Wondering what's behind your pesky wrist pain? Here, experts explain the most common causes and treatments to help you finally feel better.
5 Common Causes of Wrist Pain
1. Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition that happens when a nerve in the wrist (the median nerve) gets compressed in the tunnel of tendons (a narrow passageway or tunnel in the wrist known as the carpal tunnel), due to the thickening of a fluid called tenosynovium fluid that lines the wrist tendons, explains Alejandro Badia, M.D., board-certified hand, wrist, and upper extremity orthopedic surgeon with Badia Hand to Shoulder Center in Doral, Florida. And if that nerve gets compressed, you can experience sensations in your hands and wrists such as a pins-and-needles feeling, numbness, and weakness.
"Carpal tunnel syndrome has almost zero to do with what activities you're doing or what occupation you have," says Dr. Badia. Usually, the tenosynovium fluid thickens due to either metabolic issues such as gout, hypothyroidism, or diabetes, for example, or hormonal changes, he says. That's why "the average person who has carpal tunnel syndrome is a middle-aged woman [or assigned female at birth person] who is going through menopause," he says.
Your orthopedic surgeon or physical therapist may be able to diagnose you with carpal tunnel by looking at the history of symptoms on your medical chart, or through a physical examination that involves testing the muscles in your hand alone. But sometimes your provider will have you undergo an X-ray, nerve conductivity test, or electromyography test (three tests that are totally painless!), says Dr. Badia.
The fix: "There's not a lot of preventative care treatment for the carpal tunnel syndrome," he says. But if you have the condition, the first line of action is to wear a splint at night to reduce wrist pain when bending.
"Taking vitamin B can be helpful for mild cases," he says. Vitamin B6 is a physiologic diuretic, he explains, which means it can help the body rid itself of water-weight and puff. Although the science is still evolving, vitamin B6 is thought to be helpful for preventing carpal tunnel syndrome. Some doctors also prescribe wrist pain exercises, which can help take some of the pressure off of the compressed nerve.
"When the symptoms are significant, there's a simple nerve release surgery, which can be done endoscopically, that increases the diameter of the carpal tunnel by up to 40 percent," says Dr. Badia. Increasing the diameter of the carpal tunnel allows more room for the nerve, which can help ease the pain.
2. Wrist Tendonitis
Another common cause of wrist pain is wrist tendonitis, a condition where the tendons in the wrist become inflamed. While there are six tendons around the wrist, tendinitis most often affects the tendon in the carpal tunnel or the tendon at the base of the thumb.
Similar to carpal tunnel syndrome, tendonitis causes compression of the median nerve. With carpal tunnel syndrome the median nerve is compressed due to swollen fluid around the nerve. With tendonitis, the nerve is compressed because the tendons around the nerve are swollen.
Another type of tendonitis is called DeQuervain's tenosynovitis, which causes wrist pain on the thumb side.
"DeQuervain's tenosynovitis is colloquially known as Mommy's Wrist because it afflicts a lot of people in the postpartum period," because of the hormonal shifts that occur after pregnancy, he explains. "Just as your ankles get inflamed or bloated after pregnancy and go away, so does the inflammation in the tendons," he says.
The fix: "A single cortisol injection helps more than 80 percent of the time," says Dr. Badia. "Applying CBD ointment over the tendon twice a day can also help people manage pain."
For more chronic cases, there's a quick operation that involves opening the tunnel and removing some of the inflamed tissue to relieve pressure on the tendon, he says. Surgery may be necessary if all of the other options to treat the pain don't work, or if a tendon is damaged.
3. Traumatic Wrist Injury
Trauma to the wrist including fractures and breaks can also (and, well, obviously) cause wrist pain. "The most common traumatic wrist injury is often known as FOOSH, which is an acronym for fall on outstretched hand," says Dr. Badia. This may happen if you fall and try to catch yourself with your hand, and is common in high-impact sports, but can happen anywhere.
Breaks cause symptoms such as immediate tenderness at the touch, bruising or swelling around the wrist and thumb, and even wrist deformity.
The fix: The exact treatment will vary based on the severity of the break, as well as whether or not other joints or bones were affected. If the fracture didn't cause bone displacement (ouch!) wearing a cast for six to eight weeks may be sufficient. Otherwise, surgery may be required.
4. Osteoarthritis
Marked by the inflammation of the joints, wrist osteoarthritis is rare compared to other joints. "Osteoarthritis is far more common in the knee, hip, fingers, and base of the thumb than it is in the wrist," according to Dr. Badia. However, often arthritis at the base of the thumb is mistaken as wrist osteoarthritis due to the location of the deep, dull ache.
Women typically have more laxity in their joints compared to men, according to Dr. Badia, and although there is more research needed, it's thought that estrogen plays a role in joint laxity. Women also experience arthritis at the base of the thumb nearly three times as often as men due to declining estrogen levels with menopause.
