What causes persistent hand pain with marks?

Question

Hi doctor,

I developed a mass in my hand after something touched it. To treat this, I received injections every 15 days for five months, which caused my hand to develop a hole.

When I consulted a doctor, the doctor cleaned the area by making an incision and prescribed medication. Despite this, I still experience severe pain in that hand, along with significant bleeding and marks appearing.

I have visited three top hospitals, and the advice I received was that there is no mass in my hand; any lumps would require surgery. An MRI was performed, and my nerves appeared normal, but no one can explain why I have pain or why these marks continue to appear. Can you help me understand why this is happening and how to treat it?

Please advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concerns.

I understand how distressing this situation has been for you, and I empathize with what you are going through.

You mentioned having a ganglion cyst on your wrist, for which your doctor started a steroid injection to reduce the swelling you experienced over the course of about four months. Later, you had swelling in the area, which led to a procedure for drainage, cleaning, and suturing.

According to the MRI (magnetic resonance imaging) report you shared, it indicates that you have a ganglion cyst on your distal forearm and tissue swelling due to the previous procedure. The rest of the report appears normal.

I want to reassure you that ganglion cysts are benign and not dangerous. Still, they can cause significant pain by pressing on nerves, causing local inflammation, and irritating tendons or joints. This is likely why you are experiencing persistent pain.

Management options for the cyst include either draining the fluid with a steroid injection or surgical excision of the cyst under local anesthesia, which is a good choice due to its low recurrence rate.

In addition to these options, proper wound care and taking analgesics for pain management will be important. You are currently being referred to a plastic surgeon for cyst removal.

Could you please send me a photo of the affected area? I would greatly appreciate it, as it would help me recommend the best treatment approach for you.

I hope this guidance proves helpful. I appreciate any feedback you have for better patient care, and if you have any further concerns, feel free to contact me anytime.

Thank you so much for reaching out.

Answer 2

Hello,

Welcome back to icliniq.com.

Thank you for your follow-up.

I have reviewed the photo you shared (attachment removed to protect the patient's identity). It shows skin bruises and bluish discoloration, likely due to the repeated injections you received. There is no obvious visible swelling, but the persistent pain you are experiencing is probably caused by nerve compression.

To help ease your discomfort, I will prescribe medication. You do not need to consider surgery at this time. Here is your medication plan:

Take one tablet of Pregabalin 50 mg at night.
Take two tablets of Paracetamol 500mg, spaced throughout the day.
Apply a skin ointment, such as Petroleum jelly, to the affected area.
Avoid rubbing the area and refrain from wearing tight bracelets.
Additionally, please do physiotherapy for your hand.

Use these medications for about a week and avoid NSAIDs (non-steroidal anti-inflammatory drugs). We will review your condition after a week.

I hope this answers your questions. If you have any further queries or need clarification, please feel free to reach out to me. I am here to help you.

Thank you.