The wrist joint consists of two bones, the ulna and the radius of the forearm, that meet with the rows of carpal bones in the hand to form the wrist joint.
Wrist pain refers to pain or discomfort felt within the wrist region due to excessive use, injuries, inflammation, strains, sprains, or underlying medical issues like arthritis.
Wrist pain may manifest as aching, throbbing, or sharp pain, often accompanied by swelling, reduced range of motion, and numbness or tingling in the wrist extending to the fingers.
Early wrist pain treatment is crucial as it helps prevent complications, reduces discomfort, and helps restore function.
What is Hand Wrist Pain?
Wrist pain is any discomfort felt at the wrist. The wrist joint connects our hand to the forearm and is critical for daily function.
Hand-wrist pain can result from an issue in the muscles, joints, ligaments, or bones. Pain in the wrist may be a sign of tissue irritation, nerve irritation, or joint compression and warrants appropriate diagnosis and care.
Wrist Pain Common Causes
The carpals consist of 8 small bones that move synchronously and together to allow for delicate and precise movements of our hand and fingers. If there is any compromise to this system, pain can occur.
Common causes of wrist pain are overuse types of injuries such as prolonged typing, mouse work, or physical work involving pushing and pulling.
Other common causes can be sudden trauma and high impact to the wrist, as well as nerve compression and irritation from overuse and poor posture.
Common causes of wrist pain include:
- Carpal Tunnel Syndrome
- Injury or Trauma
- Repetitive Stress Injuries
- Wrist Sprains and Strains
- Ganglion Cysts
Each of the wrist pain causes are discussed in detail below.
Carpal Tunnel Syndrome
The carpal tunnel is a small tunnel in the wrist where a very important nerve, called the Median nerve, traverses to innervate the hand. The tunnel is formed by thick connective tissue and ligaments that protect the tunnel.
The median nerve is a sensory and motor nerve of the arm (or upper limb). It arises from the lateral and medial cords of the brachial plexus, originating in the spinal cord, and runs through the anterior portion of the arm and forearm before finishing its path at the hand and digits (fingers).
Compression of the tunnel can result in its narrowing, putting stress and compression on the median nerve. Symptoms can include reduced sensation in specific fingers, loss of grip strength, and numbness and tingling along the median nerve pathway.
Two types of arthritis may result in pain in the wrist. Osteoarthritis and Rheumatoid Arthritis. Each of these two is going to be explained more.
We use our hands daily. Therefore, our hands and wrists, especially the thumb joint, are common sites for arthritis as we age.
Arthritis occurs over time, and the risk increases with prolonged overuse of our hands, but it also can have a genetic component.
The pain is generally achy and dull and rarely sharp and shooting. The nerves are unaffected in the case of osteoarthritis.
A specific type of autoimmune arthritis is rheumatoid arthritis (RA), which commonly affects the fingers, hand, and wrist but can also be present in other body parts.
RA is a genetic condition resulting in hand and finger deformities over time. RA can be managed by medication that suppresses the immune system.
Injuries can be sudden and high-impact, such as a slip and fall incident or a heavy item falling on the hand. Injuries can result in more serious damage, such as fractures of the carpals or the forearm bones. However, these types of injuries can also result in sprains/strains affecting the tendon and ligament function of the hand and wrist.
Activities that involve repetitive wrist movements, like typing or using handheld devices, can lead to overuse injuries and wrist pain.
This type of wrist pain can also occur in construction workers and laborers who rely extensively on their hands and carry heavy tools.
Strains and Sprains
Sprains and strains can occur from repetitive overuse and a fall or injury to the hand and wrist.
These injuries can heal within 3-6 months, and the healing process can be expedited and more ideal with proper treatment.
The triradiate cartilage is a unique structure on the outside of the wrist. It can become irritated from compression injuries and overuse injuries and cause dull and achy pain as well as sharp pain with wrist movements.
A ganglion cyst is a fluid-filled sac that forms commonly near joints and tendons of the wrist and hand and can be a source of pain in the wrist.
Ganglion cysts are lumps that most often appear along the tendons or joints of wrists or hands. They also can occur in ankles and feet. Ganglion cysts are typically round or oval and are filled with a jellylike fluid. They are not cancer.
The sacs are non-cancerous, harmless, and often painless, but they can become uncomfortable if they get large enough and compress on surrounding nerve structures.
Gout is a type of arthritis that occurs with the build-up of a chemical byproduct from food called uric acid. Uric acid crystals can build up in the joints, causing inflammation and pain.
