Outer wrist pain, particularly when performing twisting motions, is a common complaint that can significantly impact daily activities. This discomfort can range from a mild ache to sharp pain, making daily tasks challenging. While often a minor issue that resolves with rest, pain on the outer side of the wrist can sometimes indicate underlying conditions requiring attention.
Understanding Outer Wrist Pain
The wrist connects the hand to the forearm, comprising eight small carpal bones, along with the radius and ulna. The outer side of the wrist, also known as the ulnar side, is where the ulna bone is located, aligning with the pinky finger. This area is supported by ligaments, tendons, and cartilage, which allow for a wide range of motion.
The triangular fibrocartilage complex (TFCC) is a key structure on the ulnar side. This complex acts as a shock absorber and stabilizer for the wrist joint, connecting the ulna and radius bones to the small carpal bones. The extensor carpi ulnaris (ECU) tendon also runs along the outer wrist, assisting with extension and movement towards the pinky finger. When these structures are damaged or irritated, twisting motions, which involve significant rotation and load on the ulnar side of the wrist, can become painful.
Common Causes of Outer Wrist Pain When Twisting
Outer wrist pain aggravated by twisting can stem from several conditions. A common cause is an injury to the triangular fibrocartilage complex (TFCC). Tears or degeneration often result from falls onto an outstretched hand, repetitive twisting motions, or general wear and tear. Pain from a TFCC injury is felt on the pinky side of the wrist, worsening with gripping, twisting, or weight-bearing activities, and may include clicking or popping sensations.
Extensor Carpi Ulnaris (ECU) tendinopathy or subluxation can also cause pain. The ECU tendon can become inflamed (tendinopathy) due to overuse or trauma. In some cases, the ECU tendon can slip out of its normal position (subluxation), causing a snapping or clicking sensation with wrist movements, especially during twisting. This can occur if the fibrous sheath holding the tendon in place is damaged.
Ganglion cysts are fluid-filled lumps that frequently appear near wrist joints. While often painless, these cysts can cause discomfort, tingling, or weakness if they press on nearby nerves or other wrist structures. If a ganglion cyst is located on the outer wrist, it might contribute to pain during twisting motions.
Ulnar impaction syndrome occurs when the ulna bone is relatively longer than the radius bone in the forearm, causing it to “impact” or rub against the wrist bones and the TFCC. This increased pressure can lead to cartilage wear and fraying of the TFCC, resulting in pain that often worsens with twisting, gripping, or pushing movements. Some individuals are born with a longer ulna, while others may develop it after a radius fracture.
Arthritis, both osteoarthritis and inflammatory types like rheumatoid arthritis, can also affect the small joints in the wrist, leading to pain with movement. Osteoarthritis involves the breakdown of cartilage over time, while rheumatoid arthritis is an autoimmune condition where the body’s immune system attacks joint tissues. Pain from wrist arthritis can feel like a dull ache or burning sensation, often worsening with activity.
Relief and Management Strategies
Mild outer wrist pain can often find relief through self-care strategies. Resting the wrist and modifying aggravating activities is a primary step. This includes avoiding forceful twisting, gripping, or pushing motions.
Applying ice to the affected area can help reduce pain and inflammation, especially after an acute injury or flare-up. Ice packs should be used for about 15-20 minutes every few hours. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, can also help manage pain and reduce swelling.
Wearing a wrist brace or splint provides support, immobilizing the wrist to reduce strain and allow healing. Splints are helpful for overuse injuries and can be worn during activities or at night. Gentle stretches and strengthening exercises, performed as pain allows, can help maintain wrist mobility and build strength. Avoid exercises that increase pain and consult a professional before starting a new regimen if pain is significant.
When to Consult a Professional
While many cases improve with self-care, professional medical evaluation is advisable in some situations. Seek medical advice if pain is severe, rapidly worsening, or does not improve after a few days to a week of home care.
Other indicators for a healthcare provider visit include numbness, tingling, or weakness in the hand or fingers. Visible signs like swelling, redness, bruising, or an obvious wrist deformity also suggest professional assessment. If you experience a painful “clicking,” “popping,” or “grinding” sensation with wrist movement, a medical professional can determine the underlying cause. An accurate diagnosis is important for effective treatment and preventing long-term complications.