The wrist joint is a mobile joint that is formed by bones, ligaments, tendons, and muscles. Wrist pain is felt when there is an injury to any of the structures that form the wrist joint.
Let us not get bored with the anatomy of the wrist joint, so, in this post, we will be looking at the major injuries to the wrist that can cause pain, how it can be treated, and how it can be prevented.
What Can Cause Wrist Pain?
1. Poor Positioning Of The Wrist
While we use our phones or laptops, we tend to position our wrist in a hyper-extended or hyper-flexed position. The wrist does not usually have support. By the time we are done, we feel a sharp pain at the wrist and this can affect our ligaments and tendons.
A dislocated wrist is when the bones that form the wrist joint are out of alignment. This is usually caused by a fall on an outstretched wrist. The displacement of the bones from their original anatomical position will cause pain at the wrist.
A fracture is a break in the continuity of the bone. A fractured wrist is a broken wrist. A bone broken in the wrist can still be aligned or it can be displaced. One of the major symptoms of a fracture is pain.
A sprain is an injury to the ligaments. The ligaments are tissues that join two or more bones together to form joints. The ligament can either be overstretched, partially torn or completely torn. This type of injury can be caused by falling on your wrist or a sudden twist of the wrist while performing a major activity. Major signs of a sprained wrist are pain and swelling.
Arthritis is the wear and tear of the bones at a joint. It is defined as a degenerative disease because it affects us as we grow older. The cartilage that is found at the surfaces where the bones touch begins to wear off and causes the bones to come in direct contact with themselves. This can cause pain at the wrist joint.
6. Swollen Tendon
Tendons are soft tissues that connect muscles to bones. This is usually described as an overuse injury which typically means using the wrist more often due to our jobs or recreational activities. A major form of this type of injury is called de Quervain tenosynovitis which affects the tendon on the thumb side of the wrist joint.
It is also known as blackberry thumb or mother’s thumb. It can cause pain and eventually lead to muscle weakness.
7. Nerve Compression
The median nerve is a major nerve that passes through the carpal tunnel, found at the wrist joint just below your palm, to supply the fingers. The carpal bones of the wrist form the carpal tunnel. A swollen tendon or a carpal bone dislocation can compress this nerve causing pain at the wrist and a tingling sensation in the fingers. This condition is known as carpal tunnel syndrome.
Other symptoms that come with pain at the wrist joint based on the causes of pain discussed earlier are:
- Reduced movement at the wrist joint
- Tingling sensation in the fingers
- Grinding sound while trying to move the wrist
- Difficulty gripping or grasping things
- Difficulty lifting heavy objects
- Pain while writing
- Muscle weakness
How Is It Treated?
1. Do Not Massage Or Move The Wrist Joint
This is because doing this can add to the injury rather than helping the situation. Massaging the wrist or moving it can increase the effect of the chemicals that cause inflammation and add to the pain and make the injury worse than what it was originally.
2. See A Doctor
A doctor will ask questions that may help to pinpoint a likely cause of the pain. To further confirm the diagnosis, a diagnostic test will be required. After seeing the results from the tests, medications are usually prescribed and the major cause of pain is treated and then a referral is written to the physiotherapist for rehabilitation.
3. Diagnostic Tests
As we discussed earlier, different types of injuries can cause pain at the wrist joint but we need to pinpoint what is causing the pain because they are managed differently. An X-ray shows if there is a fracture or dislocation at the wrist joint while a CT scan, an ultrasound scan or an MRI can show injury to the soft tissues like the ligaments or tendons.
Protect – The wrist should be protected from another form of injury. For a fracture, a cast is applied to the broken wrist to stop movement at the wrist as the broken bone heals in order to avoid complications that may arise, such as a displaced fracture.
Rest – All movements at the wrist need to be placed on hold. The wrist is used for a lot of things like writing, eating, typing, texting, driving, to mention a few. A wrist brace is usually recommended for other conditions except for a fracture or a severe dislocation.
