Have you been struggling with wrist pain but are uncertain about its origins? You’re not alone. Joint pain is no longer a condition that only the elderly will experience, an increasing number of the younger generation in Singapore are becoming affected too. Our wrists, vital for everyday tasks, undergo significant stress daily. Whether it’s writing or engaging in more strenuous activities like rock climbing, our wrists bear the brunt of these movements.
In this article, Advanced Hand, a specialist in hand and wrist care, will shed light on common causes of wrist pain, as well as treatment options available. Keep reading to gain valuable insights.
Anatomy of the wrist
Before zooming straight into the conditions that affect the wrist joint and cause wrist pain, it is important for you to understand the anatomy of the wrist. This section looks at the various components of the wrist, providing a comprehensive understanding of this vital region.
Wrist bones
Scaphoid: The scaphoid is a boat-shaped bone located on the thumb side of the wrist. It plays a crucial role in wrist stability and articulates with the radius, lunate, trapezium, and capitate bones.
Lunate: Positioned between the radius and the capitate bone, the lunate is a moon-shaped bone that contributes to wrist movement and stability.
Triquetrum: Situated next to the lunate bone, the triquetrum is pyramidal in shape and forms part of the wrist joint complex.
Trapezoid and Trapezium: These bones are located at the base of the hand, connecting the wrist to the thumb and facilitating thumb movement and grip strength.
Capitate: The largest carpal bone, the capitate, is located in the centre of the wrist and plays a vital role in wrist stability and load-bearing activities.
Hamate: Positioned on the pinky finger side of the wrist, the hamate bone provides attachment sites for various wrist tendons and ligaments.
Pisiform: A small, pea-shaped bone located at the base of the palm, the pisiform aids in wrist movement and supports the flexor carpi ulnaris tendon.
Wrist joints
Radiocarpal Joint: Formed by the distal end of the radius and the proximal row of carpal bones, the radiocarpal joint allows for flexion, extension, abduction, and adduction movements of the wrist.
Ulnocarpal Joint: Located between the ulna and the triquetrum and lunate bones, the ulnocarpal joint contributes to wrist adaptability.
Distal Radioulnar Joint: Situated between the radius and ulna at the wrist’s distal end, this joint enables rotation movements of the forearm, essential for tasks such as turning a key or using a screwdriver.
Scaphotrapeziotrapezoid Joint: This joint involves articulations between the scaphoid, trapezoid, and trapezium bones, contributing to wrist flexibility and load distribution during gripping activities.
Wrist nerves
Ulnar Nerve: The ulnar nerve runs along the ulna bone and provides sensation to the pinky finger and half of the ring finger. It also innervates several muscles controlling hand functions.
Median Nerve: Running along the centre of the forearm, the median nerve supplies sensation to the thumb, index finger, middle finger, and half of the ring finger. It also controls the muscles responsible for specific hand movements.
Wrist tendons
Flexor Carpi Radialis (FCR) Tendon: The FCR tendon runs along the palm side of the forearm and is responsible for wrist flexion and radial deviation.
Flexor Carpi Ulnaris (FCU) Tendon: Situated on the ulnar side of the forearm, the FCU tendon aids in wrist flexion and ulnar deviation.
Palmaris Longus Tendon: The palmaris longus tendon assists in wrist flexion and tensioning the palmar aponeurosis.
Extensor Carpi Radialis Brevis (ECRB) Tendon: This tendon is part of the extensor muscle group and is involved in wrist extension and radial deviation.
Extensor Carpi Radialis Longus (ECRL) Tendon: Like the ECRB tendon, the ECRL tendon contributes to wrist extension and radial deviation movements.
Extensor Carpi Ulnaris (ECU) Tendon: The ECU tendon runs along the ulnar side of the forearm and is responsible for wrist extension and ulnar deviation.
Common conditions that cause wrist pain
Understanding the common conditions that cause wrist pain is crucial for timely diagnosis and effective treatment. Let’s delve into the various factors that contribute to wrist pain.
Arthritis
Arthritis is a major source of chronic joint discomfort, impacting millions globally. In the wrist, osteoarthritis and rheumatoid arthritis are the primary culprits. >Osteoarthritisstems from cartilage wear, leading to pain, stiffness, and limited wrist mobility. Rheumatoid arthritis, on the other hand, is an autoimmune condition, triggering wrist joint inflammation, causing pain, swelling, and potential deformity without prompt wrist arthritis treatment.
