Kienböck's Disease (Lunate Avascular Necrosis)

Common Symptoms

• Wrist pain and swelling, typically centered over the middle of the wrist
• Stiffness and reduced wrist range of motion
• Reduced grip strength
• Pain that worsens with wrist loading or gripping

Why It Happens

The exact cause often isn't clear, but a disrupted blood supply to the lunate bone — sometimes related to wrist anatomy variations, prior trauma, or repetitive loading — leads to progressive bone death and, if untreated, eventual collapse.

Why It Can Become Persistent

Like other avascular necrosis conditions, bone without adequate blood supply can't repair itself, making this a structural, potentially progressive process that generally needs staged, specialist-directed treatment rather than rest alone.

Who Commonly Gets It

Kienböck's disease most commonly affects adults in their 20s to 40s, and is more common in people who do repetitive heavy manual work.

How It Is Usually Diagnosed

Diagnosis involves X-ray and often MRI, which is more sensitive for earlier-stage disease; staging guides whether joint-preserving or more extensive surgical treatment is appropriate.

Traditional Treatment Options

• Immobilization: May be tried for very early-stage disease.
• Joint-leveling or revascularization procedures: Surgical options aimed at relieving pressure on the lunate or restoring blood supply, used for earlier-stage disease.
• Partial wrist fusion or salvage procedures: Reserved for more advanced disease with collapse.

Why Someone Might Start Looking for Another Option

Because Kienböck's disease can progress and surgical options carry their own recovery demands, there's clinical interest in less invasive, joint-preserving adjuncts, including shockwave therapy.

Where Shockwave Therapy May Fit

We found one prospective study of 22 patients with Kienböck's disease treated with shockwave therapy, which found a positive effect on wrist pain and functional impairment, with the authors suggesting it may delay the need for surgical treatment. This is a real, but small and uncontrolled study, without a comparison group — the authors themselves call for further investigation, and this is not established treatment.

How Shockwave Treatment Works for This Area

Shockwave therapy would only be considered as part of a coordinated plan with a hand specialist who has staged your disease — never as a stand-alone alternative to that evaluation.

What the Treatment Feels Like

Most patients describe a firm tapping or pressure sensation over the wrist; your provider will discuss what to expect.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• Anyone who has not yet been evaluated and staged by a hand specialist
• More advanced disease with bone collapse, where surgical treatment is typically needed
• Active infection at or near the treatment site

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.