Wrist Pain

It's common but it can be crippling: wrist pain. It will shut down your computer work, exercise, and music-making faster than just about anything but the flu.

You haven't thought about it much, but your wrist is a rather complex series of joints. Your wrist consists of eight small bones arranged in two rows between the bones in your forearm and the bones in your hand. A tube-like structure, known as the carpal tunnel, is located on the palm side of the wrist. Sturdy bands of ligament connect your wrist bones to each other and to your forearm bones and hand bones, while tendons attach muscles to bones. Damage to any of one of these many parts can cause you pain and affect your ability to use both your wrist and hand.

Because there are so many moving parts, and because so many factors can generate wrist pain, it is often not easy to diagnose the source. Some of the more common causes are injuries to bones, tendons or ligaments; compression of the nerves that pass through the wrist; or long-term problems such as repetitive stress, arthritis and carpal tunnel syndrome.

The type of pain may vary with the cause, and so will often facilitate diagnosis. Pain “like a dull toothache” is likely indicative of osteoarthritis, and a “pins and needles” pain may be symptomatic of carpal tunnel syndrome.

The most common causes of wrist pain include:

• Sudden impacts, which include sprains, strains and fractures;
• Repetitive stress, which is any activity that involves repetitive wrist motion;
• Osteoarthritis, which occurs when the cartilage that cushions the ends of your bones deteriorates over time;
• Rheumatoid arthritis, a disorder in which the body's immune system attacks its own tissues;
• Carpal tunnel syndrome, which develops when there's increased pressure on the median nerve as it passes through the carpal tunnel, a passageway in the palm side of your wrist;
• Ganglion cysts, which are soft tissue cysts occurring most often on the part of your wrist opposite your palm.
• Kienbock's disease, a disorder that occurs when the blood supply to the small bones in the wrist is compromised, typically affecting young adults.

Your doctor will likely schedule an X-ray, magnetic resonance imaging, ultrasound or computer tomography to get a better look at what is the causing your pain. If these are not helpful, he may perform an arthoscopy. This is a procedure wherein a tiny camera is inserted under your skin and into your wrist.

Treatments are as varied as the causes of the pain. Ice packs and over-the-counter painkillers such as ibuprofen and acetaminophen are usually the first line of care. Broken, sprained or strained bones or ligaments will likely necessitate some form of splint or brace. Splint are also utilized to treat some pain caused by repetitive motion.

In the case of broken bones and severe carpal tunnel syndrome, some minor surgical procedure may be required.