Wrist Injury

What is a wrist injury?

• A wrist injury is a condition in which the tissues of the wrist joint are damaged. Two types of injuries that can happen to your wrist are sprains and strains. The wrist joint is the area where the bones of your forearm meet the bones of your hand. Your wrist is made up of tissues such as muscle, nerves, bones, tendons, and ligaments. Nerves in your wrist send and receive messages from your brain, helping you feel and move your wrist. Tendons are cords of tissue that connect muscles to bones. Ligaments are strong bands of elastic tissue that connect bones to other bones. Ligaments and tendons allow your wrist to move easily and remain stable.
  
  
• Damage to the tendons or ligaments in your wrist can cause pain and problems moving your wrist. A sprained wrist is when ligaments in your wrist are stretched or torn. A strained wrist is when a tendon or the muscle connected to a tendon in your wrist is stretched or overused. Having your wrist injury treated may decrease your pain and other symptoms. Treatment may allow you to move your wrist freely and return to your daily activities.

What causes a wrist injury?

Sprains are often caused by an accident, such as falling and landing onto the palm of your hand. Strained wrists are often caused by using your wrist in repetitive activities. Repetitive activities are activities in which you use your wrist over and over again in the same way. These activities may include gymnastics, rowing, and racket sports, such as tennis. Wrist injuries can also be caused by an accident, which forces your wrist out of its normal position. A wrist injury may also happen if a heavy object falls on your wrist.

What increases my risk for a wrist injury?

The following may increase your risk for a wrist injury:

• Past injuries: Unhealed bone fractures, or sprained or strained wrists may increase your risk of having another injury.
  
  
• Playing sports: Sports that involve repetitive wrist movement increase your risk for injury. Some sports, such as gymnastics, may involve activities that bend your wrist backward, which can cause a wrist injury.
  
  
• Having an unstable wrist: You may have been born with weak wrist ligaments or tendons that injure easily.
  
  
• Putting stress on your wrist: Walking for a long time with crutches may put repeated stress on your wrist. Jobs that require repetitive or forceful work with your wrist also put extra stress on your wrist.

What are the signs and symptoms of a wrist injury?

You may have one or more of the following:

• A change in the shape of your wrist, hand, or fingers.
  
  
• A feeling of something clicking, popping, or tearing inside your wrist.
  
  
• Pain in your wrist at the time of injury or when you move it.
  
  
• Pain, weakness, or numbness (loss of feeling) in your wrist or hand.
  
  
• Swelling, bruising, or a change in the color or temperature of the skin of your wrist or hand.
  
  
• Tenderness (pain when touched) around your wrist.
  
  
• Trouble moving your wrist or hand.

How is a wrist injury diagnosed?

Your caregiver will ask you about your signs and symptoms. He will ask you how and when you hurt your wrist and if you have had a wrist injury before. He may check for any unusual sounds in your wrist when your wrist is moved. Your caregiver will feel your hand, arm, and wrist to check for painful or numb areas. He may check for breaks in the skin and look for other injuries to your hand and arm. He may check the movement and strength of your wrist. You may also need one or more of the following:

• Joint x-ray: An x-ray is a picture of the bones and tissues in your wrist joint.
  
  
• Computed tomography scan: This is also called a CT scan. A CT scan is an x-ray that uses computers to take pictures of your wrist. Your caregiver may use this test to look for broken bones and other wrist injuries.
  
  
• Magnetic resonance imaging: During magnetic resonance imaging (MRI), pictures are taken of your wrist. An MRI may be used to look for broken bones, tissue damage, or edema (fluid buildup) in your wrist. You will need to lie still during the MRI. Never enter the MRI room with any metal objects. This can cause serious injury.
  
  
• Arthrography: An arthrography test looks at the tissues in your wrist. Dye is injected into your wrist. An imaging machine, such as a CT scan or an MRI, is then used to look for problems in your wrist. These problems include tissue tears and swelling. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to the dye that is used. Tell your caregiver if you are allergic to shellfish or have other allergies.
  
  
• Arthroscopy: Arthroscopy is a type of surgery in which small holes are made in your wrist. A probe (a narrow, bendable, plastic tube) with a camera at the end is put through one hole to see inside. Arthroscopy can be used to help diagnose problems such as arthritis. Arthroscopy is also used to treat wrist injuries.

How is a wrist injury treated?

Your treatment depends on the type of wrist injury and amount of tissue damage you have. You may need any of the following:

• Rest, ice, compression, elevation (RICE): Mild sprains and strains may be treated using this method.
  
  
  • Rest: You may need to rest your wrist and avoid activities that cause you pain. You may need to rest your wrist joint for at least 48 hours. Ask your caregiver what activities you should avoid, and for how long.
    
