Wrist Pain

Wrist pain affects millions of people, from office workers to athletes, significantly impacting daily activities like typing, gripping, and lifting. The wrist's complex structure of bones, ligaments, tendons, and nerves makes it vulnerable to various injuries and conditions. Pain can develop suddenly from trauma or gradually from repetitive use, arthritis, or nerve compression. Understanding the specific location, timing, and nature of your wrist pain helps determine whether it needs immediate attention or can be managed with conservative care.

⚠️ Seek Immediate Medical Care For:

  • Obvious deformity or bones out of position
  • Inability to move wrist or fingers
  • Numbness or tingling in entire hand
  • Severe pain with any movement
  • Signs of infection (fever, red streaks, warmth)
  • Cold, pale, or blue hand
  • Severe swelling that develops rapidly
  • Open wound or visible bone
  • Loss of pulse in wrist
  • Pain after significant trauma or fall

Understanding Wrist Pain

The wrist is a complex joint where the two forearm bones (radius and ulna) meet eight small carpal bones. This intricate structure allows for the wide range of motion needed for hand function but also makes the wrist susceptible to various problems. Pain can originate from bones, cartilage, ligaments, tendons, or nerves.

Wrist pain patterns provide diagnostic clues: pain with gripping suggests tendon issues, numbness indicates nerve involvement, and pain with twisting motions often points to ligament problems. The timing of pain - whether worse in the morning, with activity, or at night - also helps identify the underlying cause.

Common Causes

Repetitive Strain

  • Carpal tunnel syndrome
  • Tendinitis (De Quervain's)
  • Repetitive strain injury (RSI)
  • Ganglion cysts
  • Trigger finger
  • Computer use syndrome

Injuries

  • Wrist sprains
  • Fractures (scaphoid, radius)
  • Ligament tears
  • TFCC injury
  • Dislocations
  • Contusions

Arthritis

  • Osteoarthritis
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Post-traumatic arthritis
  • Gout
  • Pseudogout

Other Causes

  • Nerve compression
  • Kienböck's disease
  • Intersection syndrome
  • Ulnar impaction
  • Systemic diseases
  • Tumors (rare)

Common Wrist Conditions

Carpal Tunnel Syndrome

  • Median nerve compression
  • Numbness in thumb and first three fingers
  • Night pain and tingling
  • Weakness in grip
  • Worse with repetitive activities

De Quervain's Tendinitis

  • Pain on thumb side of wrist
  • Worse with gripping or twisting
  • Swelling near base of thumb
  • Difficulty moving thumb
  • Common in new parents

Wrist Arthritis

  • Stiffness, especially in morning
  • Swelling and warmth
  • Decreased range of motion
  • Grinding sensation
  • Progressive worsening

Pain Location and Patterns

Palm Side (Volar)

  • Often carpal tunnel syndrome
  • Tendon problems
  • Ganglion cysts
  • Median nerve issues

Back of Wrist (Dorsal)

  • Ganglion cysts common
  • Extensor tendinitis
  • Kienböck's disease
  • Scapholunate ligament injury

Thumb Side (Radial)

  • De Quervain's tendinitis
  • Arthritis of thumb base
  • Scaphoid fracture
  • Radial nerve problems

Pinky Side (Ulnar)

  • TFCC tears
  • Ulnar impaction syndrome
  • ECU tendinitis
  • Ulnar nerve compression

Associated Symptoms

Wrist pain often occurs with:

  • Swelling: Visible puffiness or fullness
  • Stiffness: Difficulty moving wrist
  • Numbness/tingling: In fingers or hand
  • Weakness: Dropping objects, poor grip
  • Clicking/popping: With movement
  • Heat/redness: Signs of inflammation
  • Night pain: Disrupting sleep
  • Forearm pain: Radiating up arm

Risk Factors

  • Repetitive activities: Typing, assembly work, sports
  • Poor ergonomics: Improper workstation setup
  • Previous injuries: Old fractures or sprains
  • Age: Arthritis risk increases
  • Gender: Women more prone to some conditions
  • Pregnancy: Fluid retention affects nerves
  • Medical conditions: Diabetes, thyroid disease
  • Sports: Gymnastics, racquet sports, golf

Medical Evaluation

Physical Examination

  • Range of motion testing
  • Strength assessment
  • Special provocative tests
  • Palpation for tenderness
  • Swelling evaluation
  • Nerve function tests

Diagnostic Tests

  • X-rays: Show fractures, arthritis
  • MRI: Soft tissue injuries
  • Ultrasound: Tendon problems, cysts
  • EMG/NCS: Nerve function
  • CT scan: Complex fractures
  • Arthroscopy: Direct visualization

Treatment Options

Conservative Care

  • Rest and activity modification
  • Wrist splints or braces
  • Ice therapy
  • Anti-inflammatory medications
  • Ergonomic adjustments
  • Physical therapy

Medical Treatments

  • Corticosteroid injections
  • Prescription medications
  • Occupational therapy
  • Custom splinting
  • Ultrasound therapy
  • PRP injections

Surgical Options

  • Carpal tunnel release
  • Tendon repair
  • Fracture fixation
  • Arthroscopy
  • Joint fusion
  • Joint replacement

Alternative Therapies

  • Acupuncture
  • Massage therapy
  • Chiropractic care
  • Yoga or stretching
  • Heat therapy
  • Topical treatments

Self-Care and Exercises

Immediate Care

  • RICE protocol: Rest, Ice, Compression, Elevation
  • Avoid aggravating activities: Temporary modification
  • Gentle range of motion: Prevent stiffness
  • Over-the-counter pain relief: As directed

Stretching Exercises

  • Wrist flexor stretches
  • Wrist extensor stretches
  • Prayer stretches
  • Tendon glides
  • Nerve glides for carpal tunnel
  • Finger stretches

Strengthening (when appropriate)

  • Wrist curls with light weights
  • Grip strengthening
  • Resistance band exercises
  • Putty exercises
  • Eccentric strengthening

Prevention Strategies

  • Ergonomic workspace: Proper keyboard and mouse position
  • Regular breaks: Every 30-60 minutes
  • Stretching routine: Before and after activities
  • Proper technique: In sports and work
  • Gradual increases: In activity levels
  • Wrist support: During high-risk activities
  • Maintain fitness: Overall strength and flexibility
  • Address problems early: Don't ignore pain

When to See a Doctor

Consult a healthcare provider for:

  • Pain lasting more than a few days
  • Swelling that doesn't improve with rest
  • Inability to use wrist normally
  • Numbness or tingling in fingers
  • Signs of infection
  • Pain that wakes you at night
  • Visible deformity
  • Recurrent pain episodes
  • Pain affecting work or daily activities