Wrist Pain By Location

Back of the wrist thumb side (radial) wrist pain

The radial zone on the dorsal aspect of the wrist is the area of the back of the wrist on the thumb side.

Most common injuries:

Extensor carpi radialis tenosynovitis – inflammation of the sheath surrounding the tendon, causing pain on the back of the wrist (thumb side), worse with gripping, lifting or extending the wrist, sometimes with stiffness or creaking.

DeQuervain’s tenosynovitis – inflammation of the sheath surrounding two tendons at the base of the thumb, causing pain on the thumb side of the wrist, worse with gripping, lifting or twisting, often with tenderness and swelling, and pain when moving the thumb or making a fist.

Scaphoid fracture – a fracture of the scaphoid bone in the wrist, causing pain on the thumb side of the wrist (especially in the “anatomical snuffbox”), tenderness to touch, swelling, and pain when gripping, pinching or moving the wrist.

Distal radius fracture (Colles’ fracture) – a fracture of the end of the radius bone in the forearm, causing sudden pain and swelling around the wrist, tenderness, reduced movement, and often a visible deformity with the wrist bent backwards.

Less common:

Intersection syndrome – inflammation where the forearm tendons cross on the back of the wrist, causing pain slightly up the forearm on the thumb side, worse with repetitive wrist extension, often with swelling and a creaking or squeaking sensation on movement.

Anterior interosseous nerve compression/syndrome – compression of a branch of the median nerve in the forearm, causing deep forearm pain with weakness when pinching or gripping (difficulty making an “OK” sign), but usually without numbness or tingling.

Radial nerve compression – compression of the radial nerve, causing pain on the back of the forearm or wrist, often with weakness in wrist or finger extension (difficulty lifting the hand or fingers), sometimes with tingling or altered sensation along the back of the hand.

Extensor pollucis longus impingement – irritation or impingement of the tendon that straightens the thumb, causing pain on the back of the wrist near the thumb, worse with thumb extension or lifting, often with tenderness and pain when moving the thumb or gripping.

Lister’s tubercle irritation – irritation around the small bony prominence on the back of the radius, causing localised pain on the back of the wrist, tenderness to touch, and discomfort with thumb or wrist movement, particularly when extending the thumb.

Important not to miss:

Carpal dislocation – dislocation of one of the small bones in the wrist, causing severe pain, swelling, and loss of movement, often with visible deformity and inability to use the wrist normally, sometimes with numbness or tingling if nerves are affected.

Radial epiphyseal stress reaction – an overuse injury affecting the growth plate of the radius, most common in young athletes, causing gradual onset wrist pain (often on the thumb side), tenderness, and pain with weight-bearing or repetitive loading such as gymnastics or racket sports.

Back of the wrist central zone wrist pain

The dorsal central zone is the middle area of the back of the wrist.

Most common:

Posterior interosseous (radial) nerve entrapment – compression of a branch of the radial nerve, causing pain on the back of the forearm or wrist with weakness in finger or wrist extension (difficulty straightening the fingers), usually without significant numbness.

Ganglion cyst (wrist ganglion) – a small fluid-filled lump arising from a joint or ligament in the wrist, causing a visible swelling, localised aching or discomfort, and pain or stiffness with wrist movement, sometimes fluctuating in size.

Scapholunate ligament sprain – a wrist sprain affecting the ligament between the scaphoid and lunate bones, causing pain on the back of the wrist, especially with gripping or loading, often with swelling, weakness, and a feeling of instability or clicking.

Less common:

Wrist impingement syndromes – compression of soft tissues within the wrist joint, causing localised pain (often on the back of the wrist), worse with extension or loading, sometimes with a pinching sensation, stiffness, and reduced range of movement.

Important not to miss:

Scapholunate dislocation – dislocation between the scaphoid and lunate bones, causing significant pain on the back of the wrist, swelling, reduced grip strength, and often a feeling of instability or abnormal movement, sometimes with clicking.

Perilunate dislocation – a severe wrist injury where the carpal bones are displaced around the lunate, causing intense pain, swelling, loss of movement, and often a visible deformity, sometimes with numbness or tingling if the median nerve is affected.

Kienböck’s disease – a condition where the lunate bone loses its blood supply, causing gradual onset pain in the centre of the wrist, stiffness, reduced grip strength, and worsening symptoms with activity.

Back of the wrist pinky finger side (ulnar) wrist pain

The dorsal ulnar zone is the area of the wrist on the inside near the little finger.

