Wrist Pain Causes

Introduction

Wrist pain is defined as an ache, discomfort or soreness experienced at the wrist joint, which connects the hand to the forearm. This can range from mild to severe discomfort – which can affect a person’s everyday tasks. The wrist is a complex joint with many bones, ligaments, tendons and nerves - making it susceptible to different pains.

A good understanding of what causes wrist pain is crucial, as it is the foundation for effective prevention and treatment. Wrist pain can be a very debilitating condition and impact productivity and quality of life. If left untreated or misdiagnosed, wrist pain can result in chronic issues and potential long-term implications.

This article will explore the various factors causing and contributing to wrist pain. Assessing the anatomy of the wrist, wrist pain causes, risk factors, and diagnostic, prevention and treatment methods will allow readers to gain a good understanding of wrist pain and how to effectively address it.

Anatomy of the wrist

Structure of the wrist

To understand wrist pain, it’s useful to understand the wrist’s structure. The wrist is a complex joint between the hand and forearm. This wrist is made of bones, ligaments, tendons and cartilage working together to facilitate various movements.

The wrist joint is mainly composed of two rows of carpal bones – the distal ends of the radius and ulna (two forearm bones), and the proximal parts of the metacarpal bones (hand bones). These structures come together to create a flexible but stable joint that can facilitate a wide range of movements.¹

Key parts (bones, ligaments, tendons)

Bones: The wrist has eight carpal bones in two rows.

Ligaments: The stability of the wrist joint is maintained with a ligament network, connecting the carpal bones together and with the radius, ulna and metacarpal bones.

Tendons: The tendons attach muscles to bones and are crucial for wrist movement. Tendons originate at the forearm muscles - extending into the wrist and hand.

Role of wrist in daily activities

The wrist is essential for daily tasks and movements.  Wrist mobility and strength allow a variety of tasks to be performed – such as writing, typing and lifting. The wrist also supports fine motor skills, which is why it’s pivotal to conducting precise tasks.²

Wrist mobility and stability are crucial for comfortably and effectively conducting daily tasks. Wrist pain can have a large impact on these functions, illustrating the importance of wrist health maintenance [3].

Common causes of wrist pain

A good understanding of wrist pain is crucial for effective diagnosis and treatment. Preventative steps and proper management can aid individuals in restoring wrist functionality.

Trauma and Injuries

Sprains and strains:

Strains and sprains of the wrist commonly occur from the sudden impact of bending the wrist past its normal range of motion – leading to ligament, tendon or muscle damage.

Fractures:

Wrist fractures, often those with the distal radius or ulna, are injuries from accidents (such as falls). Fractures can cause severe pain and impact wrist functionality.

Dislocations:

Dislocations of the wrist are due to the displacement of bones within the wrist joint – resulting in extreme pain. A dislocated wrist typically requires immediate medical attention.

Repetitive strain injuries (RSIs)

Carpal tunnel syndrome:

Carpal Tunnel Syndrome is a common repetitive strain injury that happens due to a compression of the median nerve inside the wrist. Continuous repetitive wrist movements (such as typing) can contribute to this condition.

Tendinitis:

Tendinitis is the inflammation of tendons in the wrist from repetitive movements and can cause pain and discomfort.

De quervain's tenosynovitis:

De Quervain's tenosynovitis is the inflammation of the tendons in the wrist by the thumb. Repeated thumb and wrist movements, such as lifting, can contribute to this condition.

Medical conditions

Arthritis (osteoarthritis and rheumatoid arthritis):

Osteoarthritis and rheumatoid arthritis can affect the wrist joint – causing pain, stiffness, and reduced mobility. Both of these forms of arthritis are chronic and progressive.

Gout:

Gout is an inflammatory arthritis caused by a build-up of urate crystals within the joints, such as the wrist.

Nerve compression

Carpal tunnel syndrome:

The aforementioned Carpal Tunnel Syndrome is the compression of the median nerve in the wrist – which can lead to numbness, tingling, and weakness.

Radial tunnel syndrome:

Radial Tunnel Syndrome is the compression of the radial nerve in the forearm and can result in wrist and hand pain.