Gout most commonly occurs in the big toe; however, it can also occur in the wrist and hand joints and can cause swelling, redness, and even affect mobility.
Fractures often occur from a sudden trauma such as a fall or an accident. Fractures are easily diagnosed through X-ray imaging or CT scans and require healing time.
It is important to take X-rays after a fall to detect fractures, as some wrist fractures may not heal independently and require surgical intervention.
Tendonitis is inflammation of the tendons that connect muscles to bones. Tendinitis can have varying intensities and requires proper rehabilitation, exercise therapy, and, in some cases, rest for ideal healing.
Symptoms of Wrist Pain
It is crucial to recognize that wrist pain can stem from various sources, including injuries, overuse, inflammatory conditions like arthritis, nerve compression, and more.
If you encounter persistent or severe wrist pain, seek medical attention for an appropriate diagnosis of your wrist pain.
Some common symptoms associated with wrist pain are:
Pain: Ongoing or periodic wrist discomfort that can vary in intensity and frequency.
Painful Movement: Discomfort felt during specific wrist motions or activities.
Pain with Pressure: Discomfort felt with applied force to the painful area.
Swelling: Feeling of puffiness or fluid retention around the affected area.
Warmth: Increased temperature or warmth surrounding the wrist joint, potentially signaling inflammation.
Tenderness: Responsiveness to touch or pressure over the wrist area.
Bruising: Appearance of change in color in the affected area.
Stiffness: Reduced range of motion or trouble moving the wrist joint.
Weakness: Grip loss and dropping items or inability to open bottles is a sign of wrist weakness.
Numbness or Tingling: Numbness is a lack of sensation in the region, and tingling often feels like pins and needles to the patients. This feeling is a sign of nerve irritation affecting the nerves of the wrist.
Clicking or Popping: audible pops or clicks during light and daily movements may indicate joint hypermobility.
How Wrist Pain is Diagnosed?
Diagnosing wrist pain often involves:
- A thorough intake and evaluation of the full medical history of the patient.
- Conducting a physical examination involving orthopedic testing and neurological examination.
- Using medical imaging techniques when warranted.
- Occasionally performing laboratory tests to rule out systemic conditions such as RA.
The diagnostic approach and treatment will vary and be unique to the individual presentation of the wrist pain.
As there can be many causes of wrist pain, obtaining a thorough medical history and examination is critical in developing an appropriate care plan. Below is an outline of the steps involved in diagnosing wrist pain:
Medical History and Physical Examination
Your practitioner will begin by asking about your symptoms, how the pain started, and any previous related medical conditions.
The physical examination will involve an active and passive range of motion and orthopedic testing to assess pain, swelling, movement, sensitivity, and strength.
Depending on the initial assessment, the doctor may order imaging tests to view bone integrity.
Common imaging methods include X-rays and CT scans for bones and MRI to view the soft tissue structures.
These can help visualize fractures, dislocations, and arthritis.
MRI (Magnetic Resonance Imaging): This provides detailed images of soft tissues, ligaments, tendons, and nerves, helping to identify injuries or conditions like ligament tears or carpal tunnel syndrome.
Ultrasound: This can provide real-time images of tendons, ligaments, and other soft tissues, helping diagnose issues like tendonitis or cysts.
CT Scan (Computed Tomography): Sometimes used for a more detailed view of bones and joint structures.
Blood tests might be ordered to check for inflammatory markers, such as in cases of rheumatoid arthritis.
Nerve Conduction Studies
If nerve compression is presumed, such as in carpal tunnel syndrome, nerve conduction studies and electromyography (EMG) may be performed to assess nerve function and identify abnormalities.
Depending on the suspected cause of wrist pain, you might be referred to a specialist such as an orthopedic surgeon, rheumatologist, or hand therapist for further evaluation and treatment.
Never Ignore the Pain in Your Wrist
Wrist pain can stem from various factors such as overuse, arthritis, strains, sprains, sudden injury, or even without explanation.
It is crucial to get an early diagnosis of wrist pain to prevent further complications that may be irreversible, reduce pain, and restore function.
Among the prevalent indicators of wrist pain are pain during wrist movement, swelling around the wrist, and numbness or tingling at the wrist that can extend to the fingertips.
The specific diagnosis will vary from person to person based on their unique situation and the underlying source of the wrist pain.
Ultimately, wrist pain is treated using various methods ranging from rest and physiotherapy to surgical intervention in more severe cases.