A sprained wrist is an injury to any of the ligaments of the wrist. Ligaments connect two bones together where they form a joint. There are 8 carpal bones in the wrist, plus the ends of the forearm bones. As a result, there are even more ligaments in the wrist!
Sprained wrist symptoms
Symptoms of a wrist sprain vary depending on the extent of the injury and the location of the sprain. Sudden pain in the wrist will be felt at the time of injury and in more severe wrist sprains a tearing or popping feeling may be felt. Pain will be felt when moving the wrist and a tender spot may be felt where the ligament is damaged. Mild swelling could be visible and bruising might develop in more severe injuries.
What is a wrist sprain?
A wrist sprain is quite a common injury, which usually occurs after a fall onto an outstretched hand. Other accidents or impacts can cause a sprained wrist, although it usually involves the wrist being bent either forwards or back. A sprained wrist doesn't usually occur as an overuse injury. Gradual onset wrist pain is more likely to be due to RSI or repetitive strain injury such as carpal tunnel syndrome or tendonitis.
Wrist sprains can vary in severity. A mild (grade 1) wrist sprain may involve the ligament being stretched. Moderate (grade 2) injuries are partial tears of a ligament and severe (grade 3) injuries are full ruptures of one or more ligaments. Grade 3 injuries may also involve an avulsion fracture where a fragment of bone is pulled off with the ligament.
Sprained wrist diagnosis
It is important to get all but the most mild of suspected wrist sprains assessed. Even a minor sprained wrist can result in prolonged and recurring pain and disability.
A doctor will assess the wrist, looking for swelling, bruising, deformity, tenderness, pain on movements etc. They will also ask about how the injury happened and any previous injuries to the area. A referral may be made for an X-ray or MRI scan to rule out a broken wrist and to observe the extent of the injury.
Sprained wrist treatment
Most wrist sprains can be treated initially at home using the PRICE principle:
- Protection - Use a wrist support or splint to protect the joint and reduce movement to allow healing.
- Rest - Don't keep using the wrist - this will only cause additional damage.
- Ice - Apply ice or another form of cold therapy as soon as possible to reduce pain, swelling and inflammation. Repeat every 2 hours. A simple hot / cold gel pack is ideal as long as it is secured properly.
- Compression - Using a compression bandage or support will help reduce swelling. The sooner the compression bandage is applied the better. Cohesive tape or bandage is ideal as it is elastic and sticks to itself. It is easy to apply. Do not leave a compression bandage on for more than 10 minutes at a time as it may restrict blood flow.
- Elevation - Raising the wrist above the level of the heart will also help reduce swelling and encourage excess fluids to drain away.
More severe injuries may require immobilisation in a splint for 1-2 weeks to allow the ligament to heal. After this period the wrist may feel stiff so a mobility and stretching programme is important to get the wrist moving again. Wrist strengthening exercises can also be used to strengthen the muscles surrounding the wrist which helps to support the injured ligament.
Surgery is sometimes required following full ruptures, or those where there is an associated fracture. The procedure usually involves re-attaching the ligament to the bone. If there is a fracture, this may also have to be fixed in place with wires or pins. The wrist is then put in a splint or cast for around 6 weeks. A rehab programme should then follow to regain full mobility and strength.