Sprained Wrist

Wrist sprain

A sprained wrist is an injury to any of the ligaments which connect bone to bone in the wrist. Wrist sprains are common in sport and are usually caused by an impact such as a fall onto an outstretched arm.

Symptoms

Causes

Treatment

Sprained wrist symptoms

  • Symptoms of a wrist sprain 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 more severe sprains, a tearing or popping feeling may be felt.
  • Pain will be felt when trying to move the wrist.
  • A tender spot may be felt where the particular ligament is damaged.
  • Mild swelling could be visible and bruising might develop in more severe injuries.

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.


It is important to get all but the mildest of suspected wrist sprains assessed. Even a minor sprained wrist can result in prolonged and recurring pain and disability.


What is a wrist sprain?

Wrist ligaments (Dorsal/back)
Wrist ligaments (Volar/Palm side)

A wrist sprain is a tear, or stretching or any of the many ligaments in the wrist. It is quite a common injury, which may occur after a fall onto an outstretched hand.

Wrist sprains usually involve the wrist being bent either forwards or back, but doesn’t usually occur as an overuse injury.

Gradual onset of wrist pain is more likely to be due to RSI or repetitive strain injuries such as carpal tunnel syndrome or tendonitis.


How bad is my wrist sprain?

Wrist sprains can vary in severity depending on how bad they are.

  • A mild or grade 1 wrist sprain may involve the ligament being stretched.
  • Moderate or grade 2 injuries are partial tears of a ligament.
  • 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 treatment

Most wrist sprains can be treated initially at home using the PRICE principles of protection, rest, ice, compression, and elevation.

  • Protect the wrist from further damage. Wear a wrist support or splint to protect the joint and reduce movement.
  • Rest is very important. Do not keep using the wrist as this will only cause additional damage.
  • 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.
  • 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. Do not leave a compression bandage on for more than 10 minutes at a time as it may restrict blood flow.
  • Raising or elevating the wrist above the level of the heart will also help reduce swelling and encourage excess fluids to drain away.
  • After the acute stage wrist taping can provide additional support and protection.

Severe wrist sprains

  • More severe injuries may require immobilization 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.

Exercises

Wrist flexion golfer's elbow exercises

Wrist strengthening exercises can also be performed to strengthen the muscles surrounding the wrist which helps to support the injured ligament.


Surgery

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 rehabilitation program should then follow to regain full wrist mobility and strength.


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