The wrist is the point of articulation that controls hand movements and is integral for performing precise tasks like writing or tightening a screw. Because the wrist is frequently activated to perform routine and specialised tasks, wrist joint injuries and conditions are a common issue for many people ranging from office workers to athletes.

The wrist is an articulating joint with bones, muscles, ligaments, and tendons that can all be impacted by acute and chronic conditions. Due to their proximity and musculoskeletal relationship, it is not uncommon for both the hand and wrist to develop conditions simultaneously due to overuse or injury.

Wrist Anatomy

Known as the radiocarpal joint, the wrist is a synovial joint in the upper arm that separates the forearm and the hand. There are two forearm bones (radius and ulna) and eight wrist bones that make up this joint.

The radius is the largest bone and is located on the thumb side. The ulna is a smaller bone situated on the little finger side. There is a triangular-shaped disc of fibrous cartilage at the end of the ulna, which acts as a cushion for the wrist bones. At the point where the radius meets the wrist are two rows of four small bones called the carpus.

Symptoms of Wrist Conditions

Symptoms of wrist conditions will vary depending on the nature and severity of the issue. Common symptoms of wrist conditions include:

  • Wrist swelling and pain.
  • Decreased strength in wrist/difficulty performing tasks.
  • Sudden numbness or tingling sensation.

Common Wrist Conditions

Wrist Tendonitis

Wrist tendonitis (tenosynovitis) is when the tendons around the wrist joint become irritated or inflamed. Because there are so many tendons surrounding the wrist joint, wrist tendonitis can often involve multiple tendons at the same time.

Wrist tendonitis often occurs where tendons pass over each other or an area of bone, and these areas are where symptoms are experienced. The most prominent cause of wrist tendonitis is overuse. Even behaviours like texting with a phone or using a computer mouse can be triggers for this condition.

Common symptoms of wrist tendonitis include:

  • Painful swelling around the wrist joint.
  • A grinding sensation when the tendons are activated.
  • Wrist area becomes warm and red.

Wrist Fracture

A wrist fracture describes one of the bones that make up the wrist joint breaking due to severe trauma. This type of fracture occurs most often in the radius (distal radius fracture), although it can happen to any of the bones in the joint.

Like all broken bones, treatment options will depend on the severity of the injury, with stable fractures being the easiest to treat. Wrist fractures are typically the result of falling on an outstretched hand or high-impact collisions in contact sports.

The symptoms of a wrist fracture include:

  • Wrist pain, swelling.
  • Stiffness with difficulty moving hand and wrist.
  • Unusual or deformed appearance of the wrist.
  • Pain, numbness, and tingling in fingers.

Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the median nerve in the hand is compressed. This is a chronic condition that worsens over time, making it important to diagnose and treat it as soon as possible.

If untreated and allowed to worsen, this condition can lead to nerve damage and more severe symptoms. While commonly associated with repetitive use of the wrist, this condition is typically caused by a combination of factors, including hereditary predisposition and age.

Common symptoms of carpal tunnel syndrome include:

  • Tingling, burning, numbness, and pain typically felt in the thumb and fingers.
  • A ‘shock’ type sensation that radiates across the hand from the wrist.
  • Pain or tingling that moves up the forearm.
  • Weakness of the hand, reducing grip strength and making it difficult to perform precise movements.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform carpal tunnel surgery to help alleviate symptoms and return joint function.

De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis is when the tendons surrounding the base of the thumb become inflamed or irritated. This causes pain to be felt on the thumb side of the wrist and is most apparent when trying to grasp or grip things.

This condition is often the result of overuse of the tendons but is also linked to pregnancy and rheumatoid arthritis. Direct injury to the tendon can also lead to this condition.

Common symptoms of De Quervain’s tenosynovitis include:

  • Pain on the thumb side of the wrist that may travel up the forearm and get worse with use.
  • Swelling that may be accompanied by a cyst.
  • A “catching” type sensation when using the thumb.
  • Difficulty moving the thumb and wrist due to pain and swelling.

Ganglion Cysts

Ganglion cysts are the most frequently occurring type of fluid-filled lump or mass that manifest in the wrist and hands. They typically develop on the back of the wrist and are, for the most part, benign in nature. Ganglion cysts tend to appear, disappear, and change size on their own, and treatments are not required unless the cyst becomes painful, interferes with wrist function, or is a cosmetic concern.

Ganglion cysts develop due to leaking fluid from a tendon or joint, which begins to collect under the skin. The leak may be caused by arthritis or trauma, but the root cause often goes unanswered.

While primarily a cosmetic issue, if a ganglion cyst is located near a nerve, it can cause symptoms such as:

  • Pain and loss of joint mobility.
  • Numbness and tingling sensation.

Wrist Arthritis

Wrist arthritis occurs when the fibrous cartilage that separates articulating joints becomes diseased and breaks down. Diminished cartilage means that bones begin to rub against each other, causing severe pain and discomfort that limits movement. This condition can result from both main types of arthritis (osteoarthritis and rheumatoid arthritis), as well as injuries like fractures.

Symptoms of wrist arthritis will vary from patient to patient and depend on severity, but they typically include:

  • Pain and swelling in the wrist joint.
  • Stiffness and difficulty moving the wrist.
  • Weakness in the wrist that limits the ability to perform tasks.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform wrist arthritis surgery to help alleviate symptoms and return joint function.

Sprained Wrist

A sprain in the wrist is when a ligament connecting the bones in the wrist joint becomes partially or entirely torn (ruptured). This condition is typically caused by forceful impacts on the wrist, such as extreme bending, twisting, and falls onto an outstretched hand.

There are three grades for a sprained wrist that cover mild to severe cases:

  1. Mild overextension of the ligament without instability in the wrist joint.
  2. A partial tear of the ligament with mild instability.
  3. A complete tear (rupture) of the ligament with severe instability.

Symptoms of a sprained wrist include:

  • Pain and swelling.
  • Warm, tender feeling around the site of the injury.
  • A “popping” or tearing sensation felt in the wrist.
  • Bruising.
  • Weakness and loss of motion.

Experiencing hand and wrist pain?

If you are suffering from any of the conditions listed above, you should seek medical diagnosis and treatment from an orthopaedic specialist. Contact Melbourne Arm Clinic to book an appointment or ask any questions about your issue and the treatment options available (including wrist arthroscopy, partial wrist fusion, total wrist fusion, and wrist replacement surgery).

Matthan Mammen
ELBOW, WRIST AND HAND SPECIALIST

Mr. Matthan Mammen

MS, FRACS (Orth)

Matthan is an internationally qualified orthopaedic surgeon, who is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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