Wrist: Frequently asked Questions

Even though medication forms the major part of treatment for arthritis, a customized exercise program will help relieve pain and fatigue while also helping to preserve joint structures and function.

The stiffness, pain, and/or swelling linked to arthritis can largely limit the range of motion of your joints. In such situations, avoiding physical activities due to pain and discomfort can result in significant muscle loss, as well as uncontrolled weight gain. Physical therapy that is done as part of an arthritis treatment plan can help enhance your joint mobility, increase muscle strength, and overall physical condition when at the same time helping you in maintaining healthy body weight.

Glucosamine, with/without the component called “chondroitin sulfate,” seems to have some effect on the inflammatory responses that are caused by arthritic degeneration in joints, especially in the knees.

However, from a medical point of view, there is no evidence that glucosamine can slow and/or repair any articular cartilage degenerative changes. Therefore, there is no specific recommendation for using glucosamine (with/without chondroitin sulfate) is possible.

The actual cause of a ganglion cyst is not known. However, it seems that women are more susceptible than men. Also, ganglions are commonly found in gymnasts, who repetitively put pressure on their wrists. Some cases of ganglion cysts can be more painful since the fluid-filled sac gives pressure on those nerves that pass via the joint. Bigger ganglions are unattractive even if they aren’t causing any pain. On the other hand, smaller ones that stay hidden under your skin called occult ganglions can be more painful. In some cases, an MRI or ultrasound will be required to identify a ganglion cyst that is hidden underneath your skin.

Endoscopic carpal tunnel release surgery is a minimally invasive treatment procedure that will be carried out using an advanced tool known as “endoscope.” This tool is made of a thin tube with a miniature light and a camera at its end. In this procedure, the endoscope will be inserted via a tiny incision in your palm, and then the region to be operated upon will be magnified and projected on a big screen. Your surgeon will make use of the pictures on the screen to guide your surgical procedure.

The benefits of carpal tunnel release surgery are it helps with a quicker recovery, minimal pain, and less scarring.

A wrist that is fractured will be painful, and movement will be retarded. If there is a sustained injury, there will be severe inflammation, redness, and radiating sharp pain. Bruising around the wrist area is also the most prominently seen symptom during a fracture. When you have a fractured wrist, you will not be able even to grab an object. There will be a severe burning or tingling sensation in the wrist area, which can also spread to various parts in the arm.

Wrist pain is a common complaint, with many common causes responsible for it. However, you need a doctor’s aid to make an accurate diagnosis of the symptoms and reasons so that the disease can be treated well. Some of the common causes of wrist pain include:

• Tendonitis, which is due to the inflammation in the tendon sheath and this disorder doesn’t need any surgery.
• Sprain, which is a common injury in the ligaments around the wrist and joint.
• Carpal tunnel syndrome that is due to the dysfunction of any one of the nerves that are located in the wrist.
• Arthritis
• Ganglion Cyst, an inflamed swelling in the wrist, which may be benign and fluid-filled. These cysts are not cancerous but will grow and bother the usage of hands.

Carpal tunnel syndrome can be prevented easily. People at workplaces can take a break from monotonous work and can try to stretch their body, go for a walk or keep their hands warm by wearing a glove, etc. To maintain an ergonomic posture while working is essential to any worker. The hands and wrists need to be placed appropriately. People can opt for buying specially designed work furniture, workstations, handles and tools to avoid carpal tunnel syndrome. Checking the possibilities of job rotation and distribution of workforce can be done.

It is said that women have three times higher chances than men when it comes to contracting carpal tunnel syndrome. The reason is that women have a smaller carpal tunnel than men, and in most cases, the dominant hand is first affected and induces more pain. The diabetic patients and people suffering from other metabolic disorders including neurological issues also are more susceptible to carpal tunnel syndrome. However, this syndrome is reportedly seen only in adults.

The risk of contracting a severe carpal tunnel syndrome is not narrowed to people who work in a specific industry or do a specific job. However, it is more common in people who perform data entry, sewing, manufacturing, assembling, etc.

