Causes of wrist pain

The causes of wrist pain can be many and varied. In most cases, excessive or incorrect strain during writing or working leads to corresponding pain phenomena. Basically, the causes that lead to wrist pain can be divided into several groups.

Possible diseases are

The bony structures
The ribbons
The tendons
The carpal tunnel
And the muscles

The most common disease of the wrist is carpal tunnel syndrome. This involves pressure damage to the median nerve in the carpal tunnel (see above). Causes of CTS (carpal tunnel syndrome) are not apparent in most of the disease.

Possible causes are fractures near the wrist or rheumatic diseases. Accompanying symptoms of carpal tunnel syndrome are loss of sensitivity in the area of the thumb, index and middle finger on the palm of the hand. On the back of the hand, these sensations usually occur only on the end phalanges.

The frequent occurrence of these complaints at night is considered a classic indication of carpal tunnel syndrome. In addition to the discomfort caused by carpal tunnel syndrome, pain in the wrist is in many cases caused by inflammatory processes in the area of the tendon sheaths. The patient affected by tendosynovitis usually reports strong, pulling pain in the affected tendon.

Further indications of inflammatory processes are

Redness
Overheating
Swelling
And loss of mobility of the affected wrist.

The so-called “Tendovaginitis stenosans de Quervain” (synonym: housewife’s thumb) is a special form of tendovaginitis. In this disease, the pain is localized at the thumb-side wrist. It is not uncommon for the sensation to radiate into the forearm and can be aggravated by stress.The most common wrist pain caused by an accident is the fracture of the wrist (distal radius fracture).

In most cases, the radius breaks a few centimeters above the wrist. In a multi-fragment fracture, the joint surface may also be directly involved. Less frequent and occasionally unrecognized is pain caused by a scaphoid fracture.

A pain-related arthrosis of the wrist is relatively rare. This is due to the fact that the wrist joint does not have to bear any body load. Risk factors for wrist arthrosis (radiocarpal arthrosis) are pre-existing wrist fractures, especially in the case of direct joint involvement or rheumatic diseases.

Pain is often caused by arthrosis of the thumb saddle joint, a painful sign of wear and tear when the thumb is moved and stressed. The enchondrome (a bone cyst) consisting of cartilage accumulations in the bone is another cause of wrist pain. In the long term, the transformation of bone tissue into cartilage leads to a painful increase in size, which can result in a collapse or fracture of the affected bone.

In the early stages, the patient suffers from complaints that mainly occur during heavy exertion and quickly subside under gentle posture. As the cartilage formation progresses, pain already occurs at rest. Furthermore, frequently occurring sensations in the wrist can often be attributed to anatomical malformations.

An ulnar bone that is too short (ulna-minus variant), for example, can lead to pronounced pressure on the spoke-side part of the wrist and thus cause pain in the wrist. An ulna that is too long (ulna plus variant), on the other hand, causes increased pressure on the ulna-side wrist with corresponding pain symptoms on the little finger side. Malformation-related pain in the wrist can usually only be eliminated in the long term by surgical correction.

The term rheumatism covers various diseases of the whole body. These diseases have in common that the own immune system is directed against normal body parts and destroys them in the long run. Rheumatism of the wrist is usually colloquially referred to as “rheumatoid arthritis“, which can affect the wrist as well as numerous small joints in the body.

This leads to inflammation, pain, restricted movement and stiffness of the joint. In the long term, this can also lead to painful cartilage wear, which irreversibly damages the joint. Although pain in the wrist is often caused by injuries or diseases of the bone or tendon system, for the majority of those affected, such sensations are due to simple overloading or incorrect loading.

Chronic overloading of the wrist is one of the main causes of pain. Especially athletes and members of special occupational groups (office workers, construction workers, etc.) are often affected.

In these cases, a constantly recurring irritation of the joint or surrounding structures causes tiny injuries (micro injuries) in the tissue. The result is pain that increases steadily under stress and often persists even at rest. In the therapy of this type of wrist pain, muscular stabilization and the avoidance of severe stress play a major role.

Rare reasons for the development of wrist pain are In the case of gout, uric acid deposits occur in the area of the wrist. The big toe base joint, the thumb base joint, the ankle joints and the knee are primarily affected. The development of gout in the wrist is rather rare.

A pseudo-gout with deposition of calcium crystals is also more likely to occur on the knee than on the wrist. In addition, various diseases, the cause of which is still unclear, can lead to wrist pain. These diseases include: Lunatum malactia

The gout (synonym: hyperuricaemia)
And the pseudo-gout (synonym: chondrocalcinosis).
Lunatum malaria
Scaphoid necrosis

The wrist is often affected by pain due to overstraining.

