Your wrist is one of the most important joints in the human body. All of the anatomical components allow you to wave, pick up items, type on your phone, and even throw a football. The wrist’s main jobs are moving the hand back and forth and side to side, aiding with flexibility and strength of the hand, and being the transference point of motion from arm to hand. All of these abilities rely on the complete system of bone, joins, and soft tissues working together.
At AICA Lithia Springs, our team of wrist specialists treats wrist pain and injuries frequently and are experts at diagnosing and developing a comprehensive treatment plan to ensure optimal recovery. Keep reading to learn more about the wrist and common injuries that we are ready to treat today!
Anatomy of the wrist
The human hand and wrist make up one of the most complex joints in the body. Including the radius and ulna (the two bones that make up your forearm), there are 29 bones in the hand and wrist. The wrist is a joint made up of many irregular-shaped bones, 17 ligaments, 24 tendons, 3 nerves, and 2 major arteries. While not in the wrist, your fingers are similarly made up of many joints, knuckles, ligaments, and tendons. With the complexity of the wrist, it is at high risk for a variety of wrist injuries.
Ligaments
You have ligaments throughout your body responsible for connecting bone to bone. The wrist has many ligaments that fall into two categories.
- Extrinsic ligamentsconnect the wrist bones to the long bones of the arm (radius and ulna)
- Intrinsic ligamentsconnect the wrist bones to other wrist bones.
Tendons
In addition to the ligaments connecting all the bones in your wrist and arm, the tendons in your wrist connect muscles to bones. They are responsible for bending the wrist forward (flexion) and backward (extension).
Arteries
Two main arteries provide the blood supply to the wrist.
- The radial artery follows the line of your radius and into your thumb. This is the artery you feel pulsing when taking your pulse!
- The ulnar arteryfollows the ulna on the pinky side of your wrist.
Nerves
Three main nerves travel from the brachial plexus in the shoulder, down the arm, and into the wrist and hand. Nerves are electrical pathways in your body carrying signals from your brain, through your spine, and into your muscles, telling them how to move. If these nerves are damaged or pinched, it can interrupt the signal causing weakness, tingling, or pain.
- Median nerve– passes through the carpal tunnel and enervates the thumb, index finger, middle finger, and part of the ring finger. The carpal tunnel is a passageway for nerves and blood supply to pass through the wrist created by bone, ligaments, and tendon.
- Ulnar nerve– responsible for enervating the ring and little finger. Before entering the wrist, the ulnar nerve passes close to the elbow and down the ulna. The compression of this nerve at the elbow and the resulting numbness and pain is known as cubital tunnel syndrome. The ulnar nerve is what you hit when you shock your “funny bone.”
- Radial nerve– affects the forearm muscles that facilitate flexion and extension of the wrist. Damage to this nerve can result in the inability to straighten your wrist.
The 6 Most Common Wrist Injuries
Carpal Tunnel Syndrome
Carpel tunnel syndrome is caused by pressure on the median nerve at the point it passes through the carpal tunnel. The compression can be caused by acute swelling or by chronic swelling and thickening of the tendons.
Carpal Tunnel Syndrome typically starts as a minor irritant that gradually increases to debilitating pain. Sometimes the effects of CTS will result in people having to leave their profession or recreational activities.
Symptoms of Carpel Tunnel Syndrome include:
- Pain and tingling in the wrist and/or arm
- Weakness in the affected hand
- Stiff fingers
- The feeling of being shocked in your fingers
- Inability to make a fist
Carpel tunnel syndrome will worsen over time if not treated, so early diagnosis will give you the best chance at a good outcome. People at the highest risk for developing carpel tunnel syndrome include people working on assembly lines, typing all day, and athletes who have repetitive motions, such as golfers or gymnasts.
Standard treatment for carpel tunnel syndrome includes rest, bracing, icing, and pain relievers, and if the pain is significantly impacting your everyday life, surgery could be necessary.
Ganglion cysts
Ganglion cysts are soft tissue cysts that are painful and can be unsightly. They typically appear opposite your palm and are formed when fluid leaks from a joint. Your body’s immune system responds by forming a shell around it. While they can be painful, they are more often just annoying.
If you would like them removed whether due to pain or aesthetic purposes, your doctor should be able to do so permanently under local anesthesia.
Arthritis
Arthritis is the swelling and inflammation of one or more joints. Because your wrist is a joint comprised of many joints it is at a higher risk of arthritis than some other areas. The thumb is the most commonly affected joint in the wrist and hand affected by arthritis. The two main types of arthritis affecting the wrist are:
- Osteoarthritisoccurs when the cartilage that cushions your joints deteriorates. This is seen in older patients as well as a result of overuse. While osteoarthritis is the most common form of arthritis, it is less common in the wrist unless you have previously injured your wrist.
- Rheumatoid arthritisis an autoimmune disorder that attacks the body’s tissues. Usually affecting the wrists bilaterally, rheumatoid arthritis causes swelling and inflammation of the joints.
Symptoms of arthritis can include pain, stiffness of the affected joints, feeling grinding or cracking when bending your fingers or wrists, and weakness of the joints. Unfortunately, there is no fully curative treatment for arthritis. Some treatment options include rest, bracing, anti-inflammatory medication, cortisol injections, and specialized exercise that can be overseen by therapists at AICA Lithia Springs!
Wrist fracture
A wrist fracture is the medical term for a broken wrist. This wrist injury occurs when one of the many bones of the wrist breaks or cracks, usually from extreme pressure. The most common cause of a wrist fracture is due to falling hard and catching yourself on outstretched hands. In addition to this, you can also suffer a wrist fracture due to repetitive trauma that weakens the bone leaving it more susceptible to fracture.
Common symptoms include severe pain, diffcuilting closing your hand, difficulty gripping objects, swelling, bruising, and visible deformity. Wrist fractures need medical attention to determine the type and severity of the fracture and treatment.
Typically, a cast is required to immobilize the fracture, while medication, rest, and ice can help with associated symptoms.
Kienbock’s disease
Kienbock’s disease typically affects young adults and is often mistaken for a sprained wrist in its early stages. Kienbock’s disease occurs when the blood supply to any one of your wrist bones is cut off. When the blood supply is cut off, the bone will die and collapse, causing pain, swelling, stiffness, and decreased grip strength.
Sprains and Strains
A wrist sprain is the most common wrist injury, with a 2002-2014 study finding that a sprain was the most common type of injury to the hand and wrist (49%), followed by contusions (15%) and fractures (10%) in sports. Sprains and strains are similar injuries that affect different parts of your anatomy. A strain is an injury, sometimes described as a twist or pull, to the tendon or muscle. They can be caused by an acute injury or by chronic repetitive activities.
Sprains and strains are often referred to by a grading scale to identify severity.
- Grade I– stretching of the ligament, some possible joint instability. Mild swelling and bruising are present. It can usually be treated at home.
- Grade II– a more severe stretch of the ligament with some possible tearing, associated with bruising, swelling, and looseness of the joint.
- Grade III– ruptured ligament, comparable to a broken bone in that you cannot put weight on the affected joint, complete joint instability.
Symptoms of sprains and strains:
- Pain
- Swelling and tenderness
- Muscle spasms
- Weakness in the affected joint
- A ‘pop’ feeling
Everyone is at risk of spraining their wrist. The best way to prevent a wrist sprain is to take precautions! Warm up before lifting weights, wear braces when you are at risk for fallings, and clear path of trip hazards are just a few options.
Common risk factors for wrist injuries
Wrist injuries can affect anyone, but some factors will put you at a higher risk.
- Repetitive work – any work that has you using your hands and wrists constantly, especially in the same movