The long term effects of continued use of the wrist when it is painful or swollen can't truly be known (we all progress very differently), but it is possible that use could lead to deterioration that could exclude some procedures that are currently available, so do your best to keep from using it.

ICE is good for swelling, but there's a trick to using it. Place a towel or folded cloth between the wrist and the ice. An ice pack should never make the skin ice cold, only cool. Ice too near the skin will have quite the opposite effect as ice that is used properly. Generally spend only 20 minutes at a time under ice. Some say 20 minutes of each hour, some say 20 minutes on/20 minutes off. Other's still say 20 minutes/3 times a day. That's not something that you need doctors' orders for. Do what works for you.

Ice may be applied directly to a cast (so long as the cast will not get wet), but cannot be placed directly onto a brace or wrap without a protective barrier in between.

COMPRESSION is achieved by applying by a wrap. A wrap is not something that has to be ordered like medicines or procedures. It's a common sense thing, like soaking your feet if they're sore.

You could try using an elastic bandage, commonly known as an Ace bandage. It's several feet long and a few inches wide, usually beige. The trick is that you don't stretch the elastic at all as you wrap it around. There are also neoprene wraps available that are easy to apply and fasten with velcro.

If a wrap is too tight, it will cause swelling all by itself, the same way wrapping a string too tightly around your finger would cause it to swell. Blood flows in but it can't flow out. So make sure the wrap isn't tight. It should not bind. If the fingers get cold (as compared to the fingers of the other hand), it's too tight.

I don't know of any reason that a person with Kienbock's Disease should refrain from wearing a wrap if it provides comfort unless he is already in a cast or has been instructed to wear a brace at all times. A brace, like a cast, supports and protects, but does not provide compression.

ELEVATION is probably the most important and the most effective action you can take against swelling. I can't stress enough that the wrist should be kept elevated. By elevated, I don't mean on a pillow in the lap. Elevated properly means to keep the affected area above the level of the heart. (I often find myself propping my wrist on top of my head, but that's just my own quirk.) It goes back to the blood flow thing. If it's above the heart, gravity will assist in getting the blood to come back out of the area.

The salicylates --acetylsalicylic acid (aspirin), magnesium salicylate (Doan's pills, Mobegesic, some forms of Pamprin), and sodium salicylate, are anti-inflammatory agents. Of these, aspirin has the strongest anti-inflammatory properties. Because of the danger of Reye's Syndrome, aspirin should not be used in children. Aspirin also causes prolonged bleeding time. It should not be used by people with hemophilia, bleeding ulcers, or other bleeding disorders. It should not be used for one week prior to any surgery or dental procedure.

The other over-the-counter alternative is a group of meds called NSAIDs. Advil, Motrin, Aleve, (generically, Ibuprofen or Naproxyn) are NSAIDs. That means Non-Steroidal Anti-Inflammatory. They act directly on the inflammation or swelling. You can safely take both an over-the-counter NSAID and Tylenol simply by taking them alternately, not at the same time. Don't exceed the recommended doses without doctors' approval. (However, if any other NSAIDs you've taken have caused swelling, watch carefully to see if the Advil or Aleve do the same as they're weaker cousins in the same family.)

Do not take NSAIDs while taking salicylates. Read the labels of your medications to determine whether they contain aspirin or other salicylates. Excedrin, Alka-seltzer, and Anacin, among others, contain aspirin along with other active ingredients.

(Steroidal anti-inflammatories, like cortisone injections, are available only through the doctor. They often hurt like the dickens for a few days and I think we've seen mixed results.)

There are other remedies for swelling that you can try such as teas or herbal remedies. I'm in no position to advise you on what those might be, but you're on the internet anyway, so see what you can come up with.

IMPORTANT:
In the July 2002 Orthopedics Today, it was reported that Cox-2 inhibitors and, to a lesser extent, NSAIDs may interfere with bone healing in animal studies. While this has yet to be proven in humans, Thomas A. Einhorn, MD, of Boston University Medical Center, suggested, “Based on our current understanding, it would seem that a prudent approach toward the management of patients is to temporarily avoid or discontinue the use of both NSAIDs and coxibs during a period of bone healing.” Coxibs (Cox-2 inhibitors) include Celebrex. NSAIDs include ibuprofen (Advil), naproxyn (Aleve), and many of the non-narcotic prescription pain medications. Speak to your doctor about this matter as it relates to your post-operative pain management.