Wrist Pain from the Mayo Clinic
Tendinitis and Sprains
It used to be that you golfed on Mondays and Wednesdays, played tennis on Tuesday and Fridays, and perhaps did some gardening and fishing on the weekends. But then your wrist started hurting, and the new pain has gotten so bad that you’ve had to stop your favorite activities. What can be done ?
It could be that you’re experiencing pain in your ligaments or tendons, which are connective tissues that hold your wrist joint together and allow for movement of your wrist and hand. These injuries are common, particularly if you participate in certain activities that involve snapping wrist motions or heavy or repetitive wrist and hand use.
In most cases, wrist pain can be relieved with self-care measures. When that’s not enough, additional measures – including surgery – are available.
Tendons
Tendons are thick, fibrous cords that attach muscles to bone. In your wrist, many are covered with a slippery membrane called tenosynovium, which allows them to move smoothly. Inflammation can occur in either the tendons (tendinitis) or the tenosynovium (tenosynovitis), or in both simultaneously. The primary signs of either are pain, tenderness and sometimes swelling. Pain may be aggravated when you move the affected area.
The most common type of tendon problem in the wrist is called de Quervain’s tenosynovitis. It occurs in an area of the wrist that runs along the outside base of the thumb, because this is the part of the hand that takes the brunt of many common activities, such as opening doors. It can cause pain and swelling and, without rest or treatment, the pain can spread down your thumb and up your forearm. This is different from carpal tunnel syndrome, which can cause pain, numbness and eventually weakness.
Conservative treatments for tendon pain and inflammation include:
• Using heat pads, ice packs or nonprescription pain- relieving drugs to help reduce pain.
• Avoiding the movements that cause pain. A physical therapist may be able to show you wrist- strengthening exercises or teach you how to make hand and wrist movements in a way that doesn’t aggravate sore tendons.
• Wearing a splint or brace to restrict hand movement. [1]
If these aren’t enough, hand therapy with electrical stimulation or ultrasound or injections of corticosteroids may be recommended to reduce swelling. In unusually persistent cases of de Quervain’s tenosynovitis, a minor surgical procedure to cut a sheath of tissue that encapsulates the tendons and synovium can release pressure and speed healing by giving inflamed and restricted tissues more space.
Ligaments
Ligaments are fibrous tissues that connect bone to bone. Ligament injuries (sprains) are generally associated with high- impact force that bends your hand back --- as might occur when falling and catching yourself with outstretched hand. Sprains commonly occur in the scapholunate ligament, located about mid wrist.
The severity of a sprain can vary widely. A stretched ligament may cause only minor swelling and discomfort. Moderate to severe sprains involve ligaments that have partially or fully torn away from the bone, sometimes fracturing off a small chip of bone in the process. These often limit wrist movement and cause significant pain, swelling and bruising.
Less severe sprains are typically treated with the same conservative measures used to treat tendon problems. However, if a ligament is partially or fully torn from the bone, surgery may be needed to repair the ligament or to pin joint bones together while the ligament heals.
Seeking treatment
Minor tendon or ligament problems can often be treated at home. But if pain or swelling fails to improve [2] --- or gets worse --- over the course of a few days, talk to your doctor. For severe pain, seek emergency care.
A delay in repairing a torn ligament can result in poor healing, reduced range of motion, long –term disability related to progressive wear – and – tear arthritis --- and more complicated surgical procedures to repair or replace a poorly healed ligament. In addition, your pain may be caused by other problems requiring prompt treatment, such as a bone fracture or joint instability.
[1] http://www.bio-magnetictherapy.com/page11.html
[2] Swelling will be reduced with the bio-magnets in your braces.