Wrist Pain

Wrist sprain

A wrist sprain is an injury to the ligaments in the wrist. A mild sprain involves just stretching of the ligaments while more severe sprains can tear the ligaments.

You should see your primary care doctor tomorrow. He or she may request imaging to make sure that there is no further damage to the bones of the wrist.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Psoriatic arthritis

Psoriatic arthritis is a complication of psoriasis, which causes the skin to become thickened, red, and scaly. Arthritis may appear before or after the psoriasis appears.

Both conditions are autoimmune diseases, where the body attacks itself, and are thought to be caused by genetic and environmental factors.

Most susceptible are people from 30 to 50 years of age with a family history of the disease and who already have psoriasis.

Symptoms include the joints on one or both sides of the body becoming painful, swollen, and hot; swelling and deformity of the fingers and toes; pitted, flaking fingernails; foot pain in the heels and soles; and joint pain in the low back pain.

It is important to seek treatment, as psoriatic arthritis can permanently damage the joints, eyes, and heart.

Diagnosis is made through physical examination, x-rays, and MRI. Blood tests and joint fluid tests can confirm psoriatic arthritis.

Treatment includes over-the-counter, nonsteroidal anti-inflammatory drugs; anti-rheumatic medication; immunosuppressants; and steroid injections for the joints. Surgery to replace damaged joints may also be tried.

Kienbock disease

Kienbock disease is a condition where the blood going to one of the small bones in the wrist is disrupted, causing the bone to die and the wrist to become stiff and painful. The cause is not known but may be related to trauma to the wrist.

You should visit your primary care physician because most people wait too long to be seen for a chronically painful wrist. It's hard to distinguish with a sprained wrist, but x-rays and MRIs will identify the problem. Treatment depends on severity, ranging from pain meds and splinting to surgery.

Rarity: Rare

Top Symptoms: hand weakness, pain in the back of the wrist, wrist pain from an injury, wrist pain that gets worse when gripping something, difficulty moving the wrist

Symptoms that always occur with kienbock disease: wrist pain from an injury, pain in the back of the wrist

Urgency: Primary care doctor

De quervain's tenosynovitis

De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. If you have de Quervain's tenosynovitis, you will feel pain upon turning your wrist, grasping anything, or making a fist.

You should visit your primary care physician to confirm the diagnosis and discuss treatment options. You can also reduce pain and swelling with over-the-counter pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve).

Rarity: Uncommon

Top Symptoms: hand numbness, thumb pain, hand weakness, weakness in one hand, numbness in one hand

Symptoms that always occur with de quervain's tenosynovitis:thumb pain

Urgency: Primary care doctor

Contusion of the wrist

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the wrist are common, often due to minor injuries.

You can treat this at home with R.I.C.E - rest (exercise as tolerated), ice (10-20 minutes at a time), compression (this is optional, with bandage or tape), and elevation.

Rarity: Rare

Top Symptoms: wrist injury, pain in one wrist, wrist pain from an injury, swelling of one wrist, wrist bruise

Symptoms that always occur with contusion of the wrist: wrist injury

Urgency: Self-treatment

Carpal tunnel syndrome

Carpal tunnel syndrome causes numbness and pain in the underside of the wrist and hand. It is caused by narrowing of the carpal tunnel passageway, which puts pressure on the nerve running through it.

Narrowing and deformity of the tunnel is most often from overuse, especially highly repetitive activities such as typing or working on an assembly line. Wrist fracture or arthritis can damage the carpal tunnel, and so can diabetes and obesity.

Symptoms include numbness and shocklike pain in the wrist, palm, and fingers. There may be weakness in the hand when trying to hold an object.

Carpal tunnel syndrome virtually always gets worse over time. Permanent damage may result, so it is important to be seen by a medical provider.

Diagnosis is made through patient history and physical examination. X-rays or electromyography testing may be used.

Rest and cold packs to the wrist will reduce swelling. Wrist splints and ergonomically correct keyboards and other devices during work are often helpful.

