What Is a Sprained Wrist?

A sprained wrist is an injury that affects the ligaments, which are soft tissue structures connecting bone to bone. These injuries range in severity and often occur with trauma, such as a fall, or during sports activities. Mild wrist sprains usually heal within a few weeks, but severe injuries can require surgery.

This article discusses wrist sprains—types of sprains, symptoms, causes, diagnosis, and treatment.

Types of Wrist Sprains

The wrist is made up of three joints, which are:

• Distal radioulnar: This joint is between the two forearm bones—the radius on the thumb side and the ulna on the pinky side.
• Radiocarpal: This joint is between the radius and three small bones in the base of the hand—the scaphoid, triquetrum, and lunate.
• Ulnocarpal: This joint is between the ulna and two carpal bones—the lunate and triquetrum.

Wrist sprains can affect any of these joints but regularly affect the ligament between the scaphoid bone and lunate bone (two of the eight bones in the base of the hand) or the triangular fibrocartilage complex (TFCC) on the pinky side of the wrist.

Wrist sprains are categorized by the severity of the ligament injury. The three grades of sprains are:

• Grade 1: Ligaments are stretched; this is considered a mild sprain.
  
• Grade 2: Ligaments are partially torn; this is considered a moderate sprain.
• Grade 3: Ligaments are torn completely or have pulled away from the bone. Sometimes, a piece of bone comes with it—a condition called an avulsion fracture. This is considered a severe sprain.

How Do You Tell If Your Wrist Is Sprained?

The primary symptom of a wrist sprain is pain, especially with movement or when you touch the injured area. Other symptoms can include:

• Swelling
• Bruising
• Popping sensation
• Warm skin
• Decreased range of motion
• Weakness
• Numbness/tingling
• Feeling like the wrist is unstable

Causes of Wrist Sprain

The most common cause of wrist sprain is falling on an outstretched hand. Wrist sprains are also common with certain sports, such as:

• Skating
• Gymnastics
• Snowboarding
• Basketball
• Hockey
• Skiing
• Other contact sports

Wrist sprains can also occur with more serious injuries, such as a broken wrist (fracture).

How Are Wrist Sprains Diagnosed?

A healthcare provider will diagnose a wrist sprain based on your symptoms and how the injury happened. They might also perform X-rays to rule out fractures that often occur with wrist trauma.

Additional imaging is sometimes performed to determine how severely a ligament has been damaged after a wrist sprain. These tests can include:

• Magnetic resonance imaging (MRI)
• Computed tomography (CT scan)
• Arthrogram (X-rays with contrast dye)

How Are Wrist Sprains Treated?

Pain and inflammation after wrist sprain can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve (naproxen), Advil/Motrin (ibuprofen), or Bayer (aspirin). Additional treatment for wrist sprain depends on the severity of the injury.

Sprains should initially be treated with the RICE protocol:

• Rest: Minimize using the injured wrist for at least two day and wear a splint for support.
• Ice: Cold packs should be used several times per day for 20 minutes at a time to help decrease pain and swelling.
• Compression: Wrap the wrist with an elastic bandage to help reduce swelling.
• Elevation: Use pillows to elevate your wrist above the level of your heart as much as possible to help decrease swelling.

Grade 1 sprains usually heal with basic care within a week or two. Grade 2 sprains often require wearing a brace for a more extended period while the ligament heals, which can take up to six weeks. Physical therapy, occupational therapy, or treatment by a certified hand therapist can also be beneficial in reducing pain and improving your range of motion and strength after a wrist sprain.

Treatment for grade 3 sprains is more involved and often requires surgery. Grade 3 sprains that include avulsion fractures can often be in a cast for six weeks while the bones heal back together. In some cases, the bones might also require a screw or temporary wires to hold them in the proper position.

Severe wrist sprains might also require surgery to repair the injured ligament. If the original ligament can't be fixed, a piece of the tendon can be used to reconstruct it.

How Long Does a Sprained Wrist Take to Heal?

Mild to moderate wrist sprains typically recover within a few weeks without long-term issues. The prognosis for severe wrist sprains improves with early diagnosis and treatment. After surgery, ligaments usually heal within eight and 12 weeks, but it can take six to 12 months for your function to return to normal.

Summary

Wrist sprains are injuries that affect ligaments that attach bone to bone. They occur after a fall, during sports activities, or with other direct trauma. Symptoms of a wrist sprain include pain, swelling, bruising, decreased range of motion, weakness, tingling, and more.

Sprains can be diagnosed with a physical exam, but imaging might be required to rule out a fracture. Treatment includes ice, NSAIDs, compression, elevation, splinting, and hand therapy. Severe ligament injuries may require surgery.