Wrist Pain

What is Wrist Pain?

Wrist pain is defined as any ache or discomfort in the wrist. The wrist is comprised of two bones in the forearm, the radius and ulna, and eight tiny carpal bones in the palm. The bones meet to form multiple large and small joints. A trauma or injury to one or more of these bones results in wrist pain.

The wrist is a commonly injured joint in the body. Wrist pain may occur due to sprains and strains, arthritis, and fractures that can occur with lifting and carrying heavy objects, while operating machinery, bracing against a fall, or from sports-related injuries.

Signs and Symptoms of Wrist Pain

Some of the common signs and symptoms that accompany wrist pain include:

• Bruising
• Numbness
• Stiffness
• Swelling
• Tingling sensation
• Restricted movement of the hand and wrist

Common Causes of Wrist Pain

Some of the common causes of wrist pain include:

• Sprains and Strains: Sprains and strains are the two most common types of injuries affecting the wrist.  A sprain refers to an injury to a ligament and a strain refers to a muscle injury. Sprains and strains occur due to excessive force applied during a stretching, twisting, or thrusting action.
• Ligamentous Injuries: Ligaments are tissues that connect bones to other bones. They are made up of several fibers and one or all of the fibers may be involved. Complete ligament injury occurs when all the fibers are torn. A ligament injury may cause pain and swelling and limit the movement of the wrist joint.
• Fractures: A fracture is a break in the bone which occurs when more force than the bearable limit is applied against a bone. Crushing injuries to the wrist occur due to a high degree of force or pressure resulting in fracture. A fracture may cause severe pain, swelling, bruising or bleeding, discoloration of the skin, and limit the mobility of the wrist.
• Osteoarthritis: Also known as degenerative joint disease it is the most common type of arthritis that affects the elderly. It causes the cartilage, the tissue that cushions and protects the ends of bones in a joint, to wear away, causing painful rubbing of the bones.
• Rheumatoid arthritis: An autoimmune disease and a type of arthritis in which the body’s immune system attacks healthy joints, tissues, and organs. It can cause pain, stiffness, swelling, deformity, and loss of function in the joints.
• Repetitive Trauma Syndrome: Repetitive stress injury occurs as a result of repeated similar movements for long periods of time. This often causes pressure on the joints resulting in inflammation, pain, and decreased function in the extremity. The condition is more likely to develop with repetitive, rapid, forceful, and prolonged movements of the wrist, or from vibration or frequent pushing, pulling, or carrying heavy objects.  Carpal tunnel syndrome is the most common of these syndromes.
• Carpal Tunnel Syndrome: Carpal tunnel syndrome is a condition characterized by numbness or pain in the thumb and first two fingers and occurs when the median nerve is compressed at the wrist. Carpal tunnel syndrome is often a common complaint in individuals who use their hands for prolonged periods of time in a particular occupation such as computer work.

Diagnosis

In order to diagnose the cause of your wrist pain, your physician will perform a thorough physical examination and order specific tests. These may include:

• Manipulation of wrist during physical examination to elicit numbness, pain, or tingling sensation; assess your grip strength; and check for range of motion
• X-rays to evaluate the fractures of the bones and joints
• CT scans for more detailed images of the bone fractures not visible in X-rays
• MRI to identify tiny fractures and soft-tissue injuries
• Electromyography (EMG) and nerve conduction studies to measure nerve impulses and nerve damage

Treatment

Nonsurgical Treatment

• Medications: Your doctor may prescribe analgesics and anti-inflammatory medications such as ibuprofen and naproxen to relieve pain and inflammation caused by a wrist injury.
• Icing: Your doctor will advise you to apply an ice pack over a towel on the affected area for several minutes a day to relieve pain and swelling.
• Physical Therapy: Strengthening and stretching exercises may be recommended if you have arthritis to help improve range of motion and strengthen wrist muscles.
• Cortisone Injections: Injection of corticosteroid medication directly into the affected wrist is done to relieve pain and swelling.
• Casting and splinting: If the wrist fracture is not too serious and the bone is correctly positioned, your physician may place the broken wrist in a cast or splint until the bone heals satisfactorily.
• Closed reduction: If the wrist bones are displaced, your doctor will gently manipulate and align the bones properly without the need for surgery. This procedure is called closed reduction and is performed under local anesthesia to numb the wrist area. Once the procedure is complete, a cast is applied to hold the bones in place while they heal.

 
Surgery is recommended to treat severely displaced wrist fractures and is carried out under the effect of general anesthesia. Some of the common surgeries may include:

• External fixation: In this procedure, metal pins or screws may be used to treat the fracture from the outside. These pins are fixed above and below the fracture site and are held in place by an external frame outside the wrist.
• Open reduction and internal fixation: During this procedure, your surgeon makes an incision to access the bones in the wrist and repositions the broken bone fragments. Your surgeon may use temporary fixation devices such as medical pins, plates, or screws to hold the broken bones in place while they heal.
• Carpal tunnel surgery: This procedure involves cutting open the ligament that forms the roof of the tunnel in the wrist to relieve pressure on the compressed median nerve.

After the surgery, you may be advised for regular follow-up and a rehabilitation program for a quicker recovery.