Wrist Pain – Diagnosis and Treatment
Diagnosis
Scanning and Imaging Methods
Imaging methods are central to uncovering the causes of wrist discomfort, such as sprains, fractures, ganglion cysts, or arthritis.
The most frequent starting point is the X-ray, used to check for bone injuries, joint changes, or osteoarthritis. X-rays can also show swelling and carpal bone alignment.
For more detailed bone images, computed tomography (CT) scans are valuable. CT scans can detect tiny or hard-to-see fractures, like a scaphoid fracture, which might go unnoticed on regular X-rays.
| Test | Best For |
|---|---|
| X-ray | Fractures, osteoarthritis, bone issues |
| CT | Small fractures, bone details |
| MRI | Ligament/tendon injuries, soft tissue damage |
| Ultrasound | Tendons, ligaments, cysts |
Magnetic resonance imaging (MRI) gives clear and detailed pictures of both bones and soft tissues like ligaments and tendons.
An MRI may help identify ligament injuries, tendinitis, tendinopathy, avascular necrosis, or changes due to rheumatoid arthritis. In many cases, a small MRI device can be used just for the arm, making the process straightforward.
Ultrasonography (ultrasound) is another noninvasive tool. It is helpful to look at soft tissues such as ligaments, muscles, and cysts. Ultrasound is especially useful for spotting ganglion cysts, wrist sprains, De Quervain tenosynovitis, and swelling.
Wrist Joint Scoping
If imaging does not answer all questions, doctors may use arthroscopy. This procedure uses a small device called an arthroscope.
The tool is put through a small cut in the skin, so the doctor can see inside the wrist on a screen.
Arthroscopy helps find long-term wrist pain problems, like hidden injuries or arthritis not seen on scans. Sometimes, repairs are performed during this procedure if something is discovered.
Electrical Signal Analysis
When hand pain, numbness, tingling sensations, or weakness point to nerve problems—such as carpal tunnel syndrome—nerve testing is helpful. A common test is the electromyogram (EMG).
This test records electrical signals in the muscles of the hand and forearm. Another test, nerve conduction studies, checks if messages travel slower than normal along the nerves at the wrist.
These methods help spot nerve involvement in wrist injury or conditions that lead to chronic pain and stiffness.
Treatment
Medications Used to Relieve Symptoms
People often begin with nonprescription medicines such as ibuprofen or acetaminophen to help with wrist discomfort or swelling. If aches are strong or ongoing, doctors may give prescription medicines that act more strongly.
In some situations, corticosteroid injections can be used to lower inflammation right at the painful area.
Supportive Treatments and Exercises
Physical therapy is often used after injuries or surgery. A therapist may suggest gentle stretches, strengthening exercises, and ways to use the wrist safely at work or home.
In some cases, an ergonomic evaluation can help find out if the way a person uses their hands at work is making symptoms worse.
To let an injured wrist recover, people may use a wrist brace or a splint. These help keep the wrist stable and protect it, especially after a break, sprain, or overuse.
Casts are usually for broken bones, while splints often help with soft tissue injuries.
List of common support approaches:
- Stretching and range-of-motion exercises
- Use of a wrist brace or cast
- Workstation changes based on ergonomic review
Surgical Treatments
When other treatment options do not provide enough relief, surgical treatment may be needed. Surgery can help connect broken bones with the use of metal plates or pins.
For people with carpal tunnel syndrome, a common procedure involves cutting the tight ligament to make more space for the nerve. Tears of tendons or ligaments may also need repairs to restore use of the wrist.
Healthcare provider emphasizes following up with therapy after surgery to regain movement and strength.
Home Care and Everyday Tips
For mild wrist discomfort caused by inflammation or repetitive wrist movement, try these steps:
- Rest the wrist to reduce further strain.
- Apply an ice pack to help lessen swelling.
- Use an elastic bandage for gentle support.
These simple home measures may help with symptoms from repetitive stress or minor injury.
Getting Ready for Your Visit
Steps You Can Take Beforehand
It helps to write out details about symptoms, such as when the pain started, what makes it worse or better, and if anything triggers it.
Bring a list of all medicines and supplements, along with any known allergies. Include information about past or current health issues.
Family history is important, so note if parents, brothers, or sisters have had similar problems. Prepare questions you want answered during your appointment. You can use a simple table to organize your notes:
| Item | Details |
|---|---|
| Symptoms and when they started | |
| Medications and supplements | |
| Personal health problems | |
| Family health history | |
| Questions for the healthcare team |
What the Healthcare Team Might Ask
The healthcare professional will likely ask when your symptoms started and if an injury set them off.
They may ask about activities or movements that increase pain, if you feel tingling or numbness, and which hand you use most often.
Expect questions about your job and hobbies, especially if they require a lot of hand or wrist use.
You may also be asked for details about your medical history and family health conditions, and the professional may perform a physical examination.