Yes, it is possible to get carpal tunnel in both hands. Generally, the symptoms occur in one hand at first, but rarely, it is also felt in both hands at a time, especially during the night. Generally, people sleep with a clenched fist and hence they might feel the symptoms of carpal tunnel syndrome at night. A person with carpal tunnel syndrome may need to get up in the night with an urge to loosen the wrist and shake it very hard. Sometimes, symptoms worsen so much that people feel a tight tingling feeling even during the day.

Many people agree that sending a text message is an effective way of communication while others talk about the side effects of texting as a fall in grades. There is also another side of this. Texting leads to dangerous painful and physical conditions. Carpal tunnel syndrome is instigated in many ways. Especially, when there is an unwarranted pressure exerted upon your median nerve, you tend to get a severe carpal tunnel syndrome. This happens when you bend or extensively twist or exert pressure on your wrist, which commonly happens while you are texting over a phone, playing video games, when you keep on typing on the computer keyboard, and so on. It can also be due to an injury in from the past in your hand or wrist.

Bones can be injured in two ways, namely fracture and dislocation. A break or crack in a bone is called a fracture. The scaphoid bone, which is one of the eight small bones in the wrist, gets easily fractured and it is the main reason for many wrist fractures. Wrist fractures are widespread both in sports and motor vehicle accidents. Wrist fractures usually occur during a fall on the stretched out wrist. The angle at which the wrist strikes the ground may determine the type of injury.

If you have a broken wrist, you will experience:

• Acute  pain and softness
• Staining and swelling
• Difficulty in the movement of the wrists
• Deformity in the shape of the wrist and arm
• A crack or grinding noise at the time of injury
• Bleeding in the cases where the bone has damaged the skin
• Sometimes the bone may poke through the skin
• Tingling and numbness

In addition to above all, due to the stress, shock, and pain of the break in the wrist bones, feeling of dizziness and fainting can also occur.

Sprains injure the ligaments that clasp your bones together, and these ligaments are as necessary to your skeletal system as the bones themselves.

Those who suffer a wrist sprain would be expecting a less painful and challenging treatment schedule. However, for beneficial and quick healing and to reduce the swelling and pain in the case of wrist sprain, it is necessary to wear a cast. Wearing a cast will immobilize our forearm for weeks which is highly preferred for quick healing.

Casts are not always required for healing broken bones. If the sprain is mild and minor, it can be treated at home with therapy remedies, rest, and by avoiding risky activities. Whereas, if the sprain is so severe that even little movement of the affected or injured ligaments cause acute pain, permanent changes in the function of the wrist, and obstruct proper healing, then a cast is essential.

For severe wrist sprains, a cast is explicitly planned and designed in such a way to stop you from moving your wrist during the healing process. This helps in the healing of the damaged ligaments. It also keeps you from bending your wrist, which could apply more stress on them and slow down the healing process.

A sprain is the most common injury to the wrist. The sprain is a damage to the ligaments, a type of tissue that connects the bones in the wrist joint same as any other joints.

When you fall frontward, as for how you jaunt running or rollerblading, your common or instinct response is to put your hands out in front of you to catch yourself. However, this response will make you land on your palm, which results in twisting your wrist backward. This leads to stretching or tearing of the ligaments that connect the bones in your wrist, thereby resulting in a wrist sprain.

Bone fracture is another common injury to the wrist. Bones can be fractured and dislocated. A break or crack in a bone is called a fracture. A bone is said to be dislocated when it is disturbed from its original position, projecting outwards, out of place so that they no longer line up correctly at the joint.

This can decrease the ability to move and cause pain. Scaphoid (one among the eight small bones in the wrist) fractures account for many wrist fractures. Wrist fractures are widespread both in sports and motor vehicle accidents. The break usually occurs during a fall on the stretched out wrist. The angle at which the wrist strikes the ground may determine the type of injury.

