Wrist pain

DEFINITION

Wrist pain is a common complaint. It’s often caused by sprains or fractures from sudden injuries. But wrist pain can also result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome.

Because so many factors can lead to wrist pain, diagnosing the exact cause can sometimes be difficult. But an accurate diagnosis is essential for proper treatment.

CAUSES

Your wrist is a complex joint made up of eight small bones arranged in two rows between the bones in your forearm and the bones in your hand. Tough bands of ligament connect your wrist bones to each other and to your forearm bones and hand bones. Tendons attach muscles to bones. 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 following 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. Smaller ganglion cysts seem to cause more pain than larger ones do.
• 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.

SYMPTOMS

Wrist pain may vary, depending on what’s causing it. 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, especially at night. The precise location of your wrist pain also can give clues to what might be causing your symptoms.

When to see a doctor

Not all wrist pain requires medical care. Minor sprains and strains, for instance, 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. Delays in diagnosis and treatment can lead to poor healing, reduced range of motion and long-term disability.