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© 2023 by Justin Chronister, MD 

Why does my wrist hurt?

To get a better idea of why your wrist hurts, take a look at how it works. Your wrist moves in many ways and helps provide the hand with very finely detailed movements: it flexes and extends, it turns out and turns in, and even moves in a circle. When they’re working well, you don’t think about the eight carpal bones of your upper hand, the two bones of your forearm, or all the soft tissue helping them work well together at the wrist. But, when something’s wrong, the pain can be debilitating.

The wrist and hand bones fit together like no other joint. A complex of bones and joints, the wrist bridges the two rows of small carpal bones of the hand to the two forearm bones.

Many working parts

 

Carpal tunnel syndrome is a painful condition often felt in the palm of the hand at the base of the thumb, index finger, middle finger, and thumb-side of the ring finger. When the median nerve that travels through the complex wrist joint becomes compressed by the tissue surrounding it (the carpal tunnel), you may experience pain, numbness, tingling, and even grip weakness.

 

Because the wrist involves so many parts, even a small injury can begin to create bigger problems. Your pain may be due to overuse, an injury, or chronic swelling or inflammation – most often referred to as arthritis.

osteoarthritis (OA) a common form of arthritis associated with wrist pain, can be caused by wear-and tear over time or can develop years after an injury.

Post-traumatic arthritis develops when bone and cartilage don’t heal properly after an injury. When an injury doesn’t heal smoothly, resulting scar tissue can get in the way and cause pain.

Rheumatoid arthritis leaves the door open for unwelcome changes in the bone as the soft tissue that stabilizes and lubricates the joint becomes inflamed and painful.
 

Your doctor will examine your wrist and may ask you to take a few tests to determine the cause of your pain.

What will a doctor do?

At your first appointment, your orthopaedic doctor will assess what’s going on. You’ll answer a few questions about when and where your wrist hurts. The doctor may understand what’s going on right away because you show classic symptoms of a particular problem. The doctor may also ask you to have an additional diagnostic test, like an X-ray or an MRI.

Pain relief doesn’t always mean surgery. Your doctor may recommend a combination of treatments to alleviate your pain – perhaps a course of physical therapy, rest, ice, or over-the-counter anti-inflammatory medication. If you have severe pain, swelling, or discoloration, seek emergency medical treatment.

What can I do now?

You and your doctor may decide that there are some things you can do now to manage your pain without surgery.

Treatment without surgery.
Lifestyle changes

Talk with your doctor about the kinds of exercises that may strengthen your grip, improve your range of motion, and help reduce your pain. Avoid repetitive tasks and take frequent breaks from any activity that requires use of your hands – typing, repair work, crafts, etc.

 
Self-care

The acronym R.I.C.E. stands for Rest, Ice, Compression, and Elevation. Your doctor may suggest these practical and conservative approaches to help joint pain from injury or overuse.2 Rest to avoid further injury. (Especially avoid repetitive tasks.) Ice your wrist on and off for 15 minutes at a time. Apply an elastic bandage for compression of your wrist to help reduce swelling and provide some support. Elevate your hand and wrist when you rest.

 
Physical therapy

Physical therapists may be able to help lessen your pain and improve pain-free movement. Your physical therapist may perform manual therapy or recommend stretching and strengthening exercises, depending on your anatomy, joint functioning, and disease progression. A physical therapist may even recommend a wrist brace to remind you to keep your wrist in a neutral position.

 
Medication

Your doctor may recommend over-the-counter or prescription anti-inflammatory medicines to take the edge off the swelling and pain in your hand and wrist. Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can be helpful even when taken for a long period of time; steroid medications, like corticosteroid injections, can’t be used as often because, although they’re effective, they may further damage the joint you’re trying to protect.2 Use of these medications must be monitored by your doctor.

Talk with your doctor about the non-surgical approaches to decreasing your wrist pain. If these approaches don’t lessen your pain, you’ve still got options. Learn more about surgical approaches to relieve your wrist pain.