Why does my wrist hurt?

What is wrist pain?

Wrist pain is any type of pain or discomfort in the wrist. We use our wrists for the majority of tasks and activities and as such, wrist pain due to wear and tear, overuse or injury is common. Wrist pain can be mild and annoying, or severe and prevent us from carrying out normal daily activities.

Wrist pain can have a variety of causes. You can often treat wrist pain yourself at home, but in some cases, wrist pain may be a sign of something more serious. Wrist pain can occur suddenly as a result of an accident or injury, or develop gradually due to conditions like arthritis or repetitive stress injury (RSI).

Let’s look at some common causes of wrist pain, how wrist pain can be treated, and some steps you can take to prevent wrist pain or stop it from coming back.

How our wrists work

The wrist is a complex joint that connects the hand to the forearm. It is made up of bones, joints, muscles, tendons, ligaments, nerves, and blood vessels. Problems with any of these structures can cause wrist pain.

Wrist anatomy

The wrist connects the end of the arm bones (radius and ulna) and the five finger bones (metacarpals). There are eight carpal bones and three joints in the wrist.

The eight carpal bones are surrounded by a joint capsule that supports and lubricates the wrist, reducing friction and allowing for movement of the wrist joint.

The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of the hand. A nerve called the median nerve runs through the tunnel. When this nerve is compressed, it can lead to a condition called carpal tunnel syndrome.

Function of the wrist

The wrist is probably the most complex joint in the body. Its large number of bones and joints allows us to move our wrists in a full range of motion, allowing our hands to carry out a wide range of activities. The wrist also provides the strength needed to hold and grip objects firmly.

Wrist pain symptoms

Wrist pain symptoms may vary, depending on the cause. You may have pain all the time, it may come and go, or flare up with certain movements or activities. Wrist pain can vary in severity and type and may range from a dull ache to a stabbing or shooting pain. Your wrist pain may be accompanied by other symptoms like swelling, stiffness, warmth, redness or pins and needles.

Common causes of wrist pain

Wrist pain can be caused by a direct injury to the wrist or a long-term health condition.

Some common causes of wrist pain include:

Repetitive strain injury (RSI)

Our wrists are one of the most used parts of the body and wrist pain due to repetitive strain injury is common. You may develop repetitive strain injury due to any activity where you repeatedly use your wrists, such as typing, hairdressing, playing a musical instrument, using power tools, or working on a production line.

Symptoms of repetitive strain injury may include:

• Pain and tenderness
• A throbbing or pulsating sensation in the affected area
• Tingling in the hand or arm
• Loss of sensation
• Loss of strength

Most repetitive strain injuries can be treated at home with the RICE protocol (read more on this in our treatment section below.)

Sprains and strains

A sprain is an injury to the ligaments in a joint, whereas a strain is an injury to the muscle or tendons. Wrist sprains and strains are common, particularly as a result of putting your hands out in front of you to break your fall.

The symptoms of wrist sprain or strain are similar and include:

• Pain and tenderness
• Swelling
• Discolouration or bruising
• Wrist weakness
• Muscle spasms or cramps
• Difficulty moving your wrist

Most sprains and strains can be treated using the RICE protocol, though severe cases may need medical treatment, or, in rare cases, surgery.

Fractures

A fracture is a break in a bone. As with sprains and strains, wrist fractures commonly occur when we put our hands out in front of us during a fall, but can also occur during contact sports, a car accident, or other types of trauma.

Symptoms of a broken wrist may include:

• Sudden severe pain
• A popping, grinding or cracking sound at the time the injury occurred
• Swelling
• Tenderness
• Numbness or tingling in your fingers
• Difficulty or inability to move your wrist
• Bruising
• Loss of colour in your fingers
• Your wrist may appear deformed or out of place

Treatment for wrist fractures depends on the location, type and severity of the break. Uncomplicated fractures are immobilised in a splint or cast for around four to six weeks, whereas a more complex fracture may need surgery.

