A sprain refers to an injury to a ligament. Ligaments are bands of tough elastic tissue surrounding the joints. They play an important role in the musculoskeletal system. They provide joint support and connect one bone to another.

What is a Wrist Sprain?

A wrist sprain is a common injury. There are many ligaments in the wrist that can get stretched or torn especially when the wrist is bent forcefully, such as in a case of a fall on an outstretched hand.

Wrist Sprain Categories

Wrist sprains can be mild to severe, depending on the degree of injury to the ligaments.

Grade 1 sprains are considered mild sprains. In this form of wrist injury, the ligaments are stretched but are not torn.

Grade 2 sprains are moderate sprains. They are characterized by partial tearing of the ligaments. When you have a grade 2 sprain, you may suffer some loss of function.

Grade 3 sprains are severe sprains. This category of wrist sprain requires immediate medical attention as this involves a complete tear of the ligament.

Common Causes

Falls are the most common causes of a wrist sprain. You can also suffer from a sprained wrist if you get hit in the wrist or when extreme pressure or twisting is applied to your wrist.

Athletes are at higher risk of suffering from a wrist sprain. This injury is more common among divers, gymnasts, skateboarders, skiers, skaters, and basketball and baseball players.

Signs and Symptoms of Sprained Wrist

The signs and symptoms of a sprained wrist could vary, depending on the extent of the injury. The most common signs and symptoms of a sprained wrist include:

• Pain
• Swelling in the wrist
• Tenderness and warmth at the site of injury
• Bruising or skin discoloration around the wrist
• Feeling of popping or tearing in the wrist

When to See a Doctor

Most sprains can be managed at home but there are cases that require professional medical care. These are cases that involved rapid swelling or bruising at the injured site, loss of feeling in the injured area, inability to move the affected site, repeated injury to the same area, and the lack of improvement with home remedies.

When you see a doctor, he/she will more likely begin with your medical history. He/she will ask you about how the injury happened and if there’s a history of hand or wrist injury.

Aside from a health history check, your doctor will also do a thorough physical exam. This is to make sure that there are no other injuries in the area.

To determine whether the wrist is sprained and to find out the extent of injury, your doctor may order imaging and other tests such as an X-ray, magnetic resonance imaging (MRI), arthrography, and arthroscopy.

Managing a Sprained Wrist

Mild wrist sprains can be easily managed at home. The symptoms can be alleviated with rest, application of cold compress for 20 minutes at a time, and elevation of the affected site (it should be elevated above the level of the heart).

Moderate wrist sprains need to be immobilized with the use of a splint. Wearing of the wrist splint for weeks can cause stiffness but doing some gentle, stretching exercises can help in regaining mobility.

For severe wrist sprains, surgery is usually recommended. This is to repair the fully-torn ligament.
There is a period of rehabilitation after surgery to help restore the function and motion of the wrist. Depending on the extent of the injury, rehabilitation may take months to a year.

What is Wrist Cyst?

A ganglion cyst is the most common lump that develops along the tendons or joints of the wrist or hand. This benign (noncancerous) lump, which may also occur in the ankles and feet, is usually round or oval and filled with a jelly-like fluid.

Most cases of ganglion cyst develop on the back of the hand at the wrist. However, it can also develop on the palm side of wrist.

It is still not clear what causes the development of a ganglion cyst. It is usually seen though in women between the ages of 15 and 40. The wrist cyst is also common among gymnasts, who repeatedly apply pressure on the wrist.

Symptoms of Wrist Cyst

The most common sign of a wrist cyst is the formation of a soft mass, between 1 and 3 cm in diameter. This mass doesn’t move but changes in size. It may get smaller over time and may even go away but may come back at another time.

In some cases, there can be pain especially after a repetitive trauma. There can also be weakness in the finger if the cyst is connected to a tendon.

Diagnosing Wrist Cyst

A physical exam is needed to diagnose a wrist cyst. During the physical exam, the doctor may apply pressure on the cyst to find out if there is tenderness or pain. He/she may also shine light on it to find out if it is filled with fluid or a solid mass.

