Wrist pain

Some of the common causes of wrist pain include:

• Carpal tunnel syndrome – this is caused by pressure on the median nerve as it passes through the carpal tunnel, which is a narrow passageway on the palm side of your hand.
• Ganglion cysts – these are fluid-filled swellings that can form near the tendon or joint. They cause pain that may worsen or lessen when you use your wrist and can range from pea-sized to the size of a golf ball.
• Kienbock’s disease – this is a condition that causes one of the small bones in the wrist to loose its blood supply. This can subsequently fragment. It most commonly affects young adults.
• Arthritis – there are different type of arthritis that can affect the wrist joint. Osteoarthritis occurs when cartilage that cushions the ends of the bones starts to wear away. It is less frequent in the wrists than hips and knees and sometimes develops following a wrist injury. Rheumatoid arthritis is an autoimmune condition that causes the body to attack its own tissues. It commonly affects both wrists.
• Sprains and fractures – these can occur from falling onto an outstretched hand (see Hand and Wrist Fractures)

Symptoms may vary depending on the cause and severity of the wrist pain. Common symptoms include:

• Pain which may range from a sharp, severe pain to a dull ache.
• Tingling, numbness or pins and needles which may be worse at night.
• Clicking or clunking when using your hand.

A number of different approaches may be used to diagnose wrist pain. Initially you will be given a physical examination which may involve asking you to move your wrist in particular ways and assessing your grip strength. Depending what the examination shows you may also be offered:

• An X-ray to check for fractures or osteoarthritis.
• A CT scan, which can provide a more detailed picture of fractures.
• An MRI scan which can provide a detailed picture of soft tissue structures and bones.
• An ultrasound scan which can provide a picture of soft tissues as well as showing up ganglions.
• Arthroscopy which involves using an arthroscope that is inserted through a small incision in the skin. It allows the doctor to see what is going on inside your wrist.
• Nerve Conduction Studies which measure the speed at which signals pass along nerves. These are normally completed using skin electordes or occasioannly a very fine electrode placed into the muscle.

Treatment will depend on the type and severity of the problem. It might include:

• Pain relieving medication and/or anti-inflammatories.
• A splint or cast to protect the wrist and protect it.
• Hand Therapy to strengthen the wrist and relieve pain. This may be particularly important after surgery to restore full movement.
• Surgery to repair tendons or soft tissues or fractures.  You may also need surgery for conditions like carpal tunnel syndrome or ganglion cysts, which may be drained using a needle and syringe or removed during surgery.