When a wrist injury takes place, the exact condition of the injury cannot be determined immediately. Visible deformity, severe pain, numbness, restriction in movement of the wrist, and inability to maintain the grip are some visible signs of a possible fracture. Minimize or completely stop the movements of the arm or wrist.

As the first aid, support the injured arm and wrist with splint using a ruler, stick, or a sling using clothes and immediately see a doctor. The sudden impact or hit of the hand on the hard ground and the weight of the body getting transmitted to the hand, makes the ligaments get injured resulting in wrist sprain.

To treat a wrist injury:

• Apply ice therapy to the broken wrist for fifteen minutes for four to six times a day.
• Apply compression wrap.
• To relieve the pain and swelling, apply a packet of frozen vegetables or crushed ice in a wet cloth to the painful area. For maximum effect, apply for up to 20 minutes, every 2 hours. If any uncomfortable feeling persists, remove the ice. Don't apply the ice directly to the skin.
• Keep the wrist elevated above the heart level.
• Use of splint is advisable. However, it should be removed during the night.
• Complete rest is needed for the wrist. However, try to move your shoulders and elbows.
• Immobilization of wrist is very important for quick healing of the injury.
• Take over-the-counter medication.
• If the numbness in hand and wrist continues even after two to three days, they should be treated immediately. On the other hand, if the movement of the wrist is restored after three or four days, try to do some stretching exercises.

Human wrist is made of many bones which are connected by ligaments and the ligaments help in stabilizing and supporting the joint during the movement of hands and forearm. When a fall takes place, with an outstretched hand, sprains in wrists happen. A sudden impact or hit of the hand on the hard ground or the weight of the body getting transmitted to the hand makes the ligaments to get injured resulting in wrist sprain.

The severity of the sprain depends upon the force with which the fall takes place. Healing and recovery of the wrist sprain depend upon the severity of the wrist sprain. Pain and swelling, in the case of mild wrist sprains, will heal in two to three days, whereas moderate wrist sprains heal in a week. Recovery time varies from person to person, depending upon the health condition and age of the person. If the sprain is severe, it will take several weeks or months to get completely healed. If complete rest is given immediately to the sprained wrist, healing can be speeded up.

No, it cannot heal on its own, unless you give some therapy and proper medication and applying a cast. When you get a broken wrist, immediately immobilize the hand using a splint. Then, an X-ray is to be taken, and visit the doctor for casting is needed. Without surgery, the broken wrist can be healed, but it will take time.

No, we should not move the hand with a broken wrist before casting. For quick and proper healing of the broken wrist, it is advised to restrict the movement of a broken bone in your wrist A splint or cast is needed to keep the broken wrist at rest. It is advised to keep the hand above heart level as much as possible to reduce swelling and pain.

Inflammation or injury caused to tendons and synovium in the wrist results in wrist tendonitis. Apart from this, arthritis and infection can also lead to wrist tendonitis. Overuse of wrist is the leading and significant cause for wrist tendonitis.

If the person is affected with wrist tendonitis, the familiar feeling will be pain and inflammation in the wrist. A feeling of prolonged pain is observed in the wrist. Tenderness and numbness can also be felt in the wrist.

In addition, wrist tendonitis leads to swelling in the wrist area. Also, stiffness is felt in the wrist which reduces the range of motion. If the condition is very severe and acute, sharp shooting pain is felt in the wrist. Due to the stiffness and rigidity, flexible movement of the muscles is dropped down, which decreases the strength of the hand and lessens the gripping or grabbing ability.

Wrist fractures and wrist sprains are caused by similar mechanisms, such as slipping off the floor, falling from a height, or giving pressure on the wrist while falling. You can identify it by seeing the size and shape of the wrist to find out whether it is a sprain or a fracture. If the wrist is not straight it could be a wrist fracture. If the pain is not reducing and perseveres and the swelling gets worse, making it difficult to use to the hand, an X-ray is necessary to determine whether it is a wrist fracture or not.

