The wrist is a complex joint connecting the forearm to the hand, allowing for a wide range of motion. It is formed by the radius and ulna articulating with eight small carpal bones, stabilized by numerous ligaments and tendons. Because the wrist is intricate and frequently used, it is highly susceptible to injury, ranging from sudden trauma like falls to chronic issues caused by repetitive strain.
Wrist Sprains (Ligament Damage)
A wrist sprain is the most common acute injury, involving the stretching or tearing of the ligaments that connect and stabilize the wrist bones. This injury typically occurs during a minor fall or a sudden, forceful twisting motion.
Sprains are categorized into three grades based on severity. A Grade I sprain is a mild stretching of the fibers, while a Grade II involves a partial tear that may cause joint looseness. A Grade III sprain is a complete tear of the ligament, leading to significant joint instability and often requiring medical intervention.
Symptoms include localized pain, swelling, and sometimes bruising. Initial self-care involves the R.I.C.E. protocol: Rest, Ice, Compression, and Elevation. This immediate management helps control inflammation and pain.
Distal Radius Fracture (Broken Wrist)
A fracture of the distal radius is the most frequent type of broken bone in the arm, occurring where the larger forearm bone meets the wrist. The classic mechanism of injury is a “Fall Onto an Outstretched Hand” (FOOSH). This impact transmits force up the arm, causing the distal end of the radius to break, often resulting in displacement of bone fragments.
Following a FOOSH injury, the person experiences immediate, severe pain and rapid swelling. Displaced fractures may show a visible deformity, sometimes resembling a dinner-fork profile. The inability to move the wrist or fingers without intense pain strongly suggests a fracture.
Immediate medical diagnosis is necessary, confirmed by an X-ray to assess the fracture pattern. Since this is a structural break, treatment requires immobilization, such as casting, or surgical fixation in severe cases, to ensure proper healing and restoration of function.
Carpal Tunnel Syndrome (Nerve Compression)
Carpal Tunnel Syndrome (CTS) results from the compression of the median nerve as it passes through the carpal tunnel in the wrist. This narrow passageway is surrounded by wrist bones and the transverse carpal ligament. Swelling or thickening within this space can squeeze the nerve, making CTS a chronic issue often related to inflammation and repetitive motion.
The median nerve provides sensation to the thumb, index, middle, and half of the ring finger. Compression causes distinct sensory symptoms, including numbness, tingling, or a feeling of “pins and needles” in these digits. These symptoms often worsen at night or during activities like driving or holding a phone.
Common causes include repetitive or forceful hand and wrist movements, such as prolonged keyboard use or working with vibrating tools. Pressure on the median nerve can also lead to hand weakness, making it difficult to grip objects or perform fine motor tasks.
Tendon Inflammation
Tendon inflammation is an overuse injury resulting from repetitive strain that irritates the tendons or their protective sheaths. Tendonitis involves inflammation of the tendon itself, while tenosynovitis refers to inflammation of the synovial sheath encasing the tendon. This type of injury is centered on pain that occurs specifically with movement.
A frequent example is De Quervain’s Tenosynovitis, which affects the two tendons on the thumb side of the wrist. This condition causes pain and tenderness directly over the wrist near the base of the thumb, aggravated by grasping or pinching motions. The inflammation restricts the smooth gliding motion of the tendons, leading to pain that may radiate up the forearm.
Individuals whose work or hobbies involve repetitive gripping and twisting, such as new parents or industrial workers, often develop this condition. In addition to pain, swelling on the thumb side of the wrist or a grating sensation when moving the thumb may be present.
When Immediate Medical Attention is Necessary
While minor wrist injuries can be managed with rest and ice, certain “red flag” symptoms require immediate professional medical evaluation. Early diagnosis of severe injuries prevents long-term complications like chronic pain or permanent nerve damage.
Red Flags Requiring Immediate Attention
- A visible deformity or clear bend in the wrist, suggesting a displaced fracture.
- Severe, unrelenting pain that does not improve after a day of rest and icing.
- A complete inability to move the wrist or a loss of sensation in the fingers.
- Pain or swelling that worsens progressively or numbness/tingling that persists beyond 48 hours.