Injuries
Trauma or overuse are common causes of wrist injuries, which range widely from wrist fractures to ligament tears. Bony injuries, such as fractures of the radius, ulna, or carpal bones, can cause sharp, localised pain in the wrist, accompanied by swelling and bruising.
TFCC
TFCC injuries commonly occur due to falls onto an outstretched hand, twisting motions, or fractures involving the wrist. Additionally, degenerative changes with age can weaken the TFCC, putting it at risk of tears even with minor trauma. Symptoms include pain along the outer wrist, clicking sensations, and weakness during gripping activities.
Scapholunate dissociation
Scapholunate dissociation refers to the separation of the scaphoid and lunate bones within the wrist joint. This condition often arises from high-impact falls on an outstretched hand, leading to ligamentous injuries and instability in the wrist. Patients may experience pain, swelling, and difficulty with wrist movements.
Carpal tunnel syndrome
Carpal tunnel syndrome (CTS) results from compression of the median nerve as it passes through the carpal tunnel in the wrist. Common symptoms include numbness, tingling, and pain, especially in the thumb, index, and middle fingers. Factors such as repetitive hand movements, wrist injuries, or underlying conditions like diabetes can contribute to CTS development.
Mummy’s wrist
“Mummy’s wrist,” also known as de Quervain’s tenosynovitis, involves inflammation of the tendons on the thumb side of the wrist. Repetitive thumb and wrist movements in activities like texting or lifting objects with improper hand positioning can irritate these tendons, leading to pain, swelling, and difficulty with gripping or pinching motions.
Ganglion cyst
A ganglion cyst is a noncancerous, fluid-filled lump that commonly develops along tendons or joints in the wrist or hand. Although usually painless, larger cysts can cause discomfort, especially with wrist movements or pressure on the affected area. The exact cause of ganglion cysts remains unclear, but trauma or repetitive stress may contribute to their formation.
Distal radius fractures
Distal radius fractures are common wrist injuries, typically occurring due to falls onto an outstretched hand or direct impact. These fractures involve the larger forearm bone near the wrist joint, leading to pain, swelling, and sometimes deformity.
Lifestyle changes to reduce wrist pain
Wrist pain can be a debilitating issue that affects many aspects of daily life, from simple tasks like typing on a keyboard to more strenuous activities like sports. From modifying exercise intensity to using supportive tools, let’s explore effective strategies to alleviate wrist discomfort and improve overall wrist health.
Avoid activities that worsen wrist pain
One of the first steps in managing wrist pain is to identify and avoid activities that exacerbate discomfort. This may include repetitive motions such as typing for extended periods, using hand tools that require a tight grip, or participating in sports that strain the wrists, like tennis or golf.
Reduce activity intensity levels
If you regularly engage in activities that put significant strain on your wrists, consider dialling down the intensity a notch or two. Enjoy working out at the gym? Try reducing weights and focusing on proper form to reduce wrist strain. Similarly, if your job involves repetitive tasks like typing, talk to your employer about ergonomic solutions such as adjustable desks or ergonomic keyboard setups to lessen strain and improve overall comfort.
Use an ice pack
Applying an ice pack to the affected wrist can help reduce inflammation and numb pain. Wrap a cloth around the ice pack to protect your skin, then apply it to the sore area for about 15-20 minutes several times a day, especially after activities that strain the wrists.
Do gentle, stretching wrist exercises
Incorporating gentle wrist exercises like wrist flexion and wrist circles into your daily routine can help improve flexibility, strengthen the muscles supporting the wrist, and reduce stiffness and pain. Start with gentle movements and gradually increase intensity as your wrist pain improves. You may also consult with a hand and wrist specialist for personalised exercise recommendations based on your specific condition.
Wear a wrist splint/brace
Using a wrist splint or brace can provide support and stability to the wrist joint, especially during activities that aggravate wrist pain. Designed to keep the wrist in a neutral position, wrist splints help with minimising strain on the tendons and ligaments. They can be used for tasks during the day that need wrist support or while you sleep to avoid pain and stiffness at night.
