Pain in the wrist
Due to the complexity of the carpal and the large number of structures located in this area, pain in the carpal can indicate a variety of diseases and injuries. Often the circumstances of the complaints alone can narrow down the possible causes a bit. If, for example, the pain was preceded by a fall, bruises, sprains, ligament and tendon injuries as well as a scaphoid fracture or, more rarely, a lunar bone luxation are likely to be the cause of the complaints.
If the hands are exposed to monotonous mechanical stress over a longer period of time, such as working at a PC, tendonitis or muscle tension are possible causes. Diseases that primarily affect the joints are also very common, such as joint inflammation, i.e. arthritis, and joint wear and tear, so-called arthrosis. In addition, the nerves that pull on the hand can also be the source of pain.
These are particularly affected in the so-called bottleneck syndromes (e.g. carpal tunnel syndrome). Here, a constriction of the nerve, in addition to pain, usually also leads to loss of sensation and tingling in the fingers, as well as a reduction in strength in the muscles supplied by the nerve. In the case of longer lasting complaints, a doctor should always be consulted due to the multitude of possible causes. This doctor can then make a precise diagnosis with the help of a precise anamnesis, examination and, if necessary, imaging.
Carpal fracture
The reason for a fracture of the carpal bones is usually a fall on the overstretched hand. The most common cause is a fracture of the so-called scaphoid bone (Os scaphoideum). This often leads to initially severe pain, which improves relatively quickly in the course of time.
Therefore, such an injury is often mistaken for a sprain of the wrist. This can become problematic if the fracture edges heal incompletely or with a shift and a so-called pseudarthrosis develops. Over time, this can lead to premature wear and tear of the joint, joint changes and permanent restrictions.
Therefore, after such a fall, even if the symptoms are less severe, a doctor should be consulted to rule out a fracture. The therapy depends on the severity of the fracture. If there is no or only a slight displacement of the fracture edges, the joint is usually immobilized with the help of a plaster cast.
The wearing period varies between 6 and 12 weeks. Another possibility, which allows the wrist to be moved again very quickly, is minimally invasive screwing. In this case, the bone is accessed through a small skin incision.
In the case of severely displaced fractures, as well as a fracture in which several small fragments of the bone have formed, an open surgical direction of the fracture may be necessary.Carpal osteoarthritis usually develops on the basis of other carpal diseases, as well as inflammation or fractures that have healed into malposition. Primarily affected by the arthrosis is the radiocarpal joint between the radius of the forearm and the carpal bones. However, the joints between the individual carpal bones can also show arthrosis.
It manifests itself in severe pain in the wrist, which leads to a functional impairment, swelling of the back of the hand and sometimes palpable bone attachments to the joints. If the degree of arthrosis is less severe, immobilisation of the joint with a wrist cuff is often sufficient as therapy. If, on the other hand, the wear and tear on the joint is already very pronounced, surgical stiffening of the joint may be necessary to reduce the discomfort.