Overuse

Overusing the wrist with repeated movements (for instance, excessive typing) can lead to spraining the wrist and, therefore, discomfort and pain. Utilising good ergonomic practices can minimise wrist pain resulting from overuse.⁴

Poor ergonomics

Incorrect positioning, posture or poor ergonomics can lead to wrist pain.

Risk factors for wrist pain

Age

Osteoarthritis:

The risk of wrist pain increases with age – due to the increased risk of conditions such as osteoarthritis, which gradually wears down the joint.

Occupation

Repetitive movements:

Occupations such as officer workers, that type a lot, require repetitive wrist movements. Conducting these tasks over a prolonged period of time can increase wrist pain risk.

Forceful activities:

Occupations that involve forceful wrist activities, like those in construction or manufacturing, pose a greater risk of traumatic wrist injuries – such as fractures and strains.

Sports and activities

Sports injuries:

Participating in high-impact sports, such as gymnastics or martial arts, can cause wrist injuries, like sprains and fractures.

Repetitive movements:

Activities or hobbies requiring repetitive wrist movements, such as playing musical instruments or gaming, can cause overuse injuries.

Pre-existing medical conditions

Arthritis:

Individuals with pre-existing medical conditions like rheumatoid arthritis are at a greater risk of wrist pain as a result of joint inflammation and damage.

Diabetes:

Diabetes can impact the nerves and blood vessels, increasing the potential risk of certain conditions, like carpal tunnel syndrome.

Genetics

Family history:

Genetic factors impact some individuals in being predisposed to certain wrist conditions, like osteoarthritis or carpal tunnel syndrome.

Lifestyle

Obesity:

Being overweight can increase the risk of wrist pain, particularly with conditions like carpal tunnel syndrome, as additional weight puts additional pressure on the wrist's median nerve.

Smoking:

Smoking is linked to minimised blood flow – this can hinder the body's healing and recovery from wrist injuries.

Diagnosis of wrist pain

Medical history

Having a comprehensive medical history is the first step in diagnosing the causes of underlying wrist pain. Patients are often asked about their symptoms, pain, previous medical conditions and activities that could contribute to wrist pain. A detailed medical history can provide valuable insight into potential causes.

A comprehensive physical examination of the wrist is crucial for a good diagnosis. During this examination, a healthcare provider will assess:

• Range of Motion: Evaluating the wrist's range of motion to aid in identifying limits of movement
• Tenderness: Palpating the wrist can help locate areas of tenderness or swelling
• Strength and Grip: Assessing grip strength and weakness can indicate muscle or tendon involvement
• Nerve Function: Testing for sensory changes, reflexes, and nerve compression signs is important in diagnosing conditions (such as carpal tunnel syndrome)

Imaging tests (X-rays, MRI, CT Scan)

X-rays: X-rays are often the first imaging technique utilised in evaluating wrist pain (especially with suspected fractures). X-rays can reveal bone fractures, dislocations, and osteoarthritis signs.

Magnetic resonance imaging (MRI): An MRI scan is useful in assessing soft tissues such as ligaments, tendons, and cartilage. This can aid in the identification of ligament tears, tendinitis, or ganglion cysts. MRIs provide detailed images and are very useful when the wrist pain is not clear on an X-ray.

CT scan (computed tomography): CT scans are conducted to gain precise images of bone structures such as for complex fractures. CT scans can provide three-dimensional images for surgical planning.

Nerve conduction studies (for nerve-related issues)

Nerve conduction studies are very important in the case of nerve-related issues, like carpal tunnel syndrome. These tests are used to assess the function of nerves by measuring electrical activity. These tests aid nerve compression diagnoses and other nerve-related causes of wrist pain.

Blood Tests (for inflammatory conditions)

Blood tests are done to check for inflammatory markers and specific autoimmune conditions, if wrist pain is caused by underlying medical conditions (like rheumatoid arthritis).

Treatment options

Rest and activity modification

Resting the affected wrist and adapting or avoiding activities that exacerbate pain are often the first steps in wrist pain management. Reducing or avoiding repetitive movements can stimulate healing.

