Wrist Pain

This article was written, reviewed and contributed to by some of Australia’s leading experts in the field of pain and wrist pain. We want to help you better understand the causes of your wrist pain and alleviate any concerns or worries you may have.

If wrist pain is something you have been dealing with for a long time, then we hope to provide you a fresh perspective and perhaps give you information that will help you on the way to recovery.

Below you will find a practical and actionable treatment plan, backed by the latest research to treat your wrist pain (including things you can do from home) and help you get back to feeling your best.

Read on as we guide you in the understanding of different types of wrist pain and what you can do to treat it.

What is Wrist Pain?

Wrist pain is a term used for describing conditions or issues leading to discomfort around the radiocarpal joint (wrist joint). Injuries to the nerve, ligaments, tendons and joints can lead to wrist pain. Examples of common wrist conditions include sprains, neuropathy (nerve pain) and fractures.

Wrist pain is a common problem seen in people who regularly perform demanding activities, such as manual labourers and athletes. According to the Australian Institute of Health and Welfare, wrist injuries were the second most common physical cause of hospitalisation in sports people.[1]. Within one year, people with physically demanding jobs are almost six times more likely to experience wrist pain.[2]

Pain is categorised as either acute, subacute or chronic wrist pain

Acute wrist pain: (0 days - 6 weeks)

Acute wrist pain is usually the result of a minor injury or problem, typically from computer work or other minor impacts. These types of injuries are quick to heal once the cause has been identified and can be changed or modified.

Subacute wrist pain: (6 weeks - 3 months)

Sub-acute wrist pain is more typical and includes more tissue damage. Events like a fall on an outstretched hand for example can cause sub-acute wrist pain. These types of injuries are a bit slower to heal as there is more happening and requires more patience.

Chronic wrist pain: (3 months +)

Chronic wrist pain is defined as pain that continues for longer than three months. There may be several reasons for this; whether it be severe damage like a motor vehicle accident or other complications that may slow down the healing process. Things like poor general health and circulation issues are known to reduce the healing capacity so will need to be assessed as well.

What are the symptoms of wrist pain?

The most common symptoms of wrist pain include a dull ache at the wrist joint; this is usually associated with difficulty gripping and possibly swelling. People may also experience sharp pain with certain movements and swelling or redness around the wrist.

Common complaints of pain in the wrist

• Dull pain on the wrist

• Forearm pain

• Numbness and tingling sensation

• Swelling

• Difficulty lifting and gripping

• Inability to open doors or turn handles

• Stiffness

• Weak grip strength

• Bony bump or deformity in the wrist joint

• Pain when moving the hand.

People may experience

Pain areas: in the wrist, hand and forearm

Sensory: tingling or numbness in the wrist

Also common: weak grip strength

What causes wrist pain?

Wrist pain is most commonly caused by sprains or fractures from sudden injuries such as a fall onto an outstretched hand. People may also experience wrist pain from overuse, particularly from computer work.

According to the Mayo Clinic, wrist pain is defined as “discomfort in the wrist area, including the base of the hand”.[3]

Wrist pain can result from a problem in one or several parts of the wrist, including:

• Muscles (strain)

• Ligaments (sprain)

• Nerves

• Bone injuries - the bones of the wrist include; the carpal bones (of which there are eight) and these connect to the hand and the forearm.

Common reasons why people experience pain in the wrist

• Sporting injuries

• Fall on an outstretched hand

• Arthritis

• Prolonged computer work or use of a mobile device

• Playing an instrument.

Some jobs, such as plumbing and manufacturing jobs, may require constant use of the hand and wrist for long hours. This causes a lot of stress on the wrist joint and ligaments, potentially leading to injury and pain.

Common injuries that cause low wrist pain

Repetitive Strain Injury

Repetitive Strain Injury is a common wrist injury, usually caused by heavy computer work and using a mouse.

Sprain or strains

Muscles and ligaments can be damaged due to overstretching or overuse. This is common in racquet and ball sports which require repetitive use of the hand.