The X-ray is a reasonably uncomplicated, swift, and easy thing to do and will tell us generally if it is a fracture or not. Deformity of the wrist or bone matter breaking through the skin is the apparent sign of fracture. Pain occurs both in sprain and fracture, and intensity of pain is more or less common in both the cases and so pain cannot be considered to find out if it is sprain or fracture.

A common, often seen condition with irritation and inflammation of the tendons around the wrist is known as wrist tendonitis. It, sometimes, leads to discomfort while moving the wrist. Repetitive stress and strain to the wrist due to work and sports is the most critical cause of tendonitis.

Time of Healing:

• In mild and moderate cases, on seeing the symptoms, if the treatment is given immediately, and no other complicating factors are reported, the healing is possible in a short period, say in a couple of weeks.
• Depending upon the patient's inherent healing capacity and other related factors, healing can take weeks together, months and even a year.
• Proper and adequate rest and immobilization of wrist joints will help in reducing the pain and inflammation in a couple of weeks.
• Healing is certainly slow with the rise in age, whereas damage is much more predominant. It is seen widely and commonly that elders suffer from tendonitis symptoms for months.
• People suffering from other chronic diseases, such as diabetes, arthritis, will have delayed healing.
• Continuing to work even amidst severe pain will aggravate the inflammation and pain, and healing will take several months or years just because proper initial treatment and rest are not given.
• If the tendonitis is associated with other tissue damage due to injury, there will be an aggressive increase in the symptoms as the entire area is injured and it may take longer to get healed.

If a sense of numbness, tingling or weakness is felt in the wrist, it is more likely that it is carpal tunnel in his or her wrist. A feeling of burning sensation, tingling, itching, numbness in the palm, thumb, index or middle fingers is the underlying symptom of carpal tunnel in the wrist.

A feeling of numbness in the fingers starting from late evening and running through the night is the initial symptom. Moreover, on getting up from bed in the morning, this feeling of numbness and tingling will spread from hands over to shoulder. When the condition is severe, a feeling of having less grip strength due to the shrinking of muscles in hand, leading to severe and worse pain could be felt. Slowly, you will start to feel a loss of strength and coordination to use the thumb to do any gripping or holding work, say for example pinching. We can see swelling around the wrist and a feeling of warmth in the tendons.

Wrist pain often caused by ligament tear, sprains, minor trauma is prevalent in people who use their wrists over and over again in work. It is also caused due to tendonitis, carpal tunnel syndrome, arthritis, gout, and bone fractures. Home treatment for wrist pain is similar to almost all the cases:

• Taking a break from our repetitive activity and giving your wrist some rest is the most comfortable home treatment.
• Keeping the wrist elevated above the level of heart helps in preventing the swelling or inflammation of the wrist.
• A severe strain to the wrist, due to repetitive work or sports needs complete rest for the wrist for days and also a medical examination.
• Repetitive tasks cause mild to moderate wrist pain, which necessitates a change in the work environment. For example, if you are working at a computer for a long time, lower you, keyboard, thereby avoiding the upward motion of the wrist. Adjust the height of the chair to make your forearms parallel to the floor.
• Wearing the specially designed wrist splint is very helpful in all types of wrist pains. Wrist splints are of few types depending upon the requirement. Wrist splint should be worn in  the day time during work and sometimes needs to be worn at night also.
• If the wrist pain is caused due to sudden trauma like falling on the hand, lifting something cumbersome, the practical way of relieving pain is by applying cold therapy which prevents the swelling and also numbs the pain. Ice therapy can be done using, ice cubes, ice gel, or bags of frozen vegetables for ten to fifteen minutes. However, take care that ice is not directly applied to the skin of the wrist.
• For acute or chronic wrist pain, better go for OTC medication, such as anti-inflammatories and painkillers.
• Doing some stretching and strengthening exercises with the due precaution of checking there is no fracture in the bone will help relieve the severe pain. Remember to extend both the wrists together even if you have pain in only one wrist.
• In case of severe or prolonged wrist pain, better go to the doctor for further investigations.

