ANKLE PAIN
CARPAL TUNNEL SYNDROME
CHRONIC PAIN
ELBOW PAIN
HIP PAIN
IMPAIRMENT & DISABILITY
KNEE PAIN
MUSCLE WEAKNESS
MYOFASCIAL PAIN
NECK & LOW BACK PAIN
NUMBNESS
SHOULDER PAIN
WRIST PAIN
BIOGRAPHY
REFERALS
Spence Rehabilitation Center
1650 45th Ave. Suite 2C
Munster, IN 46321
Visit our Porter County location!
1620 Country Club Rd. Ste E
Valparaiso, IN 46383
Phone : (219) 513-2267
 
     
 
What are causes of traumatic wrist pain?
If the pain resulted after a fall on an outstretched hand,
fracture, ligament strain, or bone dislocation should be
suspected.
 
1. Wrist sprain:
A tear of the ligaments that support the radiocarpal
joint which attached the hand to the arm. Wrist pain
and swelling resulting from sprain is usually mild with
near normal range of motion. Symptoms should
resolve within two weeks with conservative therapy
such as ice, immobilization, and gentle passive
stretching exercises.
2. Scaphoid fracture:
Can occur if there is a blunt blow to the wrist or a fall
forward onto an outstretched hand and wrist. This
fracture can be difficult to pick up because x-rays are
sometimes normal even if a facture is present. Also, if
not treated, the blood to the scaphoid bone can be cut
off which can lead to bone death and arthritis.
3. Lunate dislocation:
This is a small bone found in the wrist and also results
from a fall onto an outstretched hand. The distance
between the scaphoid and lunate is measured on X-ray.
If there is greater than a distance of 3mm then a
dislocation is present.
4. Distal radius fracture:
Sometimes referred to as a Colles fractures.
5. A hamate fracture:
Usually results from a direct blow to the wrist or chronic
repetitive strain with racket sports. There is usually
tenderness and weakness in grip strength. X-rays are
often normal so a CT or bone scan may be necessary if
it is still suspected.
 
 
What are some common causes of non-traumatic
wrist pain?
1. Radiocarpal arthritis:
Usually results in pain, swelling, and loss of range of
motion at the wrist. It can develop from multiple wrist
sprains, old fractures, rheumatoid arthritis, and gout.
2. Dorsal ganglion:
Usually develops from chronic irritation of the wrist
which leads to overproduction of joint fluid. The fluid
travels up to the subcutaneous tissues to form a fluid
filled sac.
3. Carpal tunnel syndrome:
Compression of the median nerve at the wrist.
Symptoms include pain and numbness in the thumb,
index, middle and part of the ring finger. Pain can
sometimes move up to the forearm and shoulder.
4. De Quervain's tenosynovitis is:
An inflammation of tendons that make up the thumb
which usually develops from repetitive gripping and
grasping.
5. Carpometacarpal osteoarthritis:
Also caused by repetitive gripping and grasping as
well as excessive vibration. Symptoms included pain,
swelling, or enlargement at the base of the thumb.
6. Compression of the ulnar nerve in Guyon's
canal:
An uncommon syndrome where the ulnar nerve is
pinched at the wrist and usually causes numbness of
the small and ring fingers.
   
 
 
What Tests can be used to evaluate wrist pain?
1. X-ray of the wrist:
To check for fractures and arthritis. X-rays should
be ordered if there is history of trauma and focal
tenderness when touched. Simple sprains should
be normal. Osteoarthritis of the radiocarpal joint can
show narrowing of the joint space and irregularities of
the bony surface. A widened space of >3 mm between
the scaphoid and the lunate suggests lunate dislocation.
2. CT or bone scan:
Sometimes used to check for fractures of the scaphoid
in individuals with suspicious symptoms and normal
findings on plain x-ray.
3. Local anesthetic block/joint aspiration:
Can be used to draw fluid out of a joint to check for
inflammatory cells. Also, the carpal tunnel can be
injected with anesthetic to evaluate for carpal tunnel
syndrome. If the symptoms improve after injection,
carpal tunnel syndrome is more likely.
4. Electrodiagnostic testing:
(EMG and nerve conduction studies):
are used to check for compression of nerves such as
the median and ulnar nerves.
What are common treatment options for wrist pain?
Treatment will vary depending on the specific diagnosis
but may include some of the following:
1. Acetaminophen:
Also known as Tylenol.
 
2. Non-steroidal antiinflammatories (NSAIDS):
To minimize pain and inflammation. Commonly
prescribed medications include ibuprofen and
naprosyn.
3. Splinting:
Can be applied to fractures and dislocations acutely
to keep the hand immobilized until they are seen by
a hand specialist. Splints can also be used to manage
many chronic conditions
a) Thumb spica splints:
Are used to manage De Quervain’s
b) Carpal tunnel splints:
Can be worn at night to manage carpal tunnel
syndrome.
4. Corticosteroid injections:
A high dose of steroid is administered to the affected
site to minimize inflammation and limit systemic side
effects.
a) CMC joint injection
b) Carpal tunnel injection
c) De Quervain’s injection
5. Modalities:
Can include heat, ultrasound, phonophoresis,
fluidotherapy, and paraffin.
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Please consult a physician for medical advice regarding any medical condition."
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