Use gadgets/tools that make completing daily activities easier
Gadgets and tools designed to reduce strain on the wrists can significantly enhance daily comfort and functionality. For example, using a jar opener or lever door handle reduces the need for gripping and twisting motions that can worsen wrist pain. With these aids, you can say goodbye to unnecessary wrist strain and hello to a more comfortable, pain-free day.
Conservative wrist pain treatments
Wrist pain treatments range from conservative ones to surgical methods. In most cases and if your condition is not severe, most doctors and specialists would recommend conservative treatments as the initial course of action. Here are some options that may be considered.
Medications
One of the first lines of defence against wrist pain is the use of medications, specifically pain relievers and anti-inflammatory drugs. Options like ibuprofen and acetaminophen can help minimise pain and swelling associated with conditions like carpal tunnel syndrome. However, it’s crucial to follow dosage instructions and have a talk with your healthcare professional if pain persists.
Injections
Are you dealing with persistent or severe wrist pain? Corticosteroid injections could be the answer for targeted relief. These injections deliver powerful anti-inflammatory medication directly into the affected area, effectively reducing swelling and pain. Common conditions treated with corticosteroid injections include carpal tunnel syndrome and wrist arthritis flare-ups.
Physical therapy
Physical therapy plays a crucial role in rehabilitating and strengthening the wrist to lessen strain and enhance function. A skilled physical therapist can assess the underlying causes of wrist pain, develop a personalised exercise program, and guide you in proper ergonomics to prevent further injury.
Immobilisation
In cases where wrist pain is worsened by movement or strain, immobilisation through splinting or bracing can provide much-needed rest and support to the joint. By limiting motion and stabilising the wrist, these devices allow injured tissues to heal while preventing added damage.
Surgical wrist pain treatments
Wrist arthroscopy
Wrist arthroscopy is a minimally invasive surgical procedure that involves inserting a small camera called an arthroscope into the wrist joint through tiny incisions. Arthroscopy is particularly effective for addressing wrist arthritis, wrist sprains, fractures, and ganglion cysts within the wrist joint.
Carpal tunnel release
When conservative measures like splinting and corticosteroid injections fail to provide relief, carpal tunnel release surgery may be recommended. During carpal tunnel release, the surgeon cuts the transverse carpal ligament, releasing pressure on the median nerve and alleviating symptoms. This can be done through traditional open surgery or endoscopic techniques involving smaller incisions and specialised tools.
Tendonitis surgery
Tendonitis, or inflammation of the tendons in the wrist, can cause pain, swelling, and limited mobility. Surgical options for tendonitis in the wrist vary depending on the specific tendons involved and the severity of the condition. Common procedures include tendon debridement, tendon repair, and tendon release.
Recovering from wrist surgery
Whether due to injury or chronic conditions, the aftermath of wrist surgery involves several changes and challenges. Here are 4 key things to expect when recovering from wrist surgery.
Your hand may be immobilised in a bulky dressing or splint
Following wrist surgery, it’s common for the affected hand to be immobilised in a bulky dressing or splint. This dressing or splint serves to protect the surgical site, reduce swelling, and promote proper healing. You may experience some discomfort and limitations in hand movement during this phase, but remember that it’s a temporary measure crucial for a successful recovery.
Restrictions on work and activities
Depending on the type and extent of the surgery, your hand specialist may advise avoiding activities that put strain on the wrist or require gripping and lifting heavy objects. This could mean taking time off work or modifying certain activities to accommodate your healing wrist.
Physical therapy may be needed
Your doctor may recommend starting physical therapy sessions shortly after surgery or once the initial healing phase is complete. A skilled therapist will guide you through targeted exercises and stretches intended to improve your range of motion, reduce stiffness, and enhance hand and wrist function. Consistent participation in these sessions, coupled with diligent home exercises, can accelerate your recovery progress and minimise long-term complications.
Recovery time varies
Recovery time after wrist surgery is unique to each individual, and influenced by factors like surgery type, healing rates, and adherence to post-operative care. Some may see notable progress within weeks, while others may need months to return to normal activities. It’s important to be patient with yourself, set realistic expectations, and maintain consistent follow-up with your healthcare team during this period. Remember to also celebrate small milestones along the way, as they signify progress towards a full recovery and can provide encouragement during the healing journey.