To confirm the diagnosis of a ganglion cyst, the doctor has to aspirate fluid from the cyst (a ganglion cyst has thick and clear fluid).

Additional tests such as x-rays, ultrasound, or magnetic resonance imaging (MRI) may be recommended to rule out other conditions.

How It Is Treated

When ganglion cyst is diagnosed, the initial treatment of choice is nonsurgical.

Nonsurgical Treatment

To alleviate the symptoms of the wrist cyst, the use of a wrist brace or splint and aspiration may be recommended. Aspiration usually helps patients who experience pain and limitation from the cyst.

Surgical Treatment

If symptoms do not improve with nonsurgical methods, then surgery may be recommended by the doctor. The surgery involves the removal of the cyst and its root. The root can be a joint capsule or tendon sheath. This procedure is called an excision.

What is Ulnar Tunnel Syndrome?

Ulnar tunnel syndrome is a condition that affects the wrist. It occurs when the ulnar nerve is compressed.

The ulnar nerve is one of the three main nerves of the arm, running from the neck down into the hand. When pressure on this nerve occurs in the wrist, it can cause numbness and tingling sensation in the little finger and along the outside of the ring finger. And since the ulnar nerve plays a role in some hand movements and function, its compression can also lead to hand weakness.

Ulnar tunnel syndrome can happen as a result of a ganglion (a lump filled with fluid) on the joint of the wrist. It can also occur as a result of repetitive trauma or injury on the hand. People who lift weights, into cycling, and have jobs that require the use of vibrating tools are at risk of developing ulnar tunnel syndrome.

Symptoms of Ulnar Tunnel Syndrome

The symptoms of ulnar tunnel syndrome develop over time. The most common symptoms are numbness and tingling in the little and ring finger. These symptoms can be worse in the morning. When left unmanaged, this condition can eventually lead to pain in the wrist and fingers and gradual loss of hand dexterity and grasp.

Diagnosing Ulnar Tunnel Syndrome

To diagnose ulnar tunnel syndrome, the doctor has to do a thorough physical exam. He/she will examine the hand for common signs and symptoms of the syndrome which include muscle atrophy and muscle weakness. In order to rule out other possible causes of the tingling sensation, the doctor will tap the ulnar nerve.

Because the ulnar nerve also travels through the elbow, the doctor may also examine the elbow. Oftentimes, when pressure is applied over the ulnar nerve at the elbow, hand symptoms occur.

Additional tests such as magnetic resonance imaging (MRI) and computed tomography (CT) scan may be required to determine what puts pressure on the nerve.

How It Is Treated

There are nonsurgical and surgical treatment options for ulnar tunnel syndrome.

Nonsurgical Treatment

If the compression of the nerve is a result of repetitive use or palmar pressure, activity modification will be recommended. The use of a wrist brace and anti-inflammatory medications such as ibuprofen may also be suggested to provide symptoms relief.

Surgical Treatment

If symptoms persist even with the nonsurgical treatment options, surgery may be recommended by the doctor. The goal of the surgery is to release the pressure.

If the cause of the pressure is a cyst or scar tissue, then the procedure would involve removing it.

What is a broken wrist?

A broken wrist refers to a break or crack in one or more of the bones of the wrist or hand. Also known as distal radius fracture, a broken wrist is a common hand injury. In fact, in the United States, 1 out of 10 broken bones is a broken wrist.

A broken wrist is very common in people who are into contact sports as well as those who are into biking, inline skating, and skiing. People who have osteoporosis or thinning of the bones are at risk of suffering from a broken wrist. Falls and severe trauma from motorcycle and vehicular accidents can also lead to this condition.

Symptoms of a Broken Wrist

Pain and swelling are the most common manifestations of a broken wrist. The pain can worsen when one grips, squeezes, or moves the hand or wrist. There can also be tenderness, bruising, stiffness which makes it difficult to move the fingers or thumb, and an obvious deformity (this can be a bent wrist or crooked finger).

