Wrist Pain

Wrist pain is an extremely common complaint yet there are various causes, including Carpal Tunnel Syndrome (CTS), Tendonitis and Sprain. Making of an accurate diagnosis is important for directing an appropriate treatment at the cause.

Carpal Tunnel Syndrome occurs when the median nerve is pinched as it passes through the wrist at the carpal tunnel (a passage that is made up of wrist bones at the bottom and a tight ligament on the top). Compression of the median nerve affects both its sensory and motor functions. Symptoms include pain, numbness, tingling and weakness. The areas usually affected are the wrist, the palm (especially thenar eminence), the thumb, index finger, and middle finger, sometimes pain may extend up to the arm. People who are over 40 years of age and heavily involved in work which depend on wrist motion such as lifting , typing, driving, racquet sports are at higher risk to develop CTS. Some systemic conditions are associated with CTS also, including diabetes, hypothyroidism, arthritis, and pregnancy.

Wrist Tendonitis, also called Tenosynovitis, is a common condition characterized by irritation and inflammation of the tendons around the wrist joint. As many tendons surround the wrist joint, Tendonitis may involve a single tendon or more. Often Wrist Tendonitis occurs at points where the tendons cross each other or pass over a bony prominence. Normally wrist tendons slide through smooth sheaths (or tenosynovium) as they pass by the wrist joint, which allow the tendons to glide smoothly in a low-friction manner. When wrist tendonitis occurs, these tendon sheaths become thickened and constrict the gliding motion of the tendons. Irritation and inflammation of the wrist tendons make wrist and finger movements painful and difficult.

One can sustain a Wrist Sprain when the ligaments of the wrist are stretched beyond their normal limits. The ligaments around the wrist joint are tough and fibrous tissues that help to stabilize the position of the hand and allow controlled motions. Wrist sprains are graded according to the severity of the injury:

  1. Grade I Wrist Sprain:

    A Grade I wrist sprain is a mild injury, the ligaments are stretched, but no significant tearing has occurred.

  2. Grade II Wrist Sprain:

    A Grade II wrist sprain is a moderate injury, the ligaments may be partially torn.

  3. Grade III Wrist Sprain:

    A Grade III wrist sprain is a severe sprain, the ligaments are completely torn, and there may be instability of the joint.

Wrist Sprains tend to occur after falls and sports injury. Common symptoms include pain with wrist movement, swelling, bruising and burning sensations around the wrist.

For the presence of wrist pain which persist beyond a few days, unusual swelling or bruising around the wrist, limitation of wrist motion, or difficulty to carry objects, the family doctor or orthopedic surgeon should be consulted. Sufficient rest, ice treatment and wrist support can help to alleviate acute symptoms. Medications can provide a fast track to pain control and Physiotherapy can relieve the symptoms and rehabilitate towards full recovery.