De Quervain's Tenosynovitis

De Quervain's Tenosynovitis is a condition that leads to inflammation of the tendon covering the base of the thumb. This causes wrist pain on the side of the thumb and may limit grip strength.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition that results from the entrapment of the median nerve on the wrist area (carpal tunnel). It causes pain that is usually worse at night. It can also present with numbness and a tingling sensation on the palm and fingers.

Dislocation

This can happen with a fall onto an outstretched hand, similar to the cause of wrist fractures.

Fractures

A wrist fracture is a common injury resulting from a fall on an outstretched hand. This causes swelling, pain, and tenderness, particularly on the palm of your hand.

Common conditions that cause wrist pain

Systemic medical conditions can also present with wrist pain. That’s why it is essential to understand the exact cause of your wrist pain.

• Ganglion Cyst

• Rheumatoid Arthritis

• Gout

• Osteoarthritis

Sports that increase the risk of wrist pain

Athletes who rely on the strength and mobility of the wrist for their sports are at high risk of developing wrist pain over time. Contact sports are also one of the most common sources of wrist fractures. Here is a list of the most common sports that can result in wrist pain:

• Golf

• Tennis

• Soccer

• Snowboarding

• Hockey.

How is wrist pain diagnosed?

Wrist pain can limit you from doing daily activities and may prevent you from participating in your favourite sports or hobbies. What’s worse, is it chronic if left untreated.

There are several options available to you when it comes to diagnosing the underlying cause of your wrist pain. One of the most common diagnoses referred by Australian GP’s, is an assessment from a physiotherapist.

Wrist pain is extremely common and something that physiotherapists see regularly, and the process of diagnosing is straightforward.

Physiotherapists are rehabilitation experts when it comes to pain and injuries. They are highly-qualified medical professionals that diagnose and treat joint pain and tendon problems such as conditions related to elbow pain.

Like any other pain or injury, a physiotherapist will start with a detailed history of your activities and previous injuries. This is an interview-like process that is usually referred to as a consultation. A typical session will last between 30-60 minutes, and during this time, you will discuss the specific issues you are having related to your wrist pain.

After establishing the history of your wrist pain, they will conduct a hands-on assessment, performing a series of physical tests to determine the cause of your problem and rule out other conditions.

Following your initial assessment, a treatment plan will be created that is tailored to you according to the severity of your injury. After this, the physiotherapist will establish how many sessions are required, what home exercises you need to do, and provide you with a timeline for how long a full recovery should take.

From here, the physiotherapist will provide you with the details of your treatment program which will include:

• Number of treatment sessions

• List of exercises you need to do at home

• Strategies to manage the pain and to prevent worsening of the condition

• Timeline for your recovery

• Any further recommendations or advice

How is wrist pain treated?

Wrist pain is frustrating and can impact your daily activities. More importantly, if left untreated, your pain is likely to increase, which will slow down your recovery

There are several options when it comes to treating the conditions that cause wrist pain. One of the more common, and the treatment option referred to by Australian GP’s the most is physiotherapy.

It is important to have your condition seen by a physiotherapist to diagnose your injury correctly and provide the best possible treatment options for you.

Wrist pain is an injury that physiotherapists come across regularly, and the process of treating it is straightforward. Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.

Your treatment will focus on decreasing your pain and improving the mobility and stability of the wrist joint. Strengthening exercises will also be given to make your wrist and hand muscles stronger to withstand further injuries.

Depending on the severity of your wrist pain, a physiotherapist may provide you with a combination of the following types of treatments:

• Therapeutic exercise - Exercises used to correct muscle imbalances and impairments which may be contributing to your pain or injury.

• Stretching exercises - Techniques used to relieve tension on the tendons and muscles of your palm and wrist.

• Manual therapy - Hands-on treatment by your physiotherapist to decrease pain and improve mobility of the wrist joint.

• Joint mobilisation - A treatment technique used by your physiotherapist to increase mobility and range of motion of the wrist joint. This can also alleviate pain and improve joint mechanics.

• Heat therapy - Use of heating modalities to increase the circulation of blood to the affected area resulting in increased cell activities for faster healing.

• Cryotherapy - Uses cold modalities to decrease pain and control inflammation.