Tips for a speedy recovery
Navigating the recovery phase after surgery can indeed be a challenging experience, encompassing physical discomfort, emotional adjustments, and the need for diligent care. During this crucial period, implementing effective strategies is important to facilitate a smooth and speedy recovery while ensuring optimal healing outcomes. Here, we’ll delve into several key tips that can make a significant difference in your post-surgery journey.
Keep the dressing and wound dry
Moisture around the surgical site can impede healing and increase the risk of infections. Hence, one of the primary concerns after surgery is keeping the dressing and wound dry. Follow your doctor’s guidelines regarding showering or bathing post-surgery, and use waterproof dressings or covers as recommended.
Look out for signs of infection
Redness, swelling, warmth, or increased pain around the surgical site, coupled with symptoms like fever or chills, can indicate a potential infection. Pay attention to any signs of moisture accumulation or unusual discharge, and promptly inform your medical provider if you notice any changes. Early detection and appropriate treatment of infections can significantly impact your recovery, ensuring smoother progress towards hand health.
Elevate your hand
Elevating your hand above heart level is a simple yet effective way to manage swelling and enhance circulation. Use soft pillows or cushions to provide gentle support to your hand while sitting or lying down, allowing gravity to assist in reducing fluid buildup. Maintaining an elevated hand position in the days following surgery not only helps alleviate discomfort but also promotes overall healing.
Take medication as prescribed
Following your prescribed medication regimen is crucial for managing pain, reducing inflammation, and preventing complications. Take medications exactly as directed by your hand specialist, including pain relievers and any other medications recommended for your recovery. If you experience any adverse reactions or have concerns about your medications, discuss them promptly with your doctor for appropriate guidance.
Learn more: Things To Expect After A Hand Surgery In Singapore | Advance Hand, Wrist & Nerve Centre
FAQs about wrist pain and treatment options
Dealing with wrist pain can really throw a wrench into your day-to-day activities, making even simple tasks feel challenging. This section looks at some common questions you may have about wrist pain and treatment options.
When should I see a doctor for wrist pain?
If you experience persistent or worsening wrist pain that interferes with daily activities such as gripping objects, typing, or lifting, it’s essential to consult a doctor. You should also seek prompt medical attention if you notice any accompanying symptoms like swelling, redness, warmth, or numbness in your hand or fingers. These signs could indicate conditions such as carpal tunnel syndrome, tendonitis, or fractures, which require professional evaluation and treatment for proper healing.
Is surgery compulsory to treat wrist pain?
Surgery is not always necessary to treat wrist pain. Many wrist pain conditions can be effectively managed through conservative treatments such as rest, medications, and the use of wrist splints. Physical therapy exercises and ergonomic modifications to daily activities can also help alleviate pain and improve wrist function.
Will wrist pain go away on its own?
While some minor wrist pain can fade away with rest and self-care measures, it’s important not to ignore persistent or recurring pain. Delaying treatment can lead to worsening symptoms, decreased mobility, and potential long-term complications. Early intervention is key to addressing the root cause of wrist pain and preventing further damage, which can significantly affect your quality of life.
Why should I never leave wrist pain untreated?
Ignoring wrist pain may cause your condition to worsen, leading to chronic pain and limited mobility. Conditions like nerve compression can cause nerve damage if not addressed promptly, leading to irreversible symptoms. Moreover, untreated wrist injuries or fractures may heal improperly, causing long-term issues such as stiffness, weakness, and arthritis.
What role does physical therapy play in treating wrist pain?
Physical therapy plays a crucial role in treating wrist pain by focusing on improving wrist strength, flexibility, and range of motion. Hand therapists may use exercises, manual techniques, and ergonomic education to help reduce pain, improve function, and prevent future injuries.
Conclusion
It’s easy to dismiss wrist pain initially, but ignoring it can result in mobility limitations and reduced flexibility, significantly impacting our ability to carry out daily tasks and enjoy our favourite activities to the fullest.
For accurate diagnosis and tailored treatment, consulting a specialist like Dr. Jacqueline Tan at Advanced Hand, Wrist & Nerve Centre is essential. Your wrists deserve the best care possible; reach out today to regain confidence in your daily activities without limitations.