The injuries of the multipurpose wrist

Wrist pain is common. Repetitive motion can damage your wrist. Everyday activities like typing, racquet sports or sewing can cause pain or even damage your wrist.

Wrist pain with bruising and swelling can be a sign of injury. The signs of a possible fracture include misshapen joints and inability to move your wrist. Some wrist fractures are a result of osteoporosis.

Other common causes of pain are:

  • Sprains and strains
  • Tendinitis
  • Arthritis
  • Gout and pseudogout

Because so many factors can lead to wrist pain, diagnosing the exact cause can sometimes be difficult. But an accurate diagnosis is essential for proper treatment.

Wrist pain may vary, depending on what's causing it. For example, osteoarthritis pain is often described as being similar to a dull toothache, while carpal tunnel syndrome usually causes a pins-and-needles feeling, especially at night. The precise location of your wrist pain also can give clues to what might be causing your symptoms.

 

When to see a doctor

Not all wrist pain requires medical care. Minor sprains and strains, for instance, usually respond to ice, rest and over-the-counter pain medications. But if pain and swelling last longer than a few days or become worse, see your doctor. Delays in diagnosis and treatment can lead to poor healing, reduced range of motion and long-term disability.

Your wrist is a complex joint made up of eight small bones arranged in two rows between the bones in your forearm and the bones in your hand. Tough bands of ligament connect your wrist bones to each other and to your forearm bones and hand bones. Tendons attach muscles to bones. Damage to any of the parts of your wrist can cause pain and affect your ability to use your wrist and hand.

 

Injuries

  • Sudden impacts. Wrist injuries often occur when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures. A scaphoid fracture involves a bone on the thumb side of the wrist. This type of fracture may not show up on X-rays immediately following the injury.
  • Repetitive stress. Any activity that involves repetitive wrist motion — from hitting a tennis ball or bowing a cello to driving cross-country — can inflame the tissues around joints or cause stress fractures, especially when you perform the movement for hours on end without a break. De Quervain's disease is a repetitive stress injury that causes pain at the base of the thumb.

 

Arthritis

  • Osteoarthritis. This type of arthritis occurs when the cartilage that cushions the ends of your bones deteriorates over time. Osteoarthritis in the wrist is uncommon and usually occurs only in people who have injured that wrist in the past.
  • Rheumatoid arthritis. A disorder in which the body's immune system attacks its own tissues, rheumatoid arthritis commonly involves the wrist. If one wrist is affected, the other one usually is, too.

 

Other diseases and conditions

  • Carpal tunnel syndrome. Carpal tunnel syndrome develops when there's increased pressure on the median nerve as it passes through the carpal tunnel, a passageway in the palm side of your wrist.
  • Ganglion cysts. These soft tissue cysts occur most often on the part of your wrist opposite your palm. Smaller ganglion cysts seem to cause more pain than larger ones do.
  • Kienbock's disease. This disorder typically affects young adults and involves the progressive collapse of one of the small bones in the wrist. Kienbock's disease occurs when the blood supply to this bone is compromised.

Wrist pain can happen to anyone — whether you're very sedentary, very active or somewhere in between. But your risk may be increased by:

  • Sports participation. Wrist injuries are common in many sports, including bowling, golf, gymnastics, snowboarding and tennis.
  • Repetitive work. Almost any activity that involves your hands and wrists — even knitting and cutting hair — if performed forcefully enough and often enough can lead to disabling wrist pain.
  • Certain diseases or conditions. Pregnancy, diabetes, obesity, rheumatoid arthritis and gout may increase your risk of developing carpal tunnel syndrome.

Although you may initially consult your family physician, he or she may refer you to a doctor who specializes in joint disorders (rheumatologist), sports medicine or even an orthopedic surgeon.

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