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Wrist Pain

Ok, stop sniggering, boys.

The wrist is a complex joint made up of eight small bones arranged in two rows between the long bones in your forearm (ulna [little finger side] and radius [thumb side]) and the bones in your hand. Tough, fibrous bands of ligaments join your wrist bones to each other, and to your forearm bones, and to the hand bones. Tendons attach the muscles to bones. All told, its a pretty complex area.

Wrist injuries occur frequently both in sport, and occupationally. Occupationally, they are often deemed overuse, or repetitive strain type conditions. This can be any activity that involves repetitive wrist motion which can cause inflammation of the tissues around joints – so anything from using a desk mouse all day, using your thumb all day on your phone, or using a screw-driver for long hours.

In sport, they often occur due to a fall on the outstretched hand, and are more common in children than adults. In sportspeople, the most common acute injuries are fractures of the distal radius or scaphoid, or damage to an intercarpal ligament. A scaphoid fracture involves the bone on the thumb side of the wrist. This type of fracture may not show up on X-rays immediately following the injury, and can easily be missed.

It is essential to determine the mechanism of the injury causing wrist pain, and examination should include observations, active and passive movement tests, palpation, and special tests.

Other causes of wrist pain include;

Osteoarthritis is a type of arthritis which occurs when the cartilage that cushions the ends of your bones, allowing smooth articulation, deteriorates over time. Osteoarthritis in the wrist is actually fairly uncommon and usually occurs only in people who have injured that wrist in the past.

Rheumatoid arthritis is a condition in which the body’s immune system attacks its own tissues by mistake and is more common in the wrist. If one wrist is affected, the other one usually is, too. Pain associated with rheumatoid arthritis is usually described as throbbing or aching, and it is often worse in the mornings or after a period of inactivity.

Carpal tunnel syndrome develops when there’s increased pressure on the median nerve as it passes through the carpal tunnel, which is the passageway in the palm side of your wrist, between ulna and radius. The main symptoms of carpal tunnel syndrome are tingling, pins and needles, numbness and pain in one or both hands. The symptoms tend to have a gradual onset, and can be worse at night or first thing in the morning.

Ganglion cysts are fluid-filled lumps that usually develops near a joint or tendon. The cyst can range from the size of a pea to the size of a golf ball, and are common wrist complaints – mostly on the top of the wrist. Ganglions are harmless, but can sometimes be very painful!

De Quervain’s Tenosynovitis is a painful condition affecting the sheath around the tendons on the thumb side of your wrist. Symptoms include pain when you turn your wrist, grasp anything or make a fist, and grip strength will be compromised. A plumbers worst nightmare.

Wrist injuries are common in A&E Departments, and often easily and quickly ruled out from being broken. But what then?

As always, if in doubt, get it checked out.

N.B. There are no ‘one size fits all’ style quick fixes in most injury scenarios, so these article shouldnt be seen as such. They are merely guides to a better understanding of how our bodies work.

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