Wrist Pain

The wrist is a complex region of the arm where the two forearm bones (the radius and the ulna) intersect with two rows of eight total carpal bones at the base of the hand.

This intricate area is comprised of multiple smaller joints that move in sync with one another to allow your wrist and hand to perform fine-motor movements. Occasionally, pain can develop in one of the many bones, ligaments, tendons, or nerves that make up the wrist joint.

This article will detail the most common pain-causing conditions in this region, the symptoms that typically arise with the pain, and the treatments that are currently available. 

Symptoms of Wrist Pain

Depending on the cause of your wrist pain, several other symptoms may also be present in this region. Among the most common are:

• Numbness and tingling in the fingers
• Swelling
• Bruising
• Reduced grip strength or hand weakness
• Range of motion limitation or stiffness

While mild wrist soreness, swelling, or stiffness may be treatable at home, your symptoms should be evaluated by a healthcare provider if they are more intense or occur after an acute injury.

Causes of Wrist Pain

Because of the wrist joint's intricate nature and its multiple anatomical structures, many different conditions can cause pain in this area. Some of the most common pain-causing issues include:

• Carpal tunnel syndrome: A common condition that arises when the median nerve—which travels to the hand through a pathway in the wrist called the carpal tunnel—becomes irritated or compressed. This issue causes pain, burning, tingling, and numbness in the thumb, second, and third fingers. In more severe cases, it can also cause forearm pain or weakness.
• Scaphoid fractures: This occurs when an injury causes a break or crack in the scaphoid—a carpal bone that rests on the bottom and radial portion of the hand beneath the thumb. This issue is most commonly caused by a fall onto an outstretched hand and typically leads to pain over the bone, swelling, and difficulty extending the wrist upwards. Loss of grip strength may also occur.
  
• De Quervains Tenosynovitis: This is a condition where the tunnels or sheaths that two thumb tendons (the extensor pollicis brevis and the abductor pollicis longus) travel through become inflamed. This disorder typically leads to pain in the radial wrist near the base of the thumb. This pain is usually provoked when you make a fist with your thumb inside it and move your wrist downward in an ulnar direction (called the Finkelstein Test). Occasionally, a small amount of swelling may also be present.
  
• Wrist osteoarthritis: This occurs when the smooth articular cartilage that coats the surfaces of the bones in the wrist starts to deteriorate or thin. As this happens, friction increases as the bones move on one another, and joint damage can occur. In addition to causing pain, osteoarthritis can also lead to localized swelling, stiffness (especially after inactivity or in the morning), and strength loss.
  
• Ulnar neuropathy: This is an irritation or compression of the ulnar nerve, which supplies the fourth and fifth fingers. Because this important nerve travels from the neck down the arm to the hand, there are many different potential origin points for neuropathy. The Most common is near the “funny bone” in the Guyon’s canal of the elbow. Depending on the source of the irritation, this condition can cause numbness or tingling in the fourth and fifth digits, grip weakness, elbow tenderness, and difficulty with repetitive wrist extension movements.
  

How to Treat Wrist Pain

Just as there are numerous potential causes of wrist pain, there are also several different treatment options.

Mild soreness, warmth, and swelling can typically be addressed by icing the area, taking over-the-counter (OTC) anti-inflammatory medication, and avoiding irritating activities or movements. However, more formal interventions may be needed if your symptoms are severe or caused by an acute injury.

These can include:

• Physical therapy (PT): This is frequently prescribed to help address the symptoms of wrist osteoarthritis. Gentle mobility exercises can help improve joint stiffness and strengthening activities can stabilize the affected area and reduce your pain. PT is also commonly used for carpal tunnel syndrome to teach specific stretches and nerve gliding techniques that keep the median nerve mobile in the carpal tunnel.
• Pain-relieving injections: These are sometimes used to treat a flare-up of osteoarthritis, De Quervain tenosynovitis, or carpal tunnel syndrome.
• Wrist or finger bracing: These are frequently needed with these diagnoses to limit aggravating movements or wrist positions. In the case of ulnar neuropathy, immobilization of the elbow is commonly indicated. Finally, a forearm cast is frequently applied by your healthcare provider to protect a fractured scaphoid bone.
• Surgical procedures: These may ultimately be needed to address your pain. For issues like carpal tunnel syndrome, ulnar neuropathy, or de Quervain’s tenosynovitis, these operations aim to reduce the pressure or restriction on the affected nerve. In the case of wrist osteoarthritis, a fusion of two adjoining carpal bones or a wrist replacement procedure may help alleviate the pain. Additionally, certain scaphoid fractures require an internal fixation procedure that helps maintain the bone’s proper position while it heals.

Are There Tests to Diagnose the Cause of Wrist Pain?

Several different diagnostic tests may be used to establish the cause of your wrist pain. These include:

• A comprehensive evaluation by a healthcare provider
• X-ray and MRI
• Electromyography (EMG) and nerve conduction testing

A healthcare provider will typically listen to your subjective complaints and palpate the specific area of discomfort. In the case of de Quervains tenosynovitis, they may also perform the Finkelstein test in the clinic to confirm this diagnosis.

Images may also be needed to properly establish the cause of your pain. X-rays show the condition of your bones and are useful when diagnosing osteoarthritis or a scaphoid fracture. In some cases, an MRI (or even a CT scan) may also be needed to properly check for a scaphoid fracture.

Finally, EMG and nerve conduction testing are useful for ruling in or out carpal tunnel syndrome and ulnar neuropathy. This examination helps determine whether the nerves in the arm or hand are functioning normally.

When to See a Healthcare Provider

Many instances of wrist pain can be well managed with some of the at-home treatments discussed in the previous section. That said, a healthcare provider should evaluate several specific symptoms. These include:

• Severe or worsening wrist pain
• Wrist pain that occurs after an acute injury
• Progressing numbness or tingling in the arm or hand
• Weakness in the arm, hand, or fingers
• Worsening pain or swelling in multiple joints concurrently

Summary

Many different conditions can lead to wrist pain. These include carpal tunnel syndrome, osteoarthritis, median or ulnar nerve issues, and de Quervain’s tenosynovitis. While some of these conditions can be treated at home, others require physical therapy, pain-relieving injections, or even surgery. A thorough exam by a healthcare provider and several other diagnostic tests may be needed to establish the cause of your pain.

A Word From Verywell

Whether you’re getting dressed in the morning, driving in the car, or typing on the computer at work, wrist pain can significantly affect your day. You may be tempted to ignore your symptoms, but remember that pain may be a sign of a more significant underlying condition. If you are experiencing wrist soreness or any of the other symptoms detailed above, be sure to speak to your healthcare provider. Often it only takes a simple examination to diagnose the issue and to set you off on the road to recovery.