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Wrist Pain

Overview

Wrist pain includes all conditions that lead to discomfort in the wrist area. The wrist joint connects your forearm with the hand. It allows flexibility and movement of the hand in various directions. Due to the flexibility of wrist joints, you can complete day-to-day tasks such as writing, typing, kneading, etc., with ease. Any disability or disease in the wrist can limit its movement and cause difficulty in performing regular tasks. The cause of wrist pain should be diagnosed before moving towards different treatment options. 

Causes

There are multiple causes of wrist pain. One of the causes is wrist injury or fracture. This can occur as a result of sudden impact after falling or a direct hit at the wrist area. Scaphoid fractures are a common example of this type of injury. Wrist pain can also occur due to repetitive actions such as typing, writing, knitting, sewing, etc. De Quervain's disease is a condition in which the tendons at the base of the thumb swell up due to repetitive activity.

Carpal tunnel syndrome is another major cause of wrist pain. This condition develops when the median nerve gets compressed within its passage through the carpal tunnel. This nerve supplies the thumb, index finger, median finger, and part of the ring finger. Compression of this nerve can cause pain and tingling sensation in the affected areas.

Inflammatory causes of wrist pain include osteoarthritis and rheumatoid arthritis. Wrist pain due to osteoarthritis is rare and occurs in cases of a previous wrist injury. In rheumatoid arthritis, your body’s own cells can attack its tissues. Wrist pain is common in this condition.

Other causes of wrist pain include wrist tendonitis, wrist bursitis, ganglion cyst, fibrocartilage complex injury, wrist sprain, and Kienbock's disease. The severity of pain can vary among different individuals. 

Risk Factors And Epidemiology

Wrist pain can occur to anyone at any age, but the risk increases with increasing age. Older adults with weaker bones are more prone to develop bone and joint issues. Your type of occupation can also affect your wrist activity. Those involved in sports activities that directly or indirectly impact the wrist are at risk of developing wrist pain. These sports can include gymnastics, snowboarding, tennis, bowling, golf, etc. Other occupational activities such as writing, typing, sewing, etc., can also increase the risk of certain wrist conditions. Pregnancy, diabetes, thyroid issues, gout, and rheumatoid arthritis are additional risk factors.

Cases of wrist pain are noticed more among those in sports professions or those who have to perform a repetitive task with their wrist. Age, gender, and other genetic factors may also contribute to it. 

Signs And Symptoms

Signs and symptoms of wrist pain can vary depending on its causative factor. In some cases, wrist pain presents as a pain similar to a dull toothache, whereas it can occur as a shooting pain in other cases. If you have carpal tunnel syndrome, the prominent sign is a tingling or numbing sensation in the fingers. Inflammation, bruising, swelling, or tenderness may also be noticed in certain cases. If the wrist joint is injured or involved, you may have difficulty in free movement of your wrist. This can also lead to other functional issues such as difficulty in typing, writing, playing sports, holding or gripping an object, etc. 

Diagnosis

The diagnostic procedure begins with obtaining a history of your symptoms, past medical history, family history, and other relevant details. This is followed by a clinical examination. Your doctor will check your wrist for any swelling, bruising, numbness, or tenderness. The degree of movement of the wrist joint is also noticed.

If a certain cause is suspected, your doctor may require imaging tests such as x-ray, ultrasound, CT scan, MRI, etc., to identify its origin. Nerve tests which include electromyogram (EMG), are done if carpal tunnel syndrome is suspected. Arthroscopy is considered if the imaging techniques and other tests are insufficient to obtain a conformational diagnosis. It visualizes the wrist joint and its surrounding space to detect the possible cause of long-term wrist pain. 

Differential Diagnosis

Wrist pain can occur due to several traumatic injuries and medical conditions. It is important to identify and differentiate the causative factor on the basis of symptoms, history, physical examination, and diagnostic tests. 

Treatment

Treatment of wrist pain varies depending on its cause. For mild to moderate wrist pain that occurs due to repetitive stress or tendon injury, physiotherapy is considered as the first option along with supportive medications. The purpose of physiotherapy is to improve the functioning of your wrist joint. If the cause of wrist pain is serious and cannot be managed with physiotherapy and medications, surgical intervention will be required. Surgery can be necessary for bone fractures, joint dislocation, tendon or ligament tears, and in severe cases of carpal tunnel syndrome. 

Pain killers such as ibuprofen, acetaminophen, naproxen, etc., can be taken to relieve wrist pain to some extent. If you have an autoimmune or inflammatory disease-causing wrist pain, corticosteroids will be given orally or injected into your affected wrist area. 

Prognosis

The prognosis of wrist pain varies depending on its cause. Majority of the cases recover well after physiotherapy and medications. Surgical intervention can also improve the overall functioning of your wrist joint. However, some chronic cases may persist for months or years despite treatment measures. 

Prevention

Wrist pain can be prevented by modifying your lifestyle and occupational factors. If you do some work that exerts repetitive stress on your wrist, such as typing, writing, etc., take breaks in between to relax your wrist. Use an ergonomic keyboard or wear a wrist support. Sports enthusiasts should also wear wrist support bands and exercise their wrists often to maintain their form and flexibility.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on June 04, 2023.

 

References

Wrist pain - NHS (www.nhs.uk)

https://www.nhs.uk/conditions/hand-pain/wrist-pain/

Wrist pain - Symptoms and causes - Mayo Clinic

https://www.mayoclinic.org/diseases-conditions/wrist-pain/symptoms-causes/syc-20366213#:~:text=Wrist%20pain%20is%20often%20caused,exact%20cause%20can%20be%20difficult.

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