Causes of Pain in the Wrist

Wrist pain is a problem with a high potential to affect a person’s daily work. It may be natural to have wrist pain after trauma, strenuous activities, heavy conditions or after working for a long time. However, sometimes a person cannot remember a reason that could lead to wrist pain. Complaints may start out of nowhere. So, in which diseases and problems can wrist pain be seen?

Nerve Compression in the Wrist – Carpal Tunnel Syndrome

The median nerve passes through the tunnel (wrist canal) between the upper wrist bones and the subcutaneous connective tissue on the wrist facing the palm. The median nerve receives sensation in the palm of the hand from the thumb, index finger, middle finger and half of the ring finger. In addition, the muscles that move the thumb are stimulated by the median nerve.

Conditions such as repetitive movements that force the wrist (such as using the keyboard, sewing, drawing), obesity, pregnancy, diabetes, underactive thyroid gland (hypothyroidism) and rheumatism can cause compression of the median nerve in the wrist, that is, carpal tunnel syndrome .

In carpal tunnel syndrome, there may be complaints such as pain in the wrist, numbness in the thumb and first three fingers, tingling, weakness, and melting of the thumb muscles.

Nerve Compression in the Elbow – Cubital Tunnel Syndrome

If the ulnar nerve passing through the inner side of the elbow is stretched or compressed, complaints such as pain and numbness may occur in the little finger and ring finger of the hand, where this nerve receives its sensation, and in the wrist and arm on the same side.

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Wrist Injury

Tissues such as bones, tendons and ligaments in the wrist can be damaged due to sprains of the wrist, falling, and heavy lifting. There may be findings such as pain, swelling, bruising, abnormal movement (instability) in the wrist. The scaphoid bone is a small bone at risk of fracture in the wrist. Injury and edema (tendinitis) may develop in the tendons passing through the wrist due to excessive use. Tendinitis may have symptoms such as swelling, pain, morning stiffness, increased temperature, and a feeling of friction. Ligaments, which are the ligaments that hold bones, can be stretched or even torn as a result of strain.

Joint Rheumatism (Arthritis)

Arthritis is when the immune system activates and damages the joint. If the immune system activity is high, the joint swells, becomes painful, its movements are restricted and even deformity occurs after a while. The long-term wear and tear associated with age or work is called osteoarthritis. In addition, diseases such as rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, known as inflammatory rheumatism, can affect the wrist and other joints in the hand.

Gut

As a result of increased uric acid level in the body, this molecule can accumulate in the joints. Things that increase uric acid are overeating, alcohol, diabetes, kidney disease, high blood pressure and the use of certain drugs (for example, some diuretics). In gout, the big toe joint is most commonly involved. But it can also affect other joints such as ankle, knee, wrist. It causes complaints such as pain, tenderness and redness in the joint.

Infection

Rarely, a true microbial infection may also be the cause of rheumatoid arthritis. It may not be easy to distinguish it from rheumatism.

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Gangliyon Kisti

A ganglion cyst is usually a swelling in a limited area of ​​the wrist that curves a few centimeters. These are benign, gelatin-like, fluid-filled capsular structures. It originates from the tendon sheath or joint capsule. It can occur on the inside or outside of the wrist. It usually enlarges after strenuous activities and shrinks after rest. It can cause pain and limitation of movement.

Soft tissue swelling in the wrist may also be due to a different cause such as lipoma, giant cell tumor, synovial sarcoma. Therefore, it cannot be said that swellings are always harmless.

Complaints that can be seen with pain in the wrist

In order to diagnose wrist pain, attention should be paid to other accompanying symptoms. There may be complaints such as swelling and temperature increase in the wrist and finger joints, numbness and tingling sensation in the hand, difficulty in holding and squeezing things. Pain and numbness may be worse at night. Pain may only radiate to the wrist or to the fingers or elbow.

Swelling and warmth in the wrist together with pain indicate arthritis (joint inflammation). If the pain is accompanied by a feeling of numbness that gets worse at night, there may be nerve compression in the wrist (carpal tunnel syndrome).

How Is Wrist Pain Diagnosed?

In order to evaluate nerve compression in the wrist, the wrist is bent inward for about 1 minute and it is checked whether numbness or tingling occurs. This is called the Phallen test. Another examination method is to tap the point where the median nerve passes on the wrist with a finger repeatedly and look for pain or tingling. This examination is called the Tinnel test.

By bending the wrist inward, outward and sideways, it is checked whether there is restriction of movement. Sensitivity in the wrist bones is evaluated by pressing with a finger. Swelling and edema in the joint are examined. It is checked to see if there is any meltdown in the hand muscles. The squeezing force of the hand is measured.

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Nerve compression can be determined objectively by nerve conduction study (EMG). The markers of inflammatory rheumatic diseases in the blood can be examined. X-rays can show damage to bones and joints. Soft tissue problems such as tendons and ligaments can be evaluated with MRI.

If infection is suspected, a sample of joint fluid is taken from the wrist and examined under a microscope and culture. A joint fluid sample is also required to diagnose gout.

How Is Wrist Pain Treated? What is done in the treatment?

Treatment differs according to the underlying cause.

In the treatment of carpal tunnel syndrome, the use of wristbands, hot or cold application, pain relief, edema reducing drugs, physical therapy, local injection (needle) can be done. If the nerve injury is severe, surgery may be required.

If the wrist hurts due to injury, the joint is rested using a wristband. Methods such as holding the wrist up, bandaging, cold application are useful. Pain relievers or creams can be used.

If there is joint calcification (osteoarthritis), exercises, hot or cold application, painkillers, physical therapy methods can be applied to relieve stiffness and stretch the joint.

If there is an inflammatory rheumatic disease, exercises to stretch and strengthen the hand, cold application to reduce edema, and the use of wristbands may be beneficial. There are special drug treatments according to the type of rheumatic disease. For this, you should be examined by a physical therapy and rehabilitation or rheumatology doctor.

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