Many types of wrist pain are caused by sudden injuries that result in sprains or fractures. But wrist pain also can be caused by more long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome.
Because so many factors can lead to wrist pain, diagnosing the exact cause of wrist pain can sometimes be difficult. A precise diagnosis is crucial because proper treatment depends on the cause and severity of your wrist pain.
Signs & Symptoms
The precise location quality and nature of your wrist pain can give your doctor clues as to what might be causing your symptoms. For example, osteoarthritis pain is often described as being similar to a dull toothache with stiffness, while tendinitis usually causes a sharp, stabbing type of pain upon movement of the inflamed tendons.
Your wrist is a complex joint made up of eight small bones arranged in two rows between the bones in your forearm and the bones in your hand. Tough bands of fibrous ligaments connect your wrist bones to your forearm and hand bones. Tendons attach muscles to bone. Damage to any of the parts of your wrist can cause pain and affect your ability to use your wrist and hand.
- Sudden impacts. The most common method of injuring your wrist is when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures.
- Repetitive stress. Any activity that involves repetitive wrist motion from keyboarding and regular mouse use can inflame the tissues around joints, especially when you perform the movement for hours on end without a break.
- De Quervain's disease is a repetitive stress injury that causes pain at the base of the thumb.
- Osteoarthritis. In general, osteoarthritis in the wrist is uncommon, usually occurring only in people who have injured that wrist in the past. Osteoarthritis is caused by wear and tear on the cartilage that cushions the ends of your bones. Pain that occurs at the base of the thumb may be caused by osteoarthritis.
- Rheumatoid arthritis. A disorder in which the body's immune system attacks its own tissues, rheumatoid arthritis is common in the wrist. Both wrists are usually affected.
- Carpal tunnel syndrome. Carpal tunnel syndrome develops when there's increased pressure on the median nerve, which passes through the carpal tunnel, a passageway in the palm side of your wrist.
Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a fairly common condition that results from compression of the median nerve within the tunnel formed by the carpal bones on the palm side of the wrist. This tunnel protects a main nerve to your hand and the tendons that bend your fingers. It has numerous causes such as long hours spent working on a computer keyboard and mouse.
Long term pressure placed on the nerve produces pain, numbness and eventually hand weakness and atrophy.
Signs & Symptoms
Carpal tunnel syndrome typically starts with a gradual ache in your wrist that can extend to your hand or forearm. Other common carpal tunnel syndrome symptoms include:
- Tingling or numbness in your fingers or hand, especially your thumb, index, middle or ring fingers, not your pinky. This sensation often occurs while driving, upon waking or holding a phone. As the disorder progresses, the numb feeling may become constant.
- Pain radiating or extending from your wrist up your arm to your shoulder or down into your palm or fingers, especially after forceful or repetitive use. This usually occurs on the palm side of your forearm.
- A sense of weakness in your hands and a tendency to drop objects.
The cause of carpal tunnel syndrome is pressure on the median nerve. The median nerve is a mixed nerve, meaning it has a sensory function and also provides nerve signals to move your muscles (motor function) which is why loss of sensation and muscle atrophy often occurs. Pressure on the nerve can stem from anything that reduces the space in the carpal tunnel. Possible causes include:
- Repetitive use or injury. Repetitive flexing and extending of the tendons in the hands and wrists, particularly when done forcefully and for prolonged periods without rest can increase pressure within the carpal tunnel. Injury to your wrist can cause swelling that exerts pressure on the median nerve.
- Physical characteristics. It may be that your carpal tunnel is more narrow than normal and the slightest pressure on the tunnel compresses the nerve and tendons.