Definition and Overview

Wrist stiffness or tightness refers to a decreased ability to move the wrist through its normal range of motion. This can affect flexion (bending forward), extension (bending backward), and radial/ulnar deviation (side-to-side movement). The wrist is a complex joint involving eight small carpal bones, numerous ligaments, and tendons, making it susceptible to various conditions that can cause stiffness.

This symptom can develop gradually over time or occur suddenly following an injury. The stiffness may be worse in the morning, improve with movement, or worsen with activity depending on the underlying cause. Some people describe it as feeling like their wrist is "locked" or "frozen," while others experience a constant tight sensation that limits their daily activities.

Wrist stiffness significantly impacts quality of life as we rely on wrist flexibility for countless daily tasks - from typing and writing to cooking and personal care. Understanding the cause is essential for proper treatment, as management strategies vary greatly depending on whether the stiffness results from injury, overuse, arthritis, or other conditions.

Common Causes

Injuries and Trauma

  • Arm fractures: Affecting wrist mobility
  • Hand fractures: Including wrist bones
  • Wrist sprains: Ligament injuries
  • TFCC tears: Cartilage damage
  • Scaphoid fractures: Common wrist bone break
  • Distal radius fractures: Colles' fracture
  • Post-cast stiffness: After immobilization
  • Scar tissue: Following surgery or injury

Repetitive Strain and Overuse

  • Carpal tunnel syndrome: Nerve compression
  • Tendinitis: Inflamed tendons
  • De Quervain's tenosynovitis: Thumb-side pain
  • Ganglion cysts: Fluid-filled lumps
  • Repetitive strain injury: From computer use
  • Trigger finger: Tendon catching
  • Intersection syndrome: Forearm tendon friction

Arthritis and Systemic Conditions

  • Osteoarthritis: Wear-and-tear arthritis
  • Rheumatoid arthritis: Autoimmune inflammation
  • Psoriatic arthritis: Associated with psoriasis
  • Gout: Crystal deposits in joints
  • Lupus: Systemic autoimmune disease
  • Diabetes: Affects connective tissue
  • Dupuytren's contracture: Hand/finger tightening
  • Complex regional pain syndrome: Nerve disorder

Associated Symptoms

Local Symptoms

  • Wrist pain
  • Swelling
  • Clicking or popping sounds
  • Warmth in the joint
  • Numbness or tingling
  • Weakness in grip
  • Morning stiffness
  • Visible deformity

Functional Limitations

  • Difficulty with fine motor tasks
  • Problems typing or writing
  • Trouble opening jars
  • Pain with weight bearing
  • Difficulty with push-ups
  • Problems with daily hygiene
  • Sports limitations
  • Sleep disruption from pain

When to Seek Medical Attention

Seek prompt medical care if wrist stiffness occurs with:

  • Sudden onset after trauma or fall
  • Visible deformity or misalignment
  • Severe pain or inability to move wrist
  • Numbness or tingling in fingers
  • Signs of infection (fever, red streaks)
  • Progressive loss of function
  • Stiffness spreading to other joints
  • Night pain disrupting sleep
  • No improvement after 2 weeks of home care
  • Weakness or dropping objects
  • Color changes in hand or fingers

Diagnostic Approach

Healthcare providers evaluate wrist stiffness through:

Diagnostic Methods

  • Physical examination: Range of motion testing
  • X-rays: Check for fractures, arthritis
  • MRI: Soft tissue evaluation
  • CT scan: Detailed bone imaging
  • Ultrasound: Tendon and ligament assessment
  • Nerve conduction studies: For carpal tunnel
  • Blood tests: Inflammatory markers, arthritis
  • Arthroscopy: Direct joint visualization

Treatment and Management

Conservative Treatment

  • Rest and activity modification
  • Ice therapy for acute inflammation
  • Heat therapy for chronic stiffness
  • Gentle stretching exercises
  • Range of motion exercises
  • Wrist splints or braces
  • Anti-inflammatory medications
  • Ergonomic workplace setup

Medical Interventions

  • Physical therapy
  • Occupational therapy
  • Corticosteroid injections
  • Viscosupplementation
  • Platelet-rich plasma (PRP)
  • Surgery for severe cases
  • Arthroscopic debridement
  • Joint replacement (rare)

Exercises and Prevention

Maintain wrist flexibility and prevent stiffness:

  • Wrist circles: Gentle rotation in both directions
  • Prayer stretch: Palms together, lower hands
  • Wrist flexor stretch: Extend arm, pull fingers back
  • Wrist extensor stretch: Extend arm, push hand down
  • Tendon glides: Sequential finger movements
  • Regular breaks: From repetitive activities
  • Proper ergonomics: Neutral wrist position
  • Strengthening exercises: With resistance bands
  • Warm up: Before sports or heavy lifting
  • Protective gear: Wrist guards for sports