Ice – Ice reduces swelling and numbs the pain. An ice pack is placed on the painful wrist joint for 15 minutes to reduce the swelling and relieve pain at the wrist. This can be done every 3 to 4 hours for the first 72 hours of injury.
Compression – A compression bandage is usually wrapped firmly, not tightly, around the wrist joint to reduce swelling at the wrist.
Elevation – Dropping the wrist joint can increase the swelling. Elevating the joint on a pillow or wearing a sling to raise the wrist joint can help reduce swelling at the injured joint.
Pain relieving medications are prescribed for a particular period of time. Anti-inflammatory drugs are also given to help relieve pain and reduce swelling. Topical gels with anti-inflammatory medication as their active ingredient are applied gently on the wrist (not rubbed or massaged in) to help relieve pain.
A physiotherapist helps you recover from an injured wrist and train you to get back to your normal daily activities which had been affected by the painful wrist joint. The physiotherapist will assess the wrist and recommend other forms of treatment. The physiotherapist looks out for:
- Muscle weakness
- The range of motion at the wrist joint and the fingers especially after the cast has been removed
After assessing the wrist joint, the physiotherapist will design realistic treatment goals with you. The goals and treatment will be:
- Reduce pain by using thermal therapy such as ice, heat or therapeutic ultrasound. Electric modalities like a nerve or muscle stimulator can help to relieve pain as well
- Swelling can be done by using special forms of therapeutic massage such as effleurage or using ice and heat and also recommend exercises to reduce swelling.
- Strengthen weak muscles that can occur due to inactivity at the wrist. Exercises are prescribed based on the presenting features of the wrist and hand and as healing progresses, more exercises are added to achieve optimal function at the wrist joint.
- Increase range of motion at the wrist especially if there are some levels of joint movements. this can be achieved passively or actively.
- Proper positioning of the wrist while typing or doing other forms of activities using the wrist will be taught to you by the physiotherapist to avoid re-injury to the injured wrist.
- Put your hands in front of your chest with palms facing each other
- Put the palms together
- Let your elbows point out and feel the stretch on your wrists
- Hold for 5 – 10 seconds and release
- Stretch your hand out in front of you with your palm facing the ceiling
- Use the other hand to bend your wrist forward till your fingers point towards the ceiling
- Hold for 5 seconds
- This stretches out the wrist extensors.
- For the wrist flexors, the palm will face the floor
- The other hand will bend the wrist till the fingers point towards the ceiling
- This will stretch out the wrist flexors.
- Get a softball or a rolled up towel
- Squeeze for 10 seconds and release
- Repeat 5 times
Wrist Flexion Exercise
- This can be done by using a resistance band or a dumbbell
- Place your forearm on a table or on your thigh with your palm facing the ceiling
- Place the hand in a way that the wrist to your fingers are not supported on the table
- Put the dumbbell in your hand or hold the resistance band in your hand with the other part of the band under the chair you are sitting on or under your feet
- Bend your wrist upwards till your palm faces you and return to the original position
- This can be repeated 10 times
Wrist Extension Exercise
- This is the reverse of the wrist flexion exercise.
- In this exercise, start with the palm facing the floor and the wrist is bent upwards
Preventing A Re-injury
- Stretch the wrist joint. If you have been at the computer for over an hour typing, stretch your wrist joint. This will stretch out tight ligaments, muscles and tendons that may cause pain if not stretched out regularly.
- Wear wrist support when you will be doing a lot of work with your wrist.
- Give your wrist a break. The wrist gets tired and the only way a body part can report being tired to you is a pain. Instead of waiting for the pain, try and rest your wrist every hour especially when using your phone.
- Ensure your work station is comfortable. Use your laptop in a way that the wrist is well supported on the table and it is not hyper-extended or hyper-flexed.
Wrist pain is caused by any form of injury or overuse to the major anatomical structures at the wrist. Although some of them may not be avoided, such as those caused by trauma, others can be prevented as explained above.