If you feel the symptoms like pain, numbness, and/or tingling effect in your hand and arm, you may be having carpal tunnel syndrome. Squeezing or compressing of the median nerve (one of the primary nerves to the hand) is one of the main reasons for this. The abnormal pressure on the median nerve, due to the swelling , results in pain, numbness, and weakness in the hand.

Among the various symptoms of carpal tunnel syndrome, few to mention are:

• Lack of feeling
• Prickling and/or smoldering sensation
• Pain primarily in the thumb and index, middle, and ring fingers
• Irregular shock-like feelings that spread out to the thumb and index, middle, and ring fingers,
• Pain or tingling sensation traveling up the forearm towards the shoulder
• Weakness and gaucheness in hand, making it difficult to perform even simple activities like wearing and buttoning dresses
• Tumbling things

Many patients seem to report that the symptoms of carpal tunnel syndrome begin slowly — without a precise injury and that the pain comes and goes initially. However, as the condition deteriorates, symptoms may occur more  or may persevere for a prolonged period.

During the night due to sleeping with the wrists bent, the pain and the numbness may awaken the person from sleep. In the daytime, symptoms repeatedly occur if you hold something for a long duration with your wrist bent forward/backward as we do while holding the book or phone or while typing. When carpal tunnel syndrome becomes more rigorous, you may have less clutch strength due to the shrinking of muscles in hand. Pain and muscle cramping will also become worse. You may even experience loss of feeling in fingers, loss of coordination to use your fingers like using the thumb to pinch. Some people also experience a sensation like an electric shock. Over time, you may lose your ability to differentiate hot from cold in the areas that feel numb.

Arthritis in the wrist will give more pain and stiffness to our wrist, which is the typical symptom. It is not necessary that all the patients suffering from arthritis will have the same symptom. They vary based on the type of arthritis and the severity of the pain. Inflammation in the areas of the wrist, which is made up of many small joints, is another symptom of arthritis.

By destroying the cartilage of the wrist bones, arthritis will cause the bones to rub against one another. In addition, arthritis will make your wrists to feel very weak, with swelling and redness in the joints and restriction the motion of the wrist.

Some people will feel clicking, cracking or grinding sounds when they move the wrists. Over time, it will become harder to bend the writs or perform daily activities. Some may also have fatigue and lack of appetite, with abnormal discomfort in using the wrists. For some patients, the symptoms are not constant — but may come and go depending on their level of activity and other factors.

If the person has mild arthritis, it will be challenging for him or her to explain the problem to the doctor. They may feel pain in the wrist when they try to open a door or a bottle lid or when they grip something and try to twist them, some will feel pain in the early morning which will slowly reduce as the day progresses but will reappear by the end of the night.

Moderate arthritis will give you grief even when you are resting. Severe arthritis will lead to severe pain whatever activity one does. Physical deformity, decreased motion, severe constant pain, anxiety, depression, and inability to focus on anything are some of the significant symptoms of severe arthritis.

Depending on the location, the severity of the pain, the location of injury and the age of the patients, various treatments are carried out for wrist pain. Necessary treatment for many ordinary conditions that form the root cause of wrist pain is to rest the joint and allow the acute inflammation to decline. Not all types of wrist pain require medical treatment. Applying ice and compressing the wrist with an elastic bandage will be sufficient if the injury is minor. Mild pain relievers can be taken to reduce the pain. If the pain persists, strong pain relievers as per doctor's prescription can be considered.

After a detailed evaluation in relation to the various factors that may cause wrist pain, you will be initially suggested special treatments for wrist injuries and tendon problems. If the pain is due to a broken bone in your wrist, then, to align the bone for healing, a cast or splint should be used to hold the fragments of the bone together during healing. For a sprained or strained wrist, reinforcement is used to protect the injured tendon or the ligament. Pain in wrists that is caused by the repetitive motions can also be healed using reinforcements.