    
  • Ice: Ice causes blood vessels to constrict (get small), which helps decrease swelling and pain. Ice may also help prevent tissue damage in your wrist. Put crushed ice in a plastic bag and cover it with a towel. Put the ice pack on your wrist for 20 minutes every hour. Use the ice for as long as your caregiver says you should. Do not sleep with the ice pack on your wrist, because you can get frostbite.
    
    
  • Compression: Your caregiver may suggest wrapping an elastic bandage around your wrist. A wrist wrap will compress (put pressure on) your wrist to help decrease swelling. Compression also helps support your wrist, and allows it to heal. Wear your wrist wrap for as long as your caregiver tells you to. Ask your caregiver for instructions about how to wrap your wrist.
    
    
  • Elevate your wrist: When sitting or lying down, keep your wrist at, or above the level of your heart. Elevating (raising) your wrist may help decrease pain and swelling.
  
  
• Medicines: You may need one or more of the following:
  
  
  • NSAIDs: Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
    
    
  • Pain medicine: You may need medicine to take away or decrease pain.
    
    
    • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
      
      
    • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
    
    
  • Steroids: You may be given steroids to decrease swelling in your wrist. You may get a shot of steroids, or steroids and pain medicine, in the area of your injury.
  
  
• Wrist supports: A cast or splint may be put on your fingers, hand, and wrist to support your wrist. Casts and splints may help to decrease pain and movement in your wrist and prevent further damage. Ask your caregiver for more information about wearing casts and splints.
  
  
• Physical therapy: Your caregiver may recommend that you go to physical therapy. A physical therapist shows you how to do exercises that can help to strengthen your wrist and improve its range of movement. These exercises may also help decrease your pain.
  
  
• Surgery: You may need surgery if your wrist injury does not heal with other treatments. Ask your caregiver for more information about surgery to treat your wrist injury. Surgery may include:
  
  
  • Arthroscopy: This is also called closed surgery. During arthroscopic surgery, small holes will be made in your wrist. A probe with a camera attached will be put through one hole to see inside. Your caregiver will insert instruments into the other hole. During arthroscopic surgery, caregivers may repair tears, and remove injured and loose tissues.
    
    
  • Open surgery: If you have a sprained wrist, surgery may be done to repair or replace a torn ligament. Your caregiver may use screws or wires to attach the bones in your wrist together. The screws and wires may help support your wrist and make it stable.

What are the risks of having a wrist injury?

• Wrist supports may cause weakness of the ligaments and tendons in your wrist. Your joint may become stiff, and wrist supports may press on nerves and blood vessels. Your skin can become thinner and break down, causing skin ulcers. Wrist supports may also cause contractures (shortened muscles). Rest, wrist supports, and other nonsurgical treatments may not help your wrist heal, and you may need surgery.
  
  
• Arthroscopic surgery may not be enough to heal your injury, and you may need open surgery. Surgery to repair your wrist injury may damage the nerves and other tissues in your wrist. After surgery, you may get an infection. As a result of surgery, your wrist may feel stiff, and you may get arthritis (swelling of your joint). Even after surgery, your wrist may not heal properly, and you may have problems moving your wrist.
  
  
• Without treatment, your symptoms, such as pain, weakness, swelling, and stiffness, may get worse. Tissues, such as nerves and muscles, may be damaged from swelling and lack of blood supply. You may have a higher risk of getting arthritis in your wrist. Your injury may prevent you from having complete movement in your hand and fingers. Speak to your caregiver if you have any questions or concerns about your injury or treatment.

How can I prevent injuring my wrist again?

• Exercise as directed: Your caregiver may suggest that you do certain exercises to strengthen your hand and arm muscles. Ask your caregiver when you may return to your regular physical activities or sports. Starting exercise too soon may cause you to injure your wrist again.
  
  
• Protect your wrists: Wrist guard splints or protective tape can help to support your wrist during exercise and sports. These devices may also to keep your wrist from bending too far back. Ask your caregiver for more information about the type of wrist support that you should use.

Where can I find more information?

For more information contact:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

When should I call my caregiver?

Call your caregiver if:

• The bruising or swelling in your wrist is getting worse.
  
  
• Your pain is getting worse.
  
  
• You have a fever.
  
  
• You have questions about your wrist injury or treatment.

When should I seek immediate help?

Seek immediate help or call 911 if:

• The skin on, or near your wrist or hand feels cold, or turns blue or white.
  
  
• The skin on, or near your wrist or hand is very tight and swollen.
  
  
• You have new trouble moving and using your hands, fingers, or wrist.
  
  
• Your wrist, hands, or fingers become swollen, red, numb, or they tingle.
  
  
• Your wrist has any open wounds that are red, swollen, warm, or have pus coming out of them.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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