The Causes Behind Wrist Pain
By Orthopaedic and Neurology Clinic
Wrist pain can be caused by disease or injury affecting any aspect of the wrist joint, including the bones, ligaments, and connective tissue surrounding the area.
The wrist alone has eight bones lined up, four on top, four below. All eight bones are connected by ligaments that keep the joints together, while giving a wide range of motion for our hands. There are also many tendons that pass the wrist. These control the motion of our wrist, fingers, and thumb. Because each of those parts serves a purpose in movement, if even one area in the wrist gets inflamed or injured, you’re going to feel it.
What are some symptoms of a Wrist Pain?
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.
Squashing the nerves that pass through the wrist can also produce pain.
The most common causes include the following:
De Quervain’s disease
Repetitive motion syndrome
Triangular fibrocartilage complex injury
“Wrist pain is a common condition with various causes. The wrist joint plays a role in basic movements, from texting to writing. When pain occurs, it can interfere with day-to-day activities and even impact a person’s quality of life.”
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What types of diagnosis?During the physical exam, our doctor may:
- Check your wrist for tenderness, swelling or deformity
- Ask you to move your wrist to check for a decrease in your range of motion
- Assess your grip strength and forearm strength
In some cases, our doctor may suggest imaging tests, arthroscopy or nerve tests.
- Arthroscopy. If imaging test results are inconclusive, our doctor may perform an arthroscopy, a procedure in which a pencil-sized instrument called an arthroscope is inserted into your wrist through a small incision in your skin. The instrument contains a light and a tiny camera, which projects images onto a television monitor. Arthroscopy is considered the gold standard for evaluating long-term wrist pain. In some cases, our doctor may repair wrist problems through the arthroscope.
- Electromyography or EMG. This measures the electrical impulses produced by nerves in response to muscles. Therefore it can confirm nerve compression, which may occur with a herniated disk or spinal stenosis.
- X-rays. This is the most commonly used test for wrist pain. Using a small amount of radiation, X-rays can reveal bone fractures or signs of osteoarthritis.
- MRI, CT scan, Ultrasound. This scan can provide more-detailed views of the bones in your wrist and may spot fractures that don’t show up on X-rays.
- Nerve scans. Our doctor might order an electromyogram (EMG) if carpal tunnel syndrome is suspected. This test measures the tiny electrical discharges produced in your muscles. A needle-thin electrode is inserted into the muscle, and its electrical activity is recorded when the muscle is at rest and when it’s contracted. Nerve conduction studies also are performed as part of an EMG to assess if the electrical impulses are slowed in the region of the carpal tunnel.
Possible treatment methods?
Our therapist can implement specific treatments and exercises for wrist injuries and tendon problems. If you need surgery, our physical therapist can also help with rehabilitation after the operation. You may also benefit from having an ergonomic evaluation that addresses workplace factors that may be contributing to wrist pain.
If you have a broken bone in your wrist, the pieces will need to be aligned so that the bone can heal properly. A cast or splint can help hold the bone fragments together while they heal.
If you have sprained or strained your wrist, you may need to wear a splint to protect the injured tendon or ligament while it heals. Splints are particularly helpful with overuse injuries caused by repetitive motions.
Medication for Wrist Pain
Over-the-counter pain relievers may help reduce wrist pain. Stronger pain relievers are available by prescription.
In some cases, surgery may be necessary. Examples include:
- Bone fractures. In some cases, surgery may be necessary to stabilize bone fractures to permit healing. Our surgeon may need to connect the fragments of bone together with metal hardware.
- Carpal tunnel syndrome. If your symptoms are severe, you may need to have the ligament that forms the roof of the tunnel cut open to relieve the pressure on the nerve.
- Tendon or ligament repair. Surgery is sometimes necessary to repair tendons or ligaments that have ruptured.