Wrist pain

Overview

Wrist pain is often caused by sprains or fractures from sudden injuries. But wrist pain also can result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome.

Because so many factors can lead to wrist pain, diagnosing the exact cause can be difficult. But an accurate diagnosis is essential for proper treatment and healing.

Symptoms

Wrist pain may vary, depending on the cause. For example, osteoarthritis pain often is described as being similar to a dull toothache. Carpal tunnel syndrome usually causes a pins and needles feeling. This tingling sensation often occurs in the thumb and index and middle fingers, especially at night. The precise location of wrist pain also provides clues to what's behind the symptoms.

When to see a doctor

Not all wrist pain requires medical care. Minor sprains and strains usually respond to ice, rest and pain medicines you can buy without a prescription. But if pain and swelling last longer than a few days or become worse, see your healthcare professional. Delayed diagnosis and treatment can lead to poor healing, reduced range of motion and long-term disability.

Causes

Damage to any of the parts of your wrist can cause pain and affect your ability to use your wrist and hand. The damage may result from:

Injuries

• Sudden impacts. Wrist injuries often occur when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures. A scaphoid fracture involves a bone on the thumb side of the wrist. This type of fracture may not show up on X-rays immediately after the injury.
• Repetitive stress. Any activity that involves wrist motion that you do again and again can inflame the tissues around joints or cause stress fractures. Some examples include hitting a tennis ball, bowing a cello or driving cross-country. The risk of injury is increased when you perform the movement for hours on end without a break. De Quervain tenosynovitis is a repetitive stress injury that causes pain at the base of the thumb.

Arthritis

• Osteoarthritis. This type of arthritis occurs when the cartilage that cushions the ends of the bones deteriorates over time. Osteoarthritis in the wrist is uncommon and usually occurs only in people who have injured that wrist in the past.
• Rheumatoid arthritis. A disorder in which the body's immune system attacks its own tissues, rheumatoid arthritis commonly involves the wrist. If one wrist is affected, the other one usually is too.

Other diseases and conditions

Wrist bones Enlarge image

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Wrist bones

Wrist bones

Your wrist is made up of eight small bones, called carpal bones, plus two long bones in your forearm — the radius and the ulna. The most commonly injured carpal bone is the scaphoid bone, located near the base of your thumb.

• Carpal tunnel syndrome. This syndrome develops when there's increased pressure on the median nerve as it passes through the carpal tunnel. The carpal tunnel is a passageway in the palm side of the wrist.
• Ganglion cysts. These soft tissue cysts occur most often on the part of the wrist opposite the palm. Ganglion cysts may be painful, and pain may either worsen or improve with activity.
• Kienbock disease. This disorder typically affects young adults and involves the progressive collapse of one of the small bones in the wrist. Kienbock disease occurs when there is not enough blood supply to this bone.

Risk factors

Wrist pain can happen to anyone — whether you're very sedentary, very active or somewhere in between. But the risk may be increased by:

• Sports participation. Wrist injuries are common in many sports, both those that involve impact and those that involve repetitive stress on the wrist. These can include football, bowling, golf, gymnastics, snowboarding and tennis.
• Repetitive work. Almost any repetitive activity that involves your hands and wrists may cause wrist pain. Even knitting and cutting hair, if performed forcefully enough and often enough, can lead to significant wrist pain.
• Certain diseases or conditions. Pregnancy, diabetes, obesity, rheumatoid arthritis and gout may increase the risk of developing carpal tunnel syndrome.

Prevention

It's impossible to prevent the unforeseen events that often cause wrist injuries, but these basic tips may offer some protection:

• Build bone strength. Getting adequate amounts of calcium can help prevent fractures. For most adults, that means 1,000 to 1,200 milligrams a day.
• Prevent falls. Falling forward onto an outstretched hand is the main cause of most wrist injuries. To help prevent falls, wear sensible shoes. Remove home hazards. Light up your living space. And install grab bars in your bathroom and handrails on your stairways, if necessary.
• Use protective gear for athletic activities. Wear wrist guards for high-risk activities, such as football, snowboarding and in-line skating.
• Pay attention to ergonomics. If you spend long periods at a keyboard, take regular breaks. When you type, keep your wrists in a relaxed, neutral position. An ergonomic keyboard and a foam or gel wrist support may help.