Depending on the intensity, wrist pain can lead to a significant impairment of the quality of life. A distinction can be made between chronic and acute causes.
What is wrist pain?
One of the most common causes of wrist pain is carpal tunnel syndrome. In this case, the pain is caused by pressure damage to the median nerve. The wrist joint must have good mobility and a high load-bearing capacity. Accordingly, the joint consists of a complex structure that connects bones with the surrounding soft tissues. As a construct, the wrist can be divided into two joints. The proximal wrist is formed by the bones of the forearm, while the distal wrist connects to the carpus. Pain can occur at both joints as a result of an injury or anatomical change. In this case, wrist pain may occur only for a short time and subside after recovery. In this case, it is referred to as an acute complaint. If wrist pain exists over a long period of time, it is a chronic complaint. The same applies if the pain occurs at regular intervals and is perceived as an annoying complaint in the long term.
Causes
Among the most common causes is carpal tunnel syndrome. Here, wrist pain is caused by pressure damage to the median nerve. Pressure damage, in turn, can be attributed to a sports injury or to a rheumatic disease. In addition, pain near the wrist can be caused by inflammation in the area of the tendon sheath. Affected patients complain of a strong, pulling pain. Furthermore, pain can be caused by a wrist fracture. In most cases, the radius breaks only a few centimeters above the wrist. Relatively rarely, osteoarthritis can be implicated as a cause. Finally, wrist pain can be caused by gout (hyperuricemia). In this case, uric acid is deposited in the area of the wrist. The metacarpophalangeal joint and the metacarpophalangeal joint of the thumb are affected. As a result, the patient feels a stabbing and pulling pain at the wrist. The same is true for pseudogout (chondrocalcinosis).
Diseases with this symptom
- Rheumatism
- Wrist fracture
- Arthritis
- Scaphoid fracture
- Sports injuries
- Osteoarthritis
- Pseudogout
- Ganglion
- Carpal tunnel syndrome
- Tendonitis
- Gout
- Lunate malacia
Diagnosis and course
If wrist pain occurs at recurrent intervals, a doctor should be consulted. This may be the family doctor or an orthopedic surgeon. The physician begins with an anamnesis, which includes the entire course of the disease and the patient’s physical condition. The wrist is then examined for noticeable deformities, discoloration and swelling. In some circumstances, the physician applies a slight force to check the load-bearing capacity of the wrist. The next step is to examine the range of motion. By giving a precise indication of the location and intensity of the pain, the physician can make an initial diagnosis. An X-ray is taken for confirmation. Anatomical changes and existing underlying diseases such as arthritis can thus be detected at an early stage. Under certain circumstances, this is accompanied by a computer tomography and a joint endoscopy. In this way, a view of the interior can be obtained. Finally, a neurological nerve test will reveal if any loss of sensation has occurred.
Complications
Untreated wrist pain can lead to worsening health. The discomfort becomes more frequent and intense. In addition, the affected person begins to engage in sparing and avoidance behavior. This can lead to tensions in the professional and social environment. Performing everyday tasks is more difficult and requires support. This requires understanding and tolerance on the part of fellow human beings. In addition, well-being may be reduced in the form of a change in general mood and irritability. Both can be perceived by outsiders as sudden and unexpected.The practice of sporting activities may be limited and at the same time cause greater dissatisfaction. If the affected person decides to undergo treatment, he or she should be informed about further complications. Taking or using medication may be associated with individual side effects or intolerance. Tingling in the hand, loss of strength, or loss of sensation may occur. Often the hand is immobilized for some time, cooled, or the joint is placed in an elevated position. If the wrist pain is caused by gout, complications can occur that are life-threatening. Among them is kidney failure. If the condition is irreparable, surgery and its associated side effects may be required. In the worst case, the joint is replaced with an artificial one.
When should you go to the doctor?
Wrist pain affects everyday life so much that the question of when to see a doctor does not even arise. The only thing to consider is which doctor to go to. Here, the family doctor is recommended as the first address. He or she will assess the cause of the wrist pain, including whether it is acute or chronic. Wrist pain that has already existed for a long period of time and those that recur regularly are considered chronic wrist pain. After taking a medical history, the general practitioner decides to which specialist he will refer his patient. Widely recognized as a cause of wrist pain is carpal tunnel syndrome. In this wrist pain, the median nerve exerts pressure causing pain. This wrist pain often results from mechanical overuse of the wrist or a rheumatic disease. Also notorious as a cause of wrist pain is tendonitis. Osteoarthritis, on the other hand, is rarely identified as a cause of wrist pain. Gout is another cause of wrist pain, as is, of course, a wrist fracture. Depending on the cause, different specialists are considered for the treatment of wrist pain: neurologist, orthopedist or internist.