Diagnosing a Broken Wrist

A broken wrist is diagnosed after a thorough physical examination and x-rays.

The x-ray is the most common and reliable technique to determine any broken bone or bones in the wrist or hand. It can show whether there is a gap between the broken bones and how many broken bones are there.

In some cases, additional tests may be needed such as magnetic resonance imaging (MRI) and computed tomography (CT) scans to get better detail of the broken bones and to determine the extent of the injury.

How It Is Treated

There are several treatment options for a broken wrist. The choice would depend on several factors such as the age and activity level of the patient, the nature of the fracture, and the personal preference of the surgeon.

Nonsurgical Treatment

If the broken bone is in good position, the application of a plaster cast is recommended until the bone heals. However, if it is displaced (the alignment of the bone is out of place), then the doctor may do a procedure called closed reduction. It is a procedure on which the doctor “straightens” the bone without having to open the skin. Once it is aligned, a cast or splint may be placed on the arm.

The doctor usually monitors the healing of the fracture through regular x-rays. As to how frequent x-rays are taken will depend on the severity of the fracture.

Once the cast is removed (about 6 weeks), physical therapy is then recommended to improve the patient’s motion and function of the affected wrist.

Surgical Treatment

Surgery is recommended for more complicated wrist fractures or those that can’t be easily corrected with a cast.

The surgeon will perform an open reduction on which an incision is created to access and align the broken bones. The bones are then kept in their correct position using a cast, metal pins, plates and screws, an external fixator, or a combination of these.

What is arthritis of the wrist?

Arthritis of the wrist is a condition that affects various tissues of the wrist joint. It may be a short-term (acute) or long-term (chronic) inflammation in the joint and its surrounding tissues.

Different Types of Arthritis that Affect the Wrist

There are different types of arthritis that affect the wrist. These include:

• Osteoarthritis
  Osteoarthritis is a type of arthritis that develops over time. This usually results from the natural wear and tear of cartilage.
• Psoriatic arthritis
  Psoriatic arthritis is a type of arthritis that affects some people who have the skin condition psoriasis.
• Posttraumatic arthritis
  Posttraumatic arthritis occurs as a result of prior injury to the wrist.
• Rheumatoid arthritis
  Rheumatoid arthritis is a chronic condition that causes inflammation of the joints, including those of the hands.

Symptoms of Arthritis of the Wrist

Not all patients with wrist arthritis will have symptoms. If they do, the severity usually varies.

Some patients experience symptoms that come and go, depending on the type and level of their activity. Symptomatic patients (those who have symptoms) usually complain of pain, swelling, weakness in the joint, stiffness, reduced range of motion, and redness.

Diagnosing Arthritis of the Wrist

Wrist arthritis is diagnosed after a review of the patient’s medical history and after performing a thorough physical exam.

During the physical assessment, the doctor will check the wrist and will look for the presence of swelling, tenderness, and pain. He/she will also look into the range of motion of the wrist. This will help the doctor determine if it is really a case of wrist arthritis or of something else. Assessing the range of motion will also help the doctor determine the severity of the arthritis (if it is a case of wrist arthritis).

If arthritis is suspected, the doctor may order additional tests to confirm the diagnosis. This may include x-rays and blood tests. These will help determine what type of arthritis it is.

How It Is Treated

Wrist arthritis doesn’t have a cure but there are ways to manage its symptoms.

Nonsurgical Treatment

Some of the nonsurgical treatment options for wrist arthritis include the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, activity modification (limiting the activities that cause pain), cortisone injections, physical therapy, and hot and cold therapy.

Surgical Treatment

Surgery is recommended if there is no relief from nonsurgical treatment options. The goal of the surgery is to improve the hand’s function and reduce the pain.

Some of the surgical options for wrist arthritis include proximal row carpectomy, fusion, and total wrist replacement.