Various structures can form or change, which can be an expression of incorrect or excessive strain. For example, a ganglion can develop, which usually forms on the back of the hand at the transition from forearm to wrist.A ganglion is a bulge in a joint membrane or tendon sheath that surrounds the tendons so that they slide well. If this bulge thickens or water gets trapped in it, a palpable knot may form on the wrist that hinders movement.

Patients report pain in the wrist, which occurs particularly under stress, such as when doing push-ups. Tendinitis can also lead to pain under stress. It usually occurs as a result of many writing, typing or other activities with the hand.

The tendon sheath surrounding the tendon thickens and becomes inflamed. Often the tendon sheath inflammation is accompanied by redness, swelling and pain in the wrist. Other diseases can also affect the wrist and become noticeable, especially under stress.

These include above all diseases from the rheumatic range of forms. Psoriasis can also be accompanied by joint complaints (psoriasis-arthritis) and should be clarified. Arthrosis of the wrist (radio-carpal arthrosis) must also be considered.

This is an abrasion of the wrist cartilage and can occur in several ways. Sometimes the cause is unknown, but often it is secondary to another disease or fracture. The most common cause of pain in the wrist during rotation is tendovaginitis.

In this case the tendon sheath surrounding a tendon thickens. This often occurs after a period of frequently repeated movements. The tendon of the muscle that is particularly stressed during this movement rubs back and forth in its tendon sheath and becomes inflamed.

This can be triggered by screwing screws with a screwdriver or by a lot of writing and typing. Affected persons often describe pulling pain that radiates into the forearm. In addition, a crackling sound can be heard when turning the screw.

Tendinitis is usually treated by immobilization and relief, if necessary by means of cortisone injections into the tendon, or rarely by an operation involving splitting the tendon sheath. After a fall on the wrist, it may be bruised or broken. Since both can be accompanied by severe swelling, differentiation by clinical tests is often insufficient.

To find out for sure, an X-ray of the wrist is often necessary. In the case of a bruise or pulled wrist, no fracture can be detected in the X-ray image. The ligaments and tendons of the wrist have been strained by the fall, but usually heal after a few weeks without any consequences.

A pain in the wrist, which is intensified when the patient is propped up, is very typical in irritated conditions in the joint, as well as after injuries to the bone, ligament and cartilage structures in the wrist. Over time, numerous movements, injuries, sports and anatomical peculiarities can cause damage and pain to the wrist. Very often the cartilages between the ulna and the carpal bones are involved, which are called “discus triangularis“.

This area of the joint can be damaged by many years of wear but also by acute events. This cartilage is put under particularly heavy strain when it is propped up. Supporting, as well as shocks in sports or supporting the hands when falling can cause and aggravate damage to the wrist cartilage.

A fall that is caught with the hands can often lead to cartilage damage and even fractures of the forearm and carpal bones. Supporting the hands therefore provokes pre-existing pain due to the increased pressure on bony and cartilaginous joint components. Swelling refers to an increased accumulation of fluid in the tissue.

A swelling of the wrist can be purulent, bloody or clear. In most cases, it is caused by acute injury to cartilage, bones or ligaments, inflammation of joint structures or chronic irritation of tendons and joint mucosa. All acute or chronic changes to the wrist can, however, occur without swelling.

Swelling is merely an accompanying symptom that can occur as a reaction to joint diseases. But even without swelling, a rupture of ligaments and cartilage or a fracture of the bones can occur after an acute event. The absence of severe swelling even enables faster healing in chronic irritation, pulled muscles, inflammation and injuries.The swelling itself causes additional pain.

With appropriate acute therapy, swelling after injuries can even be reduced and prevented. For this purpose, the joint should be cooled, compressed, protected and elevated. Pain can also occur in the thumb after injuries and degeneration of the cartilage and bone.

The most common cause of wrist pain in the thumb, however, is tendosynovitis in this area. This occurs without causative pathogens as a result of a permanent irritation. The thumb is particularly frequently affected by tendosynovitis.

Due to its exposed anatomical position and its important function when grasping, the thumb is particularly exposed to stress. Tendinitis often begins at wrist level and continues on the extensor side of the thumb and on the forearm. Wrist pain associated with numb fingers is an important indication of “carpal tunnel syndrome”.

In the middle area of the wrist, important tendons and muscles pull together with the median nerve through the carpal tunnel from the forearm into the hand. The carpal tunnel is an anatomically very narrow space. Even slight pressure on the inside of the wrist can lead to pinching of the nerve and thus to tingling, numbness, muscle weakness and paralysis in the fingers. If this anatomical tightness increases, pain and numbness can occur permanently. In many cases, carpal tunnel syndrome must be treated surgically so that the pain does not suffer lasting damage.