Dislocation

A dislocation occurs when your bones are pushed out of their usual position. The wrist is made up of eight small bones and a wrist dislocation can affect any of them. A dislocated wrist can be caused by trauma, like a car accident or fall, or due to continuous pressure on the ligaments in your wrist, such as walking with crutches.

Symptoms of a dislocated wrist may include:

• Sudden, severe pain that’s worse when you try to move your wrist. You might also have pain in your forearm
• A deformed or misshapen wrist
• Swelling
• Tenderness
• Weakness
• Bruising or discolouration
• Tingling or numbness in your fingers

Dislocated wrists are treated with a procedure called a reduction. This can either be a closed reduction, where your doctor manipulates your wrist bones back into position under local or general anaesthetic, or an open reduction involving surgery to move your bones back into their correct position.

Wrist osteoarthritis

Osteoarthritis is a common condition that occurs when the protective cartilage around our joints breaks down, causing bone to rub against bone and resulting in pain, stiffness, and swelling. It becomes more common as we age. The joints of the hand and wrist are among the most commonly affected and the condition can make it difficult to carry out daily activities.

Symptoms of wrist osteoarthritis may include:

• Pain
• Reduced range of motion
• Redness, warmth or swelling around your wrist joint
• Stiffness that’s often worse in the morning and improves throughout the day
• Wrist and hand weakness

There’s no cure for osteoarthritis, but symptoms can be managed using a combination of treatments including non-steroidal anti-inflammatory drugs (NSAIDs), wearing a brace or splint on the affected wrist, physiotherapy and steroid injections.

Rheumatoid arthritis

Rheumatoid arthritis has similar symptoms to osteoarthritis but is an autoimmune disease that occurs when your immune system mistakenly attacks its own tissues — in this case, the joints.

Symptoms of RA may come and go in episodes called flares. They may include:

• Pain
• Swelling
• Changes to the shape of the wrist joint over time
• Small firm bumps (nodules) around the wrist joint
• Fatigue
• Muscle weakness
• Unexplained weight loss
• Low-grade fever

Treatment for wrist RA is normally with physiotherapy and medications like NSAIDs, steroids or disease-modifying antirheumatic drugs (DMARDs). In some cases, surgery may be recommended to repair or replace a damaged joint.

Carpal tunnel syndrome

Carpal tunnel syndrome is a common condition that occurs when one of the main nerves to the hand, the median nerve, is compressed, causing numbness, tingling, and pain in the hand and forearm.

Left untreated, carpal tunnel syndrome often gets worse over time, so it’s important to get medical attention if you experience symptoms. Symptoms often come on gradually and may come and go. They’re usually worse at night.

Symptoms of carpal tunnel syndrome may include:

• Pain in your fingers, hand or arm
• Numbness, tingling or pins and needles in your hands
• Weakness in your thumb or difficulty gripping objects

Treatment for carpal tunnel includes exercises, wearing a wrist splint, steroid injections and, in some cases, surgery.

Bursitis

Bursitis is inflammation of a bursa, the fluid-filled sac that protects and lubricates a joint. There are two bursae in the wrist which can become inflamed because of repetitive movement, friction or trauma.

Symptoms of wrist bursitis may include:

• Pain when putting pressure on the wrist or bending the wrist backwards
• Swelling and tenderness
• A small lump or swelling on the top of the wrist
• Your wrist may feel warm to the touch

Bursitis is normally treated with RICE therapy and non-steroidal anti-inflammatory drugs (NSAIDs).

Tendonitis

Tendonitis is inflammation of a tendon, a band of connective tissue that attaches muscle to bone. One of the most common types of wrist tendonitis is De Quervain’s tenosynovitis, which affects the tendons near your thumb. Symptoms of wrist tendonitis include:

• Wrist pain, especially around the thumb or little finger
• Swelling around your wrist or the bases of your fingers
• Stiffness in your wrist joint
• A catching or popping sensation when you move your wrist or fingers
• Difficulty performing tasks where you use your wrist, such as opening jars or turning doorknobs

Wrist tendonitis is normally with the RICE protocol, wrist splints, non-steroidal anti-inflammatory drugs (NSAIDs) and physiotherapy.