A diagnosis of wrist osteoarthritis begins with a discussion of your past wrist aches, pains, and traumas, and also includes a physical exam that allows the provider to see how the wrist moves, he says. In some instances, you might also get an X-ray that will allow your doctor to see how bad the joint damage is or a blood test to rule out other types of arthritis.
The fix: "You can't really reverse osteoarthritis," says Joy Baganz, lead occupational therapist at Northwestern Medicine Central DuPage Hospital. "If a patient comes in with a real flare-up, we'll inject them with cortisol to nip the inflammation in the bud," she says. When the inflammation has settled, doctors often prescribe a series of wrist pain exercises to help patients gradually improve the range of motion in the wrist.
That said, because the issue here is often the thumb (not wrist!) arthritis, Dr. Badia says you should book an appointment with a hand specialist if you're experiencing stiffness and soreness at the base of the thumb.
5. TFCC (Triangular Fibrocartilage Complex)
Triangular fibrocartilage complex or TFCC is a load-bearing structure along the pinky side of the wrist. You can injure the TFCC from over-rotating the wrist, explains Banganz, which can happen during an injury, or from normal wear and tear, but this is more common in older adults. Some people also have naturally longer bones in the wrist, which can cause wear on the area and result in injury according to Banganz.
The fix: "If it's so severe that you can't painlessly turn the steering wheel, it's best to see a hand specialist who can come up with a game plan suited to your needs," she says.
"If the pain is less severe, often the treatment is to immobilize the wrist for a while by wearing a wrist brace to calm the inflammation." Then after a few weeks, working with a physical therapist to incorporate a variety of wrist strength and mobilization exercises can help, she says.
What to Do If You're Experiencing Wrist Pain
If you fell on your hand, wrist, or arm and are experiencing pain, go to the doctor ASAP. "If you don't seek the help you need, and it heals wrong you're going to have a host of problems, including not being able to adequately rotate your wrist," says Dr. Badia.
If you're experiencing wrist pain that's not due to a fall or traumatic injury, Baganz says you can treat it with ibuprofen to reduce inflammation. She also recommends ice for swelling and heat for stiffness. If the pain lasts longer than three days, that's when it's time to see your doctor. A doctor can run the appropriate tests and refer you to a hand or wrist specialist who can administer treatment or schedule surgery if needed, she says.
Can You Prevent Wrist Pain?
Wrist pain is preventable, depending on the kind of wrist pain.
Wrist injuries are a little trickier to prevent because most result from a combo of bad luck and genetic predisposition. The biggest risk factors for osteoarthritis, for example, are genetics and sex while for carpal tunnel its hormonal changes and metabolic mayhem.
That said, below are three tips for preventing wrist pain if you're concerned about developing issues in the future or you've started to feel some initial tenderness.
1. Optimize your workstation.
Wrist issues such as carpal tunnel are usually caused by a combination of factors such as genetics, hormonal mayhem, previous contact injury, and internal inflammation — and not just one thing including repetitive movement or poor positioning. But for people who are at an increased risk of wrist pain, long-term sub-optimal wrist position while typing can trigger and/or worsen symptoms.
That's why Baganz recommends making sure that your workstation has an ideal wrist position. "A good workstation puts your feet flat on the ground with a 90-degree bend in your knee," she says. "It also allows your back to be supported, your elbows to be at 90 degrees, and your wrists in a neutral position."
2. Don't ignore wrist pain.
Baganz says it's common for people to ignore their wrist pain. "Athletes, in particular, are prone to having a no pain no gain mentality," she says.
Unfortunately, ignoring pain doesn't mean it's not there. "If you're experiencing wrist pain, stop and do something that doesn't cause pain to your wrists," she says. Otherwise, you may worsen your condition. Her recommendation: If the pain is severe, or lasts longer than three or four days, seek the care of a physical or occupational therapist.
3. Modify exercises as needed.
Speaking of everyday athletes, Baganz says to avoid exercises that load weight on your wrists if you're experiencing pain.
For example, if doing push-ups with flat hands hurts she suggests doing them from your fists, which allows your wrists to maintain a more neutral position. FYI: Same goes for burpees and planks. Don't be afraid to ask a certified trainer or your physical therapist for ways to modify exercises if you have wrist pain.
4. Add some wrist-specific exercises to your workout.
If you're feeling motivated to ward of wrist woes (and your provider gives you the green light to do so), you might add in some specific stretches and exercises for your wrist. "Any grip strength exercises can have a therapeutic benefit on the wrist," says Baganz because all the muscles in the hand connect to those in the wrist and forearm.
There is also a number of wrist mobility movements you might incorporate into your routine, she says, including wrist extension stretch, wrist flexion stretch, and tendon glides. Your doctor will be able to walk you through exactly how to do these movements correctly and explain how often you should be doing them for maximal benefit.
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