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Wrist pain

Definition

Wrist pain is any pain or discomfort in the wrist.

Alternative Names

Pain - wrist

Causes

Carpal tunnel syndrome: A common cause of wrist pain is carpal tunnel syndrome. You may feel aching, burning, numbness, or tingling in your palm, wrist, thumb, or fingers. The thumb muscle can become weak, making it difficult to grasp things. Pain may extend up to your elbow.

Carpal tunnel syndrome occurs when the median nerve gets compressed at the wrist because of swelling. This is the nerve in the wrist that allows feeling and movement to parts of the hand. Swelling can occur if you:

  • Do repetitive movements with your wrist, such as typing on a computer keyboard, using a computer mouse, playing racquetball or handball, sewing, painting, writing, or using a vibrating tool
  • Are pregnant, menopausal, or overweight
  • Have diabetes, premenstrual syndrome, an underactive thyroid, or rheumatoid arthritis

Injury: Wrist pain with bruising and swelling is often a sign of an injury. Signs of a possible broken bone include deformed joints and inability to move the wrist, hand, or a finger. Other common injuries include sprain, strain, tendinitis, and bursitis.

Arthritis: Arthritis is another common cause of wrist pain, swelling, and stiffness. There are many types of arthritis:

  • Osteoarthritis occurs with age and overuse.
  • Rheumatoid arthritis generally affects both wrists.
  • Psoriatic arthritis accompanies psoriasis.
  • Infectious arthritis is a medical emergency. Signs of an infection include redness and warmth of the wrist, fever above 100°F, and recent illness.

Other Causes

  • Gout: This occurs when your body produces too much uric acid, a waste product. It forms crystals in the joints, rather than being excreted in the urine.
  • Pseudogout: This occurs when calcium deposits in the joints, causing pain, redness, and swelling. The wrists and knees are most often affected.

Home Care

For carpal tunnel syndrome, you may need to make adjustments to your work habits and environment:

  • Make sure that your keyboard is low enough that your wrists are not bending upward while you type.
  • Take plenty of breaks from activities that aggravate the pain. When typing, stop often to rest the hands, if only for a moment. Rest your hands on their sides, not the wrists.
  • An occupational therapist can show you ways to ease pain and swelling and stop the syndrome from coming back.
  • Over-the-counter pain medications, such as ibuprofen or naproxen, can relieve pain and swelling.
  • Various, typing pads, split keyboards, and wrist splints (braces) are designed to relieve wrist pain. These may help symptoms. Try a few different kinds to see if any help.
  • You may only need to wear a wrist splint at night while you sleep. This helps reduce the swelling. If this does not help, you may need to wear the splint during the day as well.
  • Apply warm or cold compresses a few times during the day.

For a recent injury:

  • Rest your wrist. Keep it elevated.
  • Apply ice to the tender and swollen area.
  • Take over-the-counter pain medication, such as ibuprofen or acetaminophen.
  • Wear a splint for several days. Wrist splints can be purchased at many drugstores and medical supply stores.

For non-infectious arthritis:

  • Do flexibility and strengthening exercises every day. Work with a physical therapist to learn the best and safest exercises for your wrist.
  • Try the exercises after a hot bath or shower so that your wrist is warmed up and less stiff.
  • Do not do exercises when your wrist is inflamed.
  • Make sure that you also rest the joint. Both rest and exercise are important when you have arthritis.

When to Contact a Medical Professional

Get emergency care if:

  • You are unable to move your wrist, hand or a finger.
  • Your wrist, hand, or fingers are misshapen.
  • You are bleeding significantly.

Call your doctor right away if:

  • You have a fever over 100°F.
  • You have a rash.
  • You have swelling and redness of your wrist and you have had a recent illness (like a virus or other infection).

Call your doctor for an appointment if:

  • You have swelling, redness or stiffness in one or both wrists.
  • You have numbness, tingling, or weakness in the wrist, hand, or fingers with pain.
  • You have lost any muscle mass in the wrist, hand, or fingers.
  • You have been following self-care treatments for two weeks, but still have pain.

What to Expect at Your Office Visit

Your health care provider will perform a physical exam, and ask about your symptoms and history, such as:

  • When did the wrist pain begin?
  • Did it occur suddenly and severely or gradually and mildly?
  • Is the pain constant, or does it come and go?
  • Is the pain worse in the morning or at night?
  • Does it go away without self-care?
  • Is the pain sharp, throbbing, or burning? Is there numbness or tingling in any of your fingers?
  • Where exactly is the pain? Is it in both wrists? Does it extend into the fingers?
  • Does the pain occur only with certain movements or positions?
  • Does the pain prevent normal use of the wrist, hand, or arm?
  • Is the pain worse with movement?
  • What helps it? Is it better with immobilization to prevent movement? Does splinting the wrist or applying heat help?
  • Do any medicines help?
  • Is there joint pain elsewhere?
  • Is there pain elsewhere, such as the neck?
  • What medications are you taking?
  • Have you had any recent injuries or illnesses?
  • Are you involved in activities requiring repetitious hand and wrist movements, such as sewing, knitting, computer keyboard use?

X-rays may be taken. If your health care provider thinks that you have an infection, gout, or pseudogout, fluid may be removed from the joint to examine under a microscope.

Anti-inflammatory medicines may be prescribed. Injection with a steroid medicine may be done. Surgery may be needed to treat some conditions.

Prevention

To prevent carpal tunnel syndrome:

  • Adjust your keyboard so that you do not have to bend your wrist upward while typing.
  • Take frequent breaks from activities that require wrist movement.
  • Work with an occupational therapist.

To prevent gout attacks:

  • Limit alcohol.
  • Lose weight if you are overweight.
  • Drink plenty of water.
  • Eat lower amounts of liver, anchovies, sardines, and herring.
  • Your doctor may prescribe medication.

References

Shebab R. Evaluation and diagnosis of wrist pain: a case-based approach. Am Fam Physician. 2013;87:568-573.

Swigart CR. Hand and wrist pain. In: Firestein GS, Budd RC, Gabriel SE, et al., eds. Kelly's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2012:chap 50.


Review Date: 4/16/2013
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial Team.
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