• Kinesio taping - A specialised taping technique that allows movement of the joint while decreasing the pain.

• Advice and education - Professional advice to help you manage the pain and improve your recovery.

A single physiotherapy session can last for 30 to 60 minutes. Most patients can already feel the benefits immediately after treatment.

Next step - Creating a treatment plan for you

Following your initial evaluation, your physiotherapist will create a detailed treatment plan that will guide you step-by-step. You will also receive home exercise programs to support your rehabilitation and maximise your recovery.

Self-care strategies

If you are experiencing wrist pain, here are the best things you can do and avoid.

Things to do:

• Rest

Wrist pain usually happens when you overwork your hand and wrist muscles. Try to rest them for at least 24 to 48 hours and monitor whether the pain is decreasing or increasing. Also, take note of signs of swelling and difficulty moving your hands.

• Use hot compress / Ice compress.

Apply cold compress immediately after injury within 48 hours. Use it for at least 10 to 15 minutes every two hours to manage swelling and decrease pain.

If you have wrist pain for a long time without any swelling, you can use a hot compress to relax the muscles and relieve stiffness around the wrist joint.

• Use elastic bandages

Wrap your hand with a figure of 8 bandages to limit motions that are causing you pain.

• Use splints

If you injure your hand by falling on an outstretched hand or via vehicular accident, use a splint to restrict bending of your hands to prevent further damage. Consult a doctor immediately to check for fracture.

Things to avoid:

• Avoid activities that worsen the pain

Avoid activities that require repetitive movements of the wrist.

• Don’t lift with your affected hand.

Avoid lifting heavy objects on your affected hand while you are healing.

Do I need a specialist or surgery?

Surgery on the wrist is often done when all conservative treatments have not been successful. X Rays or MRIs are used to screen for wrist fractures, spurs and other bone or ligament pathology.

A nerve conduction velocity test can also measure nerve impulses if you have nerve injury symptoms such as carpal tunnel syndrome.

If you have a fever for several days, a blood test can be done to rule out cases of infection.

Physicians and surgeons may refer you for physiotherapy for proper treatment.

What is the recovery time / prognosis for wrist pain?

Ultimately, the time taken to recover is dependent on your proactiveness to seek professional treatment as well as the severity of your wrist pain.

Important factors in your recovery post-treatment:

• Being consistent when following your physiotherapy treatment plan

• Resuming your sports activity gradually

• Paying attention to pain and resting as necessary.

Other factors that may influence your recovery time:

• Age

• Severity of condition

• Lifestyle.

Physiotherapy can accelerate your recovery and help you manage the symptoms. The key to your healing is patience and consistency with your treatment program. Most of the time, patients can feel immediate improvement after their initial session.

Can pain in the wrist be prevented?

These tips for preventing wrist pain can also double as treatment options for wrist pain.

• Strengthening exercises: If you can’t avoid repetitive stress to your wrist, you need to strengthen your forearm muscles and grip strength to prevent future injuries.

• Prevent falls: The majority of wrist fractures are due to falls on outstretched hands. Remove home hazards and improve the lighting system in your living space to decrease the risk of falling accidents. Make sure that the bathroom is always dry and safe, especially for the elderly.

• Work ergonomically: Take frequent breaks when working in front of a computer. Keep your wrist and shoulders relaxed when typing.

Outlook and the main takeaways

This guide should hopefully have helped highlight that there are many causes, types and severities of wrist pain. In the case that you have wrist pain, make sure you listen to your body and act upon it. Book a time with your local physiotherapist and have your wrist pain assessed today.

Anatomy of the wrist

Your wrist joint (the radiocarpal joint) plays a significant role in connecting the forearm and hands. It is formed by the proximal carpal bones (except pisiform) and the radius.

Carpal bones:

• Scaphoid

• Lunate

• Triquetral

• Pisiform

• Trapezium

• Trapezoid

• Capitate

• Hamate.

Ligaments of the wrist joint:

• Palmar radiocarpal

• Dorsal radiocarpal

• Ulnar collateral

• Radial collateral

• Collateral ligament

• Annular ligament.