The wrist is not one joint. Instead, it's made up of several small joints where the bones of the hand and forearm meet.
Wrist pain can develop due to a sudden impact or injury. For example, a wrist sprain can cause pain if a ligament is overstretched. This type of wrist pain usually comes on suddenly when the injury occurs. Here we will explore the common causes, symptoms, and treatment options.
What causes wrist pain?
The most common cause of wrist pain is injury to the wrist, which can come with overexertion or exercise.
Pain may occur for many reasons, whether simple fatigue or an underlying issue. Commonly, injuries to the wrist are the main cause. Squashing the nerves that pass through the wrist can also produce pain.
The most common causes include the following:
Carpal tunnel syndrome
Carpel tunnel syndrome is a condition that develops when a ligament thickens and puts pressure on a nerve. The nerve is squeezed, which can cause pain, numbness, and weakness in the hand.
The condition is also linked with repetitive work that involves lifting, typing, or using equipment that vibrates the hand.
Osteoarthritis causes inflammation of the joints and occurs when the cartilage that covers the bones wears away. The condition can affect a wide range of joints, including the wrist. Osteoarthritis of the wrist tends to occur most often in people who are middle age or older, and those with a family history of the condition.
Rheumatoid arthritis is an autoimmune disease where healthy tissues are broken down by the body's immune system. This can cause wrist pain if the joints in the area are affected.
De Quervain's disease
In this condition, tendons and their coverings on the thumb side of the wrist become inflamed and swell. The exact cause is not known, but it is often associated with an injury to the area or overuse. Symptoms include a grating feeling inside the wrist, swelling, and weakness along the wrist, forearm, and thumb.
Repetitive motion syndrome
As the name suggests, repetitive motion syndrome occurs from repeating a task over and over again, such as typing, or knitting. Overworking the joint can cause it to swell, putting pressure on the surrounding nerves.
It can affect many joints in the body, including the wrist.
Triangular fibrocartilage complex injury
The triangular fibrocartilage is located on the pinky side of the wrist. It acts as a cushion and support for the small bones. The cartilage can wear away over time or tear due to an injury.
Wrist tendonitis can occur when the tendons of the wrist develop small tears or become irritated and inflamed. The condition usually occurs due to repetitive movement involving the wrist.
Bursa are small fluid-filled sacs that help cushion joints. When these become inflamed it is referred to as bursitis. These can occur in many areas of the body, including the wrist. Symptoms include tenderness over the tendons of the wrist, redenss in the region, and swelling.
This cause of wrist pain is due to fluid-filled soft tissue cysts that often develop on the wrist opposite the palm but will occur on the palmar aspect of the wrist. Smaller cysts often tend to hurt more than large cysts.
According to the American Society for Surgery of the Hand, a wrist sprain is usually caused by falling and bending the wrist backward when the hand hits the ground. This movement overstretches the ligament.
Symptoms of wrist pain
The symptoms of wrist pain include soreness, aching, and swelling in the wrist.
Wrist pain symptoms can vary depending on the cause. Some people may have pain that they describe as achy or dull; others may have pain that is sharp. The location of the pain can also vary.
In addition to pain, other symptoms may develop. Symptoms of an injury, such as a wrist sprain, can include swelling and bruising. Numbness, tingling, and weakness of the hand might also occur when pain is due to carpal tunnel syndrome.
Some people may develop the following symptoms:
- Stiffness - in the wrist and potentially the fingers.
- Trouble gripping objects - grasping or holding on may be difficult or uncomfortable.
- A clicking sound when moving the wrist - this can be more severe after periods of rest.
Depending on the cause, symptoms may be mild to start and become worse as time goes on.
At first, pain may only occur during certain activities. In time, as the condition worsens, pain might occur even at rest. Numbness can also progress to the point where a person cannot feel cold or heat and may drop things.
When to see a doctor for wrist pain
It's important to see a doctor if:
- Pain is interfering with everyday activities.
- Numbness or tingling is becoming worse, and there is little or no feeling in the fingers or hand.
- Simple hand movements are no longer possible.
- Weakness makes holding things difficult.
Complications of wrist pain can include weakness and a decreased ability to carry out activities such as gripping objects and using a keyboard.
How is wrist pain diagnosed?
After a physical exam and symptom review, a doctor may also diagnose wrist pain and the underlying condition by:
- Medical imaging scans - including an X-ray, CT scan, and MRI.
- Arthroscopy - this procedure involves a small cut on the wrist. A small instrument that has a tiny camera attached is inserted in through the cut. The pictures from the camera are then projected onto a computer monitor for the doctor to see.
- Nerve conduction studies - these measure how fast nerve impulses travel through the carpal tunnel region of the wrist.
Typically, invasive diagnosis techniques are only used after rest and recovery from injury have been unsuccessful.
Treatment and prevention of wrist pain
Treatment for wrist pain depends on the cause of the pain and its severity. The least invasive treatment is given first before treatments are recommended. They include:
- Home treatment - often simply resting the wrist as much as possible to allow it time to heal is effective. Pain medication and ice may also be recommended to reduce inflammation and pain.
- Splints - in some cases, wearing a wrist splint can help. Splinting may prevent certain wrist movements that cause irritation. A splint might also reduce squeezing of the nerve.
- Exercises - depending on the type of pain, wrist exercises may work. Certain exercises can be prescribed to stretch and lengthen muscles and tendons. When it comes to which exercises to do, patients should get recommendations from a doctor or physical therapist.
- Additional treatment - cortisone injections, which decrease inflammation and reduce pain can be effective.
- Surgery - only used if less invasive treatments have not worked. The type of surgery performed depends on the cause of the pain. Surgery for carpal tunnel syndrome involves cutting a ligament in the wrist to release pressure on the nerve.
Treatments are undertaken by process of elimination until the condition is resolved. Physiotherapy may also help in some cases.There are a few things that can be done to reduce a person's chances of developing wrist pain:
- Using proper posture when sitting at a workstation, and keeping the wrists in a relaxed position.
- Considering a wrist-friendly keyboard if long hours are spent at the keyboard.
- Learning how to use hand tools properly, so less stress is placed on the hands and wrists.
- Taking regular breaks from using a keyboard.
- Using wrist guards to prevent injuries when participating in sports, such as skateboarding, snowboarding, and rollerblading.