Wrist pain is a common problem that is more frequently seen these days with prolonged computer and electronic device use. It can be acute where it arises suddenly and often resolves in a short period of time with rest and medical treatment. Wrist pain can also be chronic where it exists over a long period of time with episodes of intense pain and restricted movement.
The wrist is a joint that connects the forearm and hand. It is made up of eight small rows that are arranged in two rows. A bony tunnels allows structures like nerves, blood vessels and tendons to travel between the forearm and hand. These tendons that traverse the wrist through the bony tunnel known as the carpal tunnel arise from muscles in the forearm which controls hand movements.
Pain in the Wrist
The wrist is a complex joint. Articulation between the many small bones that make up the wrist allows the flexibility of the hand that has plays an important role in the way we interact with our environment. As with any complex structure, there are many possible problems that can arise. This includes conditions affecting the bones, nerves, blood vessels, tendons, ligaments and overlying skin.
Other Signs and Symptoms
Pain is only a symptom and usually indicates injury and inflammation. Wrist pain may therefore present with a host of other signs and symptoms such as:
- Restricted movement
- Tingling and numbness
- Hand weakness
- Deformity of the wrist joint
- Lumps or masses
- Skin rash
If wrist pain is occurring with arm pain and there are other symptoms such as dizziness, chest pain, breathlessness and excessive sweating then immediate medical attention is necessary. These symptoms may be an indication of a heart attack.
Causes of Wrist Pain
There are various possible causes of wrist pain. The exact cause may not always be obvious and diagnostic investigations may be necessary to identify the underlying problem. It is therefore important that wrist pain is assessed and diagnosed by a medical professional.
Strain and Overuse
This is one of the more comon causes of wrist pain. The wrist joint is used everytime the hand is moved. With the hands being one of the main ways that we physically interact with the environment, it is understandable that that there may be strain of this joint with overuse and particularly with repetitive actions.
This is commonly seen with the prolonged use of electronic devices like computers (particularly the mouse), mobile phones and tablets as well as video game controllers. Repetive stress can lead to conditions like carpal tunnel syndrome but wrist pain can occur even without this condition being present.
Injury to the wrist can occur through a variety of ways. A blunt or sharp blow can cause obvious trauma to the joint. A fall whereby the wrist strikes a hard surface can also lead to injury and pain. Another way that the wrist may be injured and wrist bones are fracture occurs when the hands are extended during the fall in order to break the fall. This can lead to a distal radius fracture whereby the end of the forearm bone known as the radius is fractured.
Arthritis of the wrist joint is relatively common, particularly in the elder. The wrist joint may be affected by osteoarthritis or rheumatoid arthritis. In osteoarthritis (OA), the bones and cartilage become worn down due to prolonged wear and tear. With rheumatoid arthritis (RA), the lining of the joint becomes inflamed because the immune system attacks it. Gouty arthritis is another possible cause although it rarely affects the wrist joint.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common wrist condition that is seen these days with overuse and repeated strain of the wrist joint. This overuse and strain causes the tendons of the forearm muscles which run through the wrist tunnel to become swollen and then compress the median nerve that is also present in this tunnel. It leads to pain, tingling, numbness and muscle weakness.
A number of skin conditions can arise on the skin over the wrist. Pain is more likely to arise with inflammatory skin diseases. Contact dermatitis is a condition where the skin becomes inflamed after making contact with a substance. Usually these ae harmless substances which irritate the skin or trigger an allergic reaction. Wristwatches, shirt cuffs and other jewelry can act as irritants or allergense and lead to contact dermatitis.
An infection of the wrist is not common but can occur through different routes. Bacteria can enter the deeper wrist structures if there is a break in the skin like with a wound. Less commonly, microorganisms may reach the wrist through the bloodstream.
There are many types of masses, both cancerous and non-cancerous, that can arise on the wrist including the skin over it. One of the most common growths in the wrist area is a ganglion cyst. These fluid-filled masses are not cancerous. Ganglion cysts grow out of the tissue of the joint like a balloon. It is usually not serious and may appear and resolve even without medical treatment. Painful skin lesions should be investigated for cancer, especially if these skin growths are persisting and enlarging in size over time.
Fibromyalgia is a condition where there is pain at various sites throughout the body. As the name suggests, this pain is believed to arise from the muscles but may also involve other musculoskeletal structures. Fibromyalgia is not isolated to the wrist. However, there may be wrist pain with pain elsewhere in the body in fibromyalgia. The exact cause of fibromyalgia is unclear but there may be hereditary and tends to affect people after certain illness or with post-traumatic stress disorder.
Surgery of the wrist causes obvious trauma to the area during and for a period of time after the procedure. There is also the possibility that nerves may be injured during the procedure thereby leading to long term pain beyond the surgical wound.