Most common:

Extensor carpi ulnaris tenosynovitis – inflammation of the tendon sheath on the little finger side of the wrist, causing pain on the outer (ulnar) side of the wrist, worse with gripping, twisting or ulnar deviation, often with tenderness and sometimes a snapping or instability sensation.

TFCC tear (triangular fibrocartilage complex) – a tear of the cartilage on the little finger side of the wrist causing pain on the ulnar side,. It is worse with twisting or gripping, often with clicking, reduced grip strength, and a feeling of instability.

Ulnar styloid fracture – a fracture of the small bony prominence at the end of the ulna, causing pain on the little finger side of the wrist, tenderness, swelling, and pain with gripping or rotating the forearm.

Triqeutral fracture – a fracture of one of the small carpal bones on the little finger side of the wrist, causing pain on the back of the wrist. Symptoms include tenderness to touch, swelling, and pain with wrist movement or gripping.

Less common:

Distal radioulnar joint (DRUJ) instability – abnormal movement between the radius and ulna at the wrist, causing pain on the little finger side, worse with twisting the forearm (turning a key or doorknob), often with clicking, weakness, and a feeling of instability.

Ulnar fracture – a fracture of the ulna near the wrist, causing pain on the little finger side, swelling, tenderness, and reduced movement, often with pain when gripping or rotating the forearm.

Lunotriquetral ligament sprain – a sprain of the ligament between the lunate and triquetral bones, causing pain on the little finger side of the wrist, worse with gripping or twisting, often with tenderness, weakness, and a feeling of instability or clicking.

Extensor carpi ulnaris subluxation – the tendon slips out of its groove on the little finger side of the wrist, causing pain on the ulnar side, worse with twisting or gripping, often with a snapping sensation, tenderness, and a feeling of instability.

Palm side wrist pain radial zone

The volar-radial zone is the front/inside of the wrist on the thumb side.

Most common:

• Carpo-metacarpal (CMC) osteoarthritis – wear and tear of the joint at the base of the thumb, causing pain on the thumb side of the wrist/hand, worse with gripping or pinching, often with stiffness, reduced strength, and sometimes swelling or bony enlargement.

Less common:

• Flexor carpi radialis tendinopathy – irritation of the tendon on the thumb side of the front of the wrist, causing pain over the volar (palmar) wrist, worse with gripping, wrist flexion or lifting, often with tenderness along the tendon and stiffness with use.

Important not to miss:

• Carpal instability – abnormal movement between the small bones of the wrist, causing pain (often on the back or central wrist), worse with loading or gripping, frequently with clicking, weakness, and a feeling that the wrist is giving way.

Inside wrist central zone

The volar central zone is the inside middle of the wrist.

Most common:

• Carpal tunnel syndrome – compression of the median nerve at the wrist, causing pain, tingling or numbness in the thumb, index and middle fingers, often worse at night, sometimes with weakness and reduced grip strength.

Less common:

• Pisotriquetral degenerative joint disease – wear and tear of the joint between the pisiform and triquetral bones on the little finger side of the wrist, causing localised ulnar-sided pain, tenderness, and discomfort with gripping, pushing or wrist flexion, sometimes with clicking.

Inside wrist pinky finger side (ulnar) zone

The volar ulnar zone is the front/inside of the wrist on the little finger side.

Most common:

• Thoracic outlet syndrome – compression of nerves or blood vessels between the neck and shoulder, causing pain that can radiate into the arm and hand, often with tingling, numbness or weakness, sometimes worsened by overhead activity or prolonged arm positions.
• Lunotriquetral ganglion (wrist ganglion) – a fluid-filled cyst arising near the lunotriquetral joint on the little finger side of the wrist, causing a small lump, localised pain or aching, and discomfort with wrist movement, sometimes fluctuating in size.

Less common:

• Hook of hamate fracture – a fracture of the small hook-shaped bone on the little finger side of the wrist, causing pain in the palm (ulnar side), worse with gripping or holding objects, often with tenderness and reduced grip strength.
• Ulnar nerve compression – compression of the ulnar nerve, causing pain, tingling or numbness in the ring and little fingers, often with weakness in grip and fine hand movements, sometimes worse with prolonged elbow or wrist positioning.
• Flexor carpi ulnaris tendinopathy – irritation of the tendon on the little finger side of the front of the wrist, causing pain on the ulnar (palmar) side, worse with gripping or wrist flexion, often with tenderness along the tendon and discomfort with twisting movements.