Elbow, Wrist & Hand

What It Is

Kienbock's disease is a condition where the blood supply to one of the small wrist bones, called the lunate, is interrupted. Bone is a living tissue requiring a regular supply of blood to keep it nourished. If the supply to the bone stops, the bone, or parts of it, can die, which is known as osteonecrosis. Without its blood supply, the lunate loses its structural support and can collapse, causing a stiff and painful wrist. Over time, it can lead to arthritis in the surrounding wrist bones (AAOS, n.d.).

The cause of the condition isn't known. Many people with the disease think at first that they have sprained their wrist. They may have had an injury to the wrist, such as a fall, and this kind of injury can damage the blood vessels that supply the lunate (AAOS, n.d.). Other things may increase the risk. Some people have only one blood vessel supplying the lunate instead of the usual two, and if the two forearm bones (the radius and ulna) are different lengths, extra pressure can be put on the lunate (AAOS, n.d.; Lichtman and Pientka, 2025).

The most common symptoms are wrist pain and swelling, stiffness, a weaker grip and tenderness over the middle of the back of the wrist (AAOS, n.d.). The disease usually progresses slowly, often over many months or years. In the early stages X-rays may look normal, and an MRI scan is better at picking it up (AAOS, n.d.).

Kienbock's Disease Anatomy

The anatomy within the hand is quite complex, fascinating and intricate. Its integrity is imperative for individuals to be able to go through life on a regular basis and engage in normal activities. Hands can be affected by any number of disorders, but often from a traumatic injury.

The lunate is one of the small bones of the wrist (the carpal bones). It is named after its crescent-moon shape. It sits in the row of wrist bones next to the radius (forearm bone), between the scaphoid and triquetral bones.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Kienbock's Disease

Working within your medical team's plan, I can help ease pain and muscle tension in your forearm and hand, and help you regain movement and grip strength after a splint, cast or surgery. See the My Approach tab for how I work.

1. Non-Surgical Treatment

In the very early stage of the disease, AAOS (n.d.) says pain and swelling may be managed with anti-inflammatory medicines, such as aspirin or ibuprofen. (This medicine information comes from AAOS OrthoInfo, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) Resting the wrist can help relieve the pressure on the lunate, and your doctor may recommend a splint or cast for a short time (see below). It is important that you keep track of any changes in your symptoms throughout the early stages of the disease. If the pain isn't relieved with simple treatments, or it comes back, your doctor may recommend surgery (AAOS, n.d.).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Splint or cast: a short period of splinting or casting to keep the wrist still and relieve pressure on the lunate (AAOS, n.d.).
Scans: X-rays and MRI scans are used to diagnose the condition and see how far it has progressed (AAOS, n.d.).
Revascularisation: a piece of bone with its blood vessels still attached is taken from another bone, often the forearm, and placed into the lunate to try to restore its blood supply (AAOS, n.d.).
Joint levelling: if the two forearm bones are different lengths, one can be lengthened or shortened to reduce the forces pressing on the lunate (AAOS, n.d.).
Proximal row carpectomy: if the lunate has collapsed badly or broken into pieces, it is removed along with the two bones on either side of it (the scaphoid and triquetrum), which relieves pain while keeping some wrist movement (AAOS, n.d.).

How I can help (see the My Approach tab)

Hands-on care for the forearm, hand and shoulder
Gentle movement and grip strength work, within your team's limits
Swelling and scar care after a cast or surgery

Tips

The disease varies a great deal in how severe it is and how quickly it progresses. Everyone responds to treatment differently, depending on the damage to the lunate and the other wrist bones (AAOS, n.d.).
If the disease continues to progress, you might need another procedure (AAOS, n.d.).
Your wrist is not expected to return to completely normal, but treatment gives you the best chance of long-term pain relief and keeping your wrist working (AAOS, n.d.).
Because the early symptoms are so like a sprain, get a painful, swollen wrist checked if it does not settle.
When the two bones in the forearm are different lengths, extra pressure can be put on the lunate during some wrist movements (AAOS, n.d.).

Treatment

My Approach

With Kienbock's disease, your medical team leads: they decide whether the wrist needs a splint, cast or surgery. I work inside those limits to keep you comfortable and help you get movement and strength back. If you've had surgery, I need your surgeon's okay before we start hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

I assess how your wrist, hand, elbow and shoulder move, and your grip strength.

While the Wrist Is Protected

Hands-on work for the forearm, neck and shoulder, which tighten when you guard a sore wrist, with no strong pressure or forceful movement over the wrist bones
Gentle movement for the fingers, elbow and shoulder
Warm applications, and I'll show you how to use ice safely at home

After a Cast or Surgery

Gentle lymphatic drainage for swelling, and scar work once the wound has healed
Pain-free wrist movement within the range your team allows
Grip strength work with putty, a soft ball or a light weight, then real tasks like jar lids and buttons

If pain lasts more than about an hour after a session, we scale back. A wrist that gets more painful or swollen should go back to your doctor.

What to Expect

Typical Course

Typical course: Your medical team's plan sets the pace. Once they agree, most people come once or twice a week at first, then weekly, then less often, with a reassessment at about 4 to 6 weeks. Recovery after a cast or surgery usually takes a few months, and the wrist is not expected to return to completely normal.

What I Focus On

Working Within Your Team's Limits

Compensation Relief

Swelling & Scar Care

Gentle Wrist Mobility

Grip Strength

Sources

References

American Academy of Orthopaedic Surgeons (AAOS) (n.d.) Kienböck's disease. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/kienbocks-disease/ (Accessed: 7 October 2026).
Lichtman, D.M. and Pientka, W.F. II (2025) 'Kienböck disease: recent advances in understanding and management', Journal of Bone and Joint Surgery (American Volume), 107(12), pp. 1389-1402. doi: 10.2106/JBJS.24.01090.

Massage therapy · Kitchener–WaterlooKienbock's Disease

What It Is

Kienbock's Disease Anatomy

Self-Care & Treatment

How to Treat Kienbock's Disease

1. Non-Surgical Treatment

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

While the Wrist Is Protected

After a Cast or Surgery

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooKienbock's Disease

What It Is

Kienbock's Disease Anatomy

Self-Care & Treatment

How to Treat Kienbock's Disease

1. Non-Surgical Treatment

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

While the Wrist Is Protected

After a Cast or Surgery

Typical Course

References

Related Conditions

Bennett's Fracture

Boutonniere Deformity of the Finger

Carpal Bone Fracture

Colles' Fracture

Book a session