Wrist pain: common causes and treatments

The wrist is a complex area, capable of a lot of movement and fine control. Because of this, wrist pain can come on gradually due to a number of factors.

Chronic conditions causing wrist pain

A chronic condition is a long-lasting issue, often related to illness or overuse. Common chronic conditions of the wrist include de Quervain's tenosynovitis, bursitis, carpal tunnel syndrome, and arthritis.

De Quervain's tenosynovitis is when tendons of the thumb become inflamed. Pain and swelling are located on the back and outside part of the wrist and can extend toward the elbow. Other tendons around the wrist can also become aggravated with repetitive use – things like playing tennis or using work tools continuously.

Bursitis is the inflammation of the bursae – small sacks of fluid found in various parts of the body, which help reduce friction and help structure move freely. Bursae of the wrist, like those found on the back/outside area of the wrist, can become inflamed and irritated with heavy lifting or overuse. Inflammation issues like bursitis are commonly managed by physiotherapists and occupational therapists. Treatment will aim to reduce load through the area, manage symptoms, and gradually develop strength, conditioning, and returning to function and activities. For more serious cases, you may need to be referred to a specialist for other treatments such as specialised splinting, or a corticosteroid injection.

Carpal tunnel syndrome is where a nerve in the wrist is compressed. Symptoms include a ‘burning’ pain in the palm and numbness of the first three fingers. These symptoms can be worse at night and, in some instances, pain can radiate to the forearm, elbow or even up to the shoulder.

Arthritis can also occur in the wrist, where the cartilage between joints becomes worn and damage occurs. Your GP, physiotherapist and occupational therapist will help you with managing and improving your symptoms, maximising strength, conditioning and joint health, and helping you return to function.

Acute conditions causing wrist pain

An acute condition comes on suddenly and can be severe. In the wrist, this can include things like sprains, broken bones, and other sudden injuries.

Many injuries to the wrist occur due to falling onto an outstretched hand. This type of incident can cause various types of fractures, most commonly occurring in the bones of the forearm, such as the radius, or the smaller bones of the hand, such as the scaphoid.

Ligament strains or ruptures are also common from this type of fall. Ligaments are found in various areas of the wrist and hand, joining bones and functioning to provide stabilisation to these joints.

Treating acute wrist injuries

After a fall onto the hand, a minor injury might resolve itself within 1-3 days. If your injury gives you mild pain and it eases, and full use of the hand or wrist returns, there is no need to seek further medical treatment unless you’re concerned.

More intense pain, significant swelling and bruising, or pain which lasts longer than a few days should be investigated by your doctor.

Acute injuries of the wrist may be very painful at the location of injury, with associated swelling and bruising.

The R.I.C.E.R method is very useful in treatment:

• REST the joint, limiting movement
• Apply ICE for 15 minutes every 2 hours to reduce swelling
• Apply gentle COMPRESSION, such as a compression bandage
• ELEVATE the area above heart level, to reduce the amount of pain and swelling
• And REFER, by going to see your GP or physiotherapist for guidance and management

Mild strains or bruising may simply require rest and symptom management to encourage quick recovery. More significant injury to tendons or ligaments may require braces or splints to immobilise the area and ensure correct healing occurs.

A more serious injury such as a fracture, or tendon or ligament rupture, may require more significant management such as casting or, in some cases, surgery.

Cases which require a longer recovery can often benefit from a rehabilitation program created by a physiotherapist and/or occupational therapist, as pain and immobilisation can cause loss in strength, range of movement, and slow your return to daily activities. Rehabilitation can ensure you regain the strength and conditioning in your wrist, achieve greater movement and function, and return to the activities that you love.

You will be referred to a specialist doctor by your GP, physiotherapist or occupational therapist if required. For example, other assessments may be required, such as MRIs or x-rays. These are only used if a fracture is suspected, if the extent of your injury is unclear, or if further information is required in order to manage your rehabilitation. Another reason may be for a surgical opinion, if it is deemed necessary.

With all wrist injuries, your GP will guide you regarding the extent of the injury, and the management that is required.

At Ramsay Health Care, we work with multidisciplinary teams made up of orthopaedic surgeons, medical staff, specialist nurses, physiotherapists and exercise physiologists. For more information, contact us.