Ganglion cysts

Ganglion cysts are harmless fluid-filled lumps that most commonly occur along the tendons or joints of the wrists or hands, but can also affect the ankles and feet. Ganglion cysts can vary in size from the size of a pea to the size of a golf ball. Large ganglion cysts can make it difficult to move your joint and may cause pain if they press on a nearby nerve.

Symptoms of a ganglion cyst may include:

• A swelling or lump that may change in size, or go away completely and return. The lump is usually soft and immobile and may be painful
• Pain when you move your nearby joints
• Muscle weakness around the affected tendon

Most ganglion cysts don’t need treatment, but if your ganglion cyst is causing problems, it may need to be drained or removed with surgery. Some ganglion cysts go away on their own.

When should I see a doctor?

Make an appointment with your consultant if:

• Your wrist pain is getting worse, not getting better or keeps coming back
• You feel unwell and have a high temperature
• Your wrist is warm, swollen and stiff
• Your wrist pain is preventing you from doing normal activities
• Your wrist pain has not improved after two weeks of home treatment
• You have tingling or loss of sensation in your hand or wrist
• You have diabetes

Go to A&E urgently if:

• You have severe wrist pain
• You heard a snapping, cracking or grinding noise at the time of the injury
• Your wrist appears deformed or has changed colour
• You cannot move your wrist
• You cannot feel all or part of your hand

Treatment for wrist pain

How wrist pain is treated depends on the cause. Mild wrist pain can usually be treated at home, but in some cases, wrist pain may need treatment with medication, physiotherapy or surgery.

The RICE protocol

The first treatment for many types of minor wrist pain is usually with the RICE protocol. RICE stands for:

• Rest — rest your wrist as much as you can and avoid activities that cause pain
• Ice packs — apply an ice pack (or a bag of frozen peas) wrapped in a cloth or towel to your wrist for up to 20 minutes every two to three hours
• Compression — applying a firm bandage or compression sleeve can help to reduce swelling and inflammation and reduce pain. Compression also helps improve blood circulation, which helps speed up the healing process
• Elevation — elevating your wrist on a pillow will help to reduce swelling and pain

Home treatments

Besides the RICE protocol, some things you can do at home to help with wrist pain include:

• Take over-the-counter medicine such as paracetamol or ibuprofen to help relieve pain and inflammation. Your pharmacist can recommend one
• Gentle exercises can ease pain and stiffness in your hands and wrists
• Wear a splint to support your wrist, especially at night
• Use gadgets or devices to make difficult tasks such as chopping or opening jars easier
• Use a soft pad to support your wrist when typing

Medication

If your wrist pain is severe or isn’t getting better with home treatments, your consultant may prescribe medication such as stronger painkillers, non-steroidal anti-inflammatory drugs (NSAIDs), or steroid injections to relieve pain and inflammation.

Physiotherapy

Your physiotherapist can show you exercises to strengthen your wrist and improve flexibility and range of motion. They may also use techniques such as massage, joint mobilisation, ultrasound and transcutaneous electrical nerve stimulation (TENS).

Immobilisation

If your wrist pain is due to an injury such as a fracture or sprain, you may need to have it immobilised in a splint, cast, or brace while it heals.

Surgery

In some cases, you may need surgery on your wrist to repair a fracture, torn tendon or ligament, release a compressed nerve or remove a growth.

Can wrist pain be prevented?

Sometimes wrist pain can’t be prevented, but there are some things you can do to reduce your risk, including:

• Keep your keyboard at the correct height when typing
• Use a soft wrist rest with your keyboard, mouse or trackpad
• Take regular breaks from typing
• Wear the correct equipment for all activities such as work and sports
• Always wear your seatbelt when travelling by car
• Reduce your risk of falls by making sure your home and workplace are free from clutter that you could trip over
• If you have difficulty with balance or walking, use a walking device such as a cane or walker

Summary

Wrist pain is a common problem that usually goes away with home treatments such as the RICE protocol. If you have sudden or severe wrist pain, your wrist pain is accompanied by other symptoms, or isn’t going away, it’s best to be on the safe side and get it checked by a specialist.