severe pain on top of hand by which I hope you mean the surface opposite of palm, you can grip painlessly means your muscles, tendons and ligaments are fine and not the source of pain. The Xray does not show an obvious fracture means no bony injury. I would request you to answer the following questions which would help me narrow down the possibilities

1. Do you remember any incident like trauma, fall, lifting heavy object etc with the onset of pain?

2. Is there swelling (even if minor)?

3. Is the pain vague over the hand or localized to single point?

4. Is there any discoloration of skin over the affected area?

5. Are you getting fever since the pain started?

Think of anything that consciously or subconsciously led to the situation and write back. It would be very kind of you if you could upload a soft copy of your Xray and a photo of your hand with a finger pointing at the site of pain (can be taken even with a mobile phone). We have the facility to upload photos at the right hand corner of the screen.

Till then, give it rest, try not to move it or lift anything with it, use hot fomentation and any medicines that your physician must have given you.

Awaiting your reply.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Severe pain top of hand, X-ray says not broken. Why can't I grip anything? 38 hours later
1. Do you remember any incident like trauma, fall, lifting heavy object etc with the onset of pain?. yes, i hit my hand with a metal drawer

2. Is there swelling (even if minor)? yes

3. Is the pain vague over the hand or localized to single point? localized on top of my hand

4. Is there any discoloration of skin over the affected area?no

5. Are you getting fever since the pain started?no

also the doctor give me dicoflenax 5% cream
Follow-up: Severe pain top of hand, X-ray says not broken. Why can't I grip anything? 6 minutes later
I can't grip anything without going into severe pain. this what i meant. sorry for the typo
 
 
Answered by Dr. Atul Wankhede 6 hours later
Hello dear,

Thanks for replying.

From the information you shared, I think you must have injured some ligament or bone after getting hit with drawer. Even if the bone is not fractured as noted on x-ray, some blood vessels must have been damaged. This causes extravasation of blood which gives rise to pain and swelling.

So all you need to do is use both hot and cold fomentation on affected area, give the hand complete rest, use a crepe bandage for swelling reduction, keep it elevated above elbow level, do not manipulate or massage the area especially with ointments. Ask your physician to give you oral anti-inflammatory medicines. This should help the pain and swelling to subside quickly.

Try this and if it does not work by the end of a week, then you may need a second opinion about your x-ray.

I hope I answered your query. If there is anything I may help you with, feel free to ask.

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health.

Good luck.
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