Ice and heat therapy

Icing the wrist as soon as possible can reduce inflammation and provide pain relief. Heat therapy can then stimulate blood circulation and reduce stiffness. Alternating between ice and heat can be helpful.   

Physical therapy

Physical therapy is an important part of wrist pain treatment. Therapists can design specific stretches and exercises for wrist strengthening and an improved range of motion. These exercises aid in the rehabilitation of wrist pain conditions.

Medications (pain relievers, anti-inflammatories)

Over-the-counter pain relievers such as ibuprofen can help reduce pain and inflammation. Prescription medications may be prescribed in severe cases or when underlying medical conditions contribute to wrist pain.

Immobilisation (splints or casts)

Immobilisation, with a splint or cast, is often recommended for wrist stabilisation and to promote healing for fractures, strains, or conditions like carpal tunnel syndrome. Splints or casts limit movement and, therefore, prevent further injury while allowing the repair of damaged tissues.

Injections (corticosteroids or hyaluronic acid):

In cases of persistent wrist pain, injections may be considered. Corticosteroid injections can give temporary relief by reducing pain and inflammation. For osteoarthritis, hyaluronic acid injections can help lubricate the joint and reduce discomfort.

Surgery:

Surgery may be required for severe or persistent wrist pains. These procedures include joint replacement and ligament repair and are dependent on diagnosis and an individual’s requirements.

Prevention and self-care

Ergonomic adjustments:

• Workspace Setup: One’s workspace must be ergonomically designed – with an appropriate chair height, good keyboard and mouse placement, and a monitor positioned to reduce wrist strain.⁵
• Ergonomic Tools: For example, an ergonomic keyboard and mouse to decrease wrist stress during computer-related tasks.

Stretching and strengthening exercises:

• Wrist Exercises: Incorporating wrist stretching and strengthening exercises into your daily routine – for improved flexibility, stability, and strength.
• Hand and Forearm Exercises: Strengthening the hand and forearm muscles can give extra support to the wrist joint – for instance, handgrip exercises and forearm curls.
• Proper Wrist Posture During Activities:
• Maintain Neutral Wrist Position: With wrist-moving activities, try to maintain a neutral wrist position and avoid excessive bending or twisting.
• Use Proper Technique: Conducting activities with proper techniques can minimise the risk of wrist injuries.

Maintaining a healthy lifestyle:

• Weight Management: A healthy body weight can lower the risk of wrist pain, especially with pre-existing conditions such as carpal tunnel syndrome, that are worsened by excess weight
• Balanced Diet: A balanced and nutrient-rich diet, with calcium and vitamin D, to support bone health and lower the risk of osteoarthritis.
• Hydration: Staying hydrated will help maintain joint lubrication and prevent some conditions that cause wrist pain, like gout.

Early symptoms and seeking treatment:

• Listen to Your Body: Paying attention to signs of discomfort in the wrist is important. Ignoring symptoms can cause more significant problems. Addressing wrist pain as early as possible is important.
• Consult a Healthcare Professional: If experiencing persistent or worsening wrist pain, one should consult a healthcare professional – as they can diagnose and recommend treatments.
• Follow Medical Advice: Adhering to a treatment plan of rest, physical therapy, or lifestyle adaptations can improve wrist pain

Summary

This article has described the wrist anatomy, causes, diagnosis and treatment options of wrist pain. It is crucial to aim for early diagnosis and treatment. If left untreated, wrist pain can lead to a lower quality of life and complications. Swiftly seeking medical attention once symptoms arise and adhering to appropriate treatments can improve recovery and pain management.

Wrist health is an important part of general health and functionality. Individuals are encouraged to be proactive in prioritising wrist health, such as with ergonomic adjustments, regular exercise and good posture. These small changes can have a substantial impact on the prevention of wrist pain and further injuries.

Maintaining healthy wrists is crucial for daily activities, work, hobbies, and overall quality of life. Adopting preventive measures and quickly addressing issues can keep wrists strong, flexible and pain-free.