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Institute of Advanced Orthopedics, MOSC Hospital and Medical College, Kolenchery, Ernakulam, Kerala

Wrist Joint Injuries

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

Symptoms

Wrist pain may vary, depending on the cause. For example, osteoarthritis pain is often described as being similar to a dull toothache, while carpal tunnel syndrome usually causes a pins-and-needles feeling or a tingling sensation, especially at night. The precise location of your wrist pain also provides clues to what’s behind your symptoms.

When to see a doctor

Not all wrist pain requires medical care. Minor sprains and strains usually respond to ice, rest and over-the-counter pain medications. But if pain and swelling last longer than a few days or become worse, see your doctor. 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.

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 repetitive wrist motion — from hitting a tennis ball or bowing a cello to driving cross-country — can inflame the tissues around joints or cause stress fractures, especially when you perform the movement for hours on end without a break. De Quervain’s disease 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 your 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

  • Carpal tunnel syndrome. Carpal tunnel syndrome develops when there’s increased pressure on the median nerve as it passes through the carpal tunnel, a passageway in the palm side of your wrist.
  • Ganglion cysts. These soft tissue cysts occur most often on the part of your wrist opposite your palm. Ganglion cysts may be painful, and pain may either worsen or improve with activity.
  • Kienbock’s disease. This disorder typically affects young adults and involves the progressive collapse of one of the small bones in the wrist. Kienbock’s disease occurs when the blood supply to this bone is compromised.
  • TFCC Injury. This is a problem in the wrist, most commonly after twisting injuries, with pain and clicking on the little finger side of the wrist. This occurs due to tear or degeneration of a fibrous disc, called the Triangular Fibrocartilage complex, the distal end of the ulna bone.

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 — 1,000 milligrams a day for most adults and at least 1,200 milligrams a day for women over age 50, — can help prevent fractures.
  • 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 rollerblading.
  • Pay attention to ergonomics. If you spend long periods at a keyboard, take regular breaks. When you type, keep your wrist in a relaxed, neutral position. An ergonomic keyboard and foam or gel wrist support may help.

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