What is Wrist Pain?

The wrist is a complex joint made up of an arrangement of small bones, ligaments, and tendons that join the forearm to the hand. The normal function of the wrist results from the harmonious and synchronized functioning of these structures, giving it mobility and stability, which allows for the globality of functions of the hand, from fine motor control, in activities such as writing or playing instruments to activities that involve a strong grip such as hammering or carrying heavy objects.

Wrist pain is a symptom that results from injury or dysfunction of any of these elements and can affect the ability to use the wrist and hand. The pain can affect either the left wrist, the right, or even both wrists, depending on the etiology of the injury, being more frequent in individuals whose professions require repetitive activities and in athletes.

Due to the complexity of this joint, pain can be caused by several causes, such as sprains or fractures, following traumatic episodes, or it can result from repetitive stresses, arthrosis, or peripheral nerve diseases, as discussed in more detail below.

Causes for Wrist Pain

The main causes of wrist pain are described below.

1. Traumatic Injury

Wrist pain can result from trauma or a fall onto the arm or hand, which can lead to wrist sprains or fractures. In these cases, pain is usually associated with edema (“swelling”) and local hematoma.

2. Repetitive Stress

Any activity that involves repetitive wrist movements can cause injuries such as inflammation or stress fractures at the wrist. This situation is particularly common in certain professions that involve repetitive activities and in some sports such as cycling or in the case of tennis players.

3. Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common cause of hand numbness and occurs when the median nerve, responsible for hand sensitivity, becomes tight on your channel at the wrist. This pathology usually causes pain in the hand and fingers, numbness, and weakness in the hand.

Risk factors for developing carpal tunnel syndrome include obesity, diabetes, osteoarthritis, pregnancy. This pathology is also related to the performance of repetitive movements or the use of equipment that causes vibration in the hand and wrist.

4. Synovial Cyst

The synovial cyst or synovial cyst is the most frequent tumor of the hand. It is a benign tumor filled with mucous content (mucin) and is usually connected to the capsule of the synovial joint or to the synovial sheath of the adjacent tendon.

They can be painful or not, increase or decrease with time or in relation to activity.

5. Tenosynovitis

The tendinitis of the wrist, also called tenosynovitis, is a common disorder characterized by irritation and inflammation of the tendons of the wrist. Wrist tenosynovitis can affect one or more tendons. This type of injury often occurs at points where tendons cross, pass through bony prominences or traverse osteoligamentous tunnels. These are possible sites of irritation that can lead to discomfort or pain at the wrist.

6. Triangular Fibrocartilage Lesion

The triangular fibrocartilage is located in the ulnar side (inner side) of the handle. It works as a cushion and support for the small bones. Cartilage can wear out over time or break as a result of a traumatic injury, causing wrist pain.

7. Osteoarthrosis

This type of injury occurs when there is the deterioration of the cartilage that covers the bones of the wrist joint, leading to pain and limitation of joint mobility. It is a rare situation at the wrist level, with the progressive onset, and that usually affects middle-aged or older individuals with a family history of this pathology or who have suffered wrist injuries in the past.

8. Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that causes pain, swelling, and inflammation of the joints, often causing pain in the wrist and hand and may also lead to numbness of the fingers and hands.

9. Kienbock’s Disease

The Kienbock disease is a disease where the blood supply to one of the small bones of the wrist, the lunate, is interrupted. Since bone is living tissue, it requires an adequate blood supply. If this fails, the bone can die, a situation called osteonecrosis. This type of injury results in a painful, stiff wrist that, over time, can lead to osteoarthritis.


Wrist Pain Diagnosis

The symptoms may vary depending on the cause. There may be the pain of variable intensity and location. This can be located at the level of the wrist or radiate to the arm and hand. It can appear at rest or with movement. In addition to pain, other symptoms may develop. Symptoms resulting from a traumatic episode may include edema (“swelling”), bruising, and limited mobility. Numbness and loss of strength are symptoms that often also arise when the pain is due to carpal tunnel syndrome.
Joint stiffness, difficulty in handling objects, or joint crackling are also symptoms that can accompany wrist pain in certain pathologies. It is important to carry out an attentive and complete clinical examination to assess the diagnostic hypotheses and guide the type of auxiliary diagnostic tests indicated for each case.

Radiography (Rx) is a fundamental test in the assessment of the integrity of osteoarticular structures. Ultrasound can also be particularly useful in evaluating soft tissue at the wrist, such as tendons and capsuloligamentous elements.

Frequently, there may be a need to perform other tests that allow more detailed information to be obtained, such as Computed Tomography (CT or CAT), Magnetic Resonance (MRI), arthro-resonance, or wrist arthroscopy.

It is important to seek medical attention when wrist pain is a consequence of a traumatic episode or persists and interferes with activities of daily living, numbness or changes in finger and hand sensitivity coexist, limitation of hand and wrist movements, or decreased strength of the hand.

Wrist Pain Treatment

The treatment of wrist pain depends on the cause of the pain and its severity. The therapeutic plan must be guided by a specialist physician who is familiar with this anatomical area. The severity of injuries varies widely. Some injuries are simple and have a favorable prognosis, and may only need rest and analgesia to speed up their recovery. Others, in turn, maybe more serious, requiring specialized follow-up and counseling for their treatment, and may involve more aggressive therapies.

Initially, and in the presence of moderate to severe pain, rest, administration of medications (or medicines) such as analgesics (e.g., paracetamol) and anti-inflammatory drugs (e.g., ibuprofen), and the application of ice can relieve pain and reduce inflammation. In some cases, it may be useful to use immobilizing orthoses or splints to minimize wrist movements, promoting healing or reducing inflammation of the affected structures. Physical therapy can also help improve symptoms. In some cases, it may be necessary to perform local infiltrations with potent anti-inflammatory drugs to eliminate or reduce pain and inflammation.

The surgical treatment (operation) to treat wrist pain may be indicated in cases where there is a failure of conservative treatment. In recent years, the evolution in surgical techniques in the treatment of wrist pathology has allowed the performance of an increasing number of procedures, which are less and less invasive and allow a faster and more complete recovery.

Dr. Munish Lal is an expert in providing interventional and non-surgical treatments for wrist pain. Contact today to book your appointment 424.254.3592