Treatment and therapy
Meanwhile, wrist pain can be treated well. First of all, it is important to take it easy on the affected wrist. In addition, an anti-inflammatory ointment is applied to relieve pain. In severe cases, a supportive bandage must be applied. This is particularly necessary if there is a fracture near the wrist. In the case of an acute complaint, an analgesic can also be taken. In contrast, in the case of a chronic condition, the triggering cause must first be treated. For example, in the case of osteoarthritis, denervation surgery is performed. Nerve fibers that cause pain are cut. In complicated cases, the implantation of a wrist prosthesis also provides a remedy. If, on the other hand, the cause is a bacterial inflammation, therapy with antibiotics is initiated. In addition, the treating physician prescribes an anti-inflammatory ointment so that effective pain relief can be guaranteed. Treatment can also be accompanied by physiotherapy. The aim of this is to increase the mobility and resilience of the wrist. In addition, a therapy is rounded off by homeopathic and herbal remedies. Supportive measures include acupuncture and osteopathy. Last, wrist pain is also relieved by consistently wearing a support bandage.
Outlook and prognosis
One of the uncomplicated courses of wrist pain is tendonitis, which usually occurs due to one-sided stress, for example, operating the mouse and computer keyboard. Often, relief and treatment with a pain ointment are sufficient. If the complaints occur repeatedly, a doctor must be consulted, who determines the cause of the wrist pain by means of a differential diagnosis, according to which the prognosis for the further course of the disease is determined. If surgery is not necessary and treatment is by medication, immobilization or physiotherapy, healing will occur within a few weeks and the symptoms will not recur. Carpal tunnel syndrome can be accompanied by complications that have a negative impact on the prognosis.The chances of recovery depend on the time of treatment and the type of treatment. In the case of a successful operation, the pain usually disappears one day after the operation. Subsequent physiotherapy, which trains the sense of touch and sensation, has a positive effect on the prognosis. If, on the other hand, carpal tunnel syndrome remains untreated for a long time, the healing process can take several months. In individual cases, the nerve may be so severely damaged that healing is no longer possible. In this case, the sense of sensation and mobility are severely limited. Complications such as postoperative bleeding or infections rarely occur. If the operation is unsuccessful, for example because the ligament located at the carpal tunnel was not completely cut, a new operation is necessary, which prolongs the course of the disease and healing.
Prevention
In the field of prevention, various methods have been proven in the past. In sports activities, a high value is attributed to the support bandage. This is particularly helpful when heavy objects have to be lifted. In addition, it is recommended to use a gel mouse pad when working at a computer. Furthermore, attention should be paid to an optimal sitting posture. The forearm and upper arm should be at a ninety-degree angle so that the forearms rest straight on the tabletop. Finally, wrist cuffs provide relief when monotonous movements have to be performed. For monotonous work, it is also advisable to take regular breaks. For example, gardening should be done in several sections.
This is what you can do yourself
Often wrist pain is overuse pain, which is common in people who work many hours at a computer. The pain is usually caused by nerve inflammation and nerve and tendon injuries. For the discomfort to reduce, the inflammation must first subside. Therefore, immobilization is the first measure for overuse pain in the wrist. Cool compresses are also suitable for reducing inflammation. However, some people respond better to heat. Anti-inflammatory ointments often relieve the symptoms within a few hours. Nevertheless, those affected should not start computer work too soon, as the pain can otherwise become chronic. A wrist splint worn overnight has also proven effective. It keeps the joint still and accelerates the healing process. As a rule, the patient must wear it for at least two months. The second most common cause is wear and tear of the joints, which occurs with increasing age. In this case, immobilization is less appropriate; rather, the patient should keep his wrists mobile. Just five minutes a day can alleviate the effects of osteoarthritis in the wrist. Circling the hand, making and unclenching a fist, and bringing each finger to the thumb one at a time are exercises that are very good for maintaining mobility and reducing pain. Heavy lifting is still not advisable.