Diagnosis

The diagnosis of inflammation of the wrist begins with a medical history followed by a physical examination. The physician first asks for more detailed information about the character and severity of the symptoms, as well as the limitations caused by them. It is also important for the physician to know how long the complaints have existed and whether there may have been a particular trigger, such as a previous infection or trauma.

During the physical examination, the examiner palpates the joint and looks for swelling, pain due to pressure and overheating. He will also carefully test for mobility. Afterwards, an x-ray of the hand including the joint is often taken in order to obtain indications of possible damage to the wrist.

Special blood tests can confirm an inflammation of the joint. Important values are the so-called inflammation parameters. These include the white blood cells (leukocytes), the C-reactive protein (CRP) and the blood sedimentation rate (BSG).

In rheumatoid arthritis, so-called rheumatoid factors are frequently found, and in gout, elevated uric acid levels in the blood can be detected. To obtain more precise information about the current situation in the wrist, computed tomography (CT) or magnetic resonance imaging (MRI of the hand) may also be indicated. Overall, MRI of the hand can be considered most valuable in the diagnosis of wrist inflammation. If these examinations are not sufficient for a diagnosis, a joint puncture (a removal of fluid or tissue material from the joint) or arthroscopy may be necessary.

Therapy

Since wrist inflammation can be triggered by different stimuli, the treatment depends on the cause. First of all, it is important to avoid the activities that trigger the inflammation of the wrist. In general, the wrist is first immobilized for some time with bandages or firm bandages to prevent further damaging stimuli and give the joint time to heal.

Cooling can alleviate the pain. It should be noted that heat is often more effective than cold in the case of an inflammation of the wrist that has already reached the chronic stage. In addition, various medicinal, physical and surgical measures are used.

Painkillers and anti-inflammatory drugs, which are regularly applied in the form of ointments, often form the basis of drug therapy. If the inflammation of the joint is caused by bacterial colonization, antibiotics are used. In the case of rheumatoid arthritis involving the wrists, special rheumatism medications are used, the so-called basic therapeutics or DMARDs (=Disease Modifying Antirheumatic Drugs).

With regard to physical therapy, there are various possibilities. The relief of the joint can be done by a joint puncture. This removes excess fluid from the joint, thereby alleviating feelings of tension, restricted movement and pain.

The complaints can also be improved with cold compresses as well as with movement exercises and physiotherapy. If the conservative measures do not lead to an improvement of the symptoms, surgical intervention can also be considered in the case of tendosynovitis. The surgeon cuts the ligament that holds the tendons together, the so-called retinaculum, and thus relieves the tendons.

In case of inflammation in the wrist, various homeopathic remedies can be used, depending on the main symptoms. If the wrist is overstressed or an acute injury occurs, Arnica and Ruta graveolens are used. If the pain occurs mainly during movement, Rus toxicodendron can relieve the symptoms.If the inflammation is particularly pronounced and becomes noticeable by swelling and redness of the wrist, Bryonia and Apis mellifica can be used.

If an inflammation in the wrist is acute, it should first be cooled. This will counteract the first inflammatory flare and at the same time relieve the pain in the wrist. However, especially when an inflammation lasts longer or even becomes chronic, warmth is usually more helpful.

The warmth leads to a relaxation of the muscles in the wrist and forearm area and can thus relieve the pressure of inflamed tendons or bursae. Whether cooling or warming helps better in a specific situation, the wrist usually “knows” best itself. This means: try out cold and warm applications and keep what feels better.

Taping the wrist can provide relief in case of inflammation. A distinction should be made between two types of taping: Rigid (usually white) tape is mainly used to stabilize the wrist. This is useful if the inflammation is very acute and the hand needs to be immobilized.

A splint usually serves the same purpose, but is often less handy and therefore more disturbing. If the wrist is already fit for use again, Kinesiotape can be used. These mostly colorful tapes are glued along muscles and thus relieve the tendons when the muscle is tensed.

A wrist bandage is used if the wrist is to be protected due to an inflammation. Such a bandage is usually elastic and thus allows some movement in the wrist. This is different from the wrist splint, which is used at the beginning of the inflammation and is intended to immobilize the wrist completely. The bandage, on the other hand, supports the wrist when the hand can already be loaded again and thus relieves muscles, tendons and bursae. In addition, the support exerts a certain compression on the wrist and thus prevents the wrist from swelling.