Corticosteroid injections and surgery may also be tried.

Buckle fracture of distal radius

A buckle fracture of the wrist, also known as a torus fracture, is a condition that are most common in children aged 5-10 years due to the elasticity of their bones. This fracture occurs when force is applied to the radius (one of the two bones of the forearm), causing the bone to split along the growth plate.

You should visit your primary care physician within the next 24 hours. The treatment for this kind of fracture is immobilization in a cast.

Rarity: Common

Top Symptoms: constant forearm pain, forearm pain from an injury, pain in one forearm, swollen forearm, wrist injury

Symptoms that always occur with buckle fracture of distal radius:forearm pain from an injury, constant forearm pain

Urgency: Primary care doctor

When to see a doctor

Sometimes the pain may persist despite at-home treatments and may require further evaluation and treatment by your physician. Your physician may recommend the following.

• Steroid injections: This is a way of directly injecting anti-inflammatory medication into an area of pain.
• Casting: Fractures are often treated with a cast.
• Aspiration: If a cyst is the cause of your pain, your doctor may use a needle to remove the fluid inside.
• Antibiotics: Only pain caused by a bacterial joint infection or Lyme disease requires antibiotic treatment.
• Rheumatologic medications: A rheumatologist may prescribe a wide range of medications if your joint pain is caused by autoimmune or crystal diseases.
• Surgery: While a more invasive option, a surgeon can help relieve pain caused by nerve compression, fractures, cysts, or ligament tears.

When it is an emergency

You should seek care immediately if:

• Your joint is very warm, red, or swollen
• You have sudden-onset weakness: Especially if it affects an entire arm or leg or if you also have slurred speech or a droopy face
• The pain is very severe
• Your wrist is deformed or looks pale or is very cold: Especially after trauma or a fall

What does carpal tunnel feel like?

Carpal tunnel is most commonly characterized by numbness and tingling of the first three fingers (thumb, forefinger, middle finger, and half of the fourth finger). You may also experience a burning sensation in these same areas, typically worse at night. Carpal tunnel may occur after typing at a computer for a long time, but periodically shaking or "wringing out" the hands may help. You can purchase a supportive bumper or pad that may alleviate or prevent carpal tunnel syndrome.

Why do my wrists hurt?

Your wrists may hurt for a variety of reasons. Trauma to the wrist is a common reason. Exercises involving wrist movement like jumping rope, playing tennis, or even sweeping with a broom may cause muscle strain that should resolve over time. Carpal tunnel syndrome is also a common cause of wrist pain and can occur if you regularly type at the computer for multiple hours per day.

What is arthritis in the hand?

Arthritis in the hand is a swelling of the joints in the hand, usually due to a mixture of wear and tear and inflammation from your immune system. In the case of wear-and-tear, this is called osteoarthritis. If it is caused by your own immune system, it is most commonly called rheumatoid arthritis.

What causes swollen wrists?

Fractures are some of the most common causes of wrist swelling. Fracturing smaller bones may not result in apparent displacement or deformation of the wrist but may present with severe swelling. Usually, a fall or trauma precedes a fracture. Swollen wrists may be caused by different types of arthritis, though the most common types of arthritis cause swelling in the joints of the fingers, not the wrists.

Can you have gout on your wrist?

Gout most commonly occurs in the big toe of the foot as well as knees and elbows. It can occur in the wrist but is less common [8]. If you have a prior diagnosis of gout and experience similar symptoms in your wrist that are responsive to your usual gout pain regimen or are prevented by your uric acid drugs, you may have gout in your wrist.

Questions your doctor may ask about wrist pain

• Have you ever been diagnosed with diabetes?
• Push the backs of your hands together like in this picture, and hold for 1 minute. Do you notice any numbness, tingling, or pain in either of your fingers/hands? (This is called the Phalen's maneuver.)
• Is your wrist pain worse when holding something?
• Lightly tap on your inner wrist. Does this cause your symptoms to reappear?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.