Acute Wrist Pain (sudden onset)

Acute wrist pain comes on suddenly, usually after a fall, impact, or awkward movement. It is commonly caused by sprains, strains, or fractures, and may be accompanied by swelling, bruising, and reduced movement. Identifying the cause early helps guide the right treatment and prevent further injury.

When should I see a doctor?

Seek medical attention if you have any of the following:

• Severe pain after a fall
• Visible deformity or significant swelling
• Unable to move or use your wrist
• Numbness, tingling or weakness
• Pain in the thumb side “snuffbox” area
• Symptoms not improving after 1–2 weeks

Wrist sprains & strains

A sprain is a tear of a ligament which joints bone to bone. A strain is a tear of a tendon which joins muscle to bone. They can occur at the same time.

Wrist sprain

A sprained wrist is an injury to any of the ligaments which connect bone to bone in the wrist. Wrist sprains are usually caused by trauma such as falling onto an outstretched arm.

• Symptoms vary depending on the extent and the location of the sprain.
• Sudden pain in the wrist will be felt at the time of injury.
• In severe sprains, a tearing or popping feeling may be felt.
• A particularly tender spot may be felt where the ligament is damaged.
• Swelling could be visible and bruising might develop in more severe injuries.

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TFCC tear

A TFCC tear is an acute injury to the triangular fibrocartilage complex, found in the wrist, between the end of the ulna bone and the carpals. A tear can be caused by a specific incident or come on gradually, resulting in wrist pain and restricted wrist and hand function. This wrist injury can often be treated with a splint, although if it is too severe, surgery may be needed.

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Wrist strain

A wrist strain is a tear of any of the tendons in the wrist. It usually occurs suddenly (acute injury), or can develop over time through repetitive stress and overuse (chronic wrist pain). Symptoms of a wrist strain include:

• Pain in the wrist which may develop gradually or suddenly.
• There may be a specific area which feels tender to touch.
• Swelling may develop, but not always.

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Fractures

Broken wrist symptoms vary slightly depending on the type and grade of the fracture. However, in general, they consist of:

• Severe pain after injury
• Rapid swelling
• Deformity
• Tenderness (especially anatomical snuff box)
• Reduced movement or grip strength
• Tingling or numbness in the hand or fingers (nerve damage)

Distal radius fracture (Colles fracture)

A Colles fracture is a particular type of broken wrist that involves a break of the radius or forearm bone on the thumb side of the wrist. Symptoms which would indicated a fracture consit of:

• Severe pain
• Deformity
• Rapid swelling would indicate a fractured wrist.

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Scaphoid fracture

The scaphoid is one of the small group of bones in the wrist called the carpal bones. It is the most common carpal bone to fracture among athletes and is often caused by falling onto an outstretched hand. Wrist pain and trouble gripping things are symptoms of this type of fracture, and medical advice should be sought for treatment.

Symptoms of a scaphoid fracture include pain in the wrist at the time of injury and rapid swelling at the back of the wrist. Pain may settle down soon after the fall but the patient will have difficulty gripping things. There will be tenderness when pressing in on the wrist compared with the noninjured wrist.

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Hook of hamate fracture

The wrist contains a number of small bones called carpals. The hamate is a carpal bone on the outside (little finger side) of the wrist.

It has a hook-shaped part which protrudes outwards and can under certain circumstances be fractured. With this injury, wrist pain occurs on the side of the little finger and the strength of grip can be reduced.

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Distal radial epiphysis injury

A distal radial epiphysis injury is an acute injury to the growth plate at the wrist end of the radius (forearm) bone. It mostly affects children and young athletes, particularly gymnasts, between the ages of 6 and 10 years old. Overuse is the most likely cause.

• Symptoms include acute pain in the wrist, especially when the wrist is bent backward with the palm facing down (known as dorsiflexion).
• They are likely to have limited movement in the wrist, which can prevent gymnasts from performing certain movements.
• There may be tenderness and swelling around the end of the bone.
• Other injuries with similar symptoms include ganglion cysts, wrist tendonitis.

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Distal radioulnar joint instability

The distal radioulnar joint is the joint at the wrist, between the radius and the ulna, the two forearm bones. This injury is usually a subluxation, or a partial dislocation, although fractures of either bone can be involved.

It is often caused by a direct impact like a fall, and medical help is needed immediately to check and treat the wrist injury.

Dislocated wrist

A wrist dislocation is a rare but serious injury involving one or more of the small carpal bones in the wrist becoming displaced. It usually happens after a traumatic fall onto the hand or wrist and causes sudden severe pain with an obvious deformity.

Symptoms may include:

• Severe wrist pain and swelling
• Visible deformity of the wrist
• Difficulty moving the wrist or hand
• Tingling or numbness in the thumb, index and middle fingers if the median nerve is affected

A wrist dislocation requires immediate medical attention because ligaments, nerves and other soft tissues are often badly damaged. If left untreated, permanent loss of wrist function can occur.

Once out of the plaster cast a full rehabilitation program with wrist strengthening exercises should be done to restore the hand and wrist to full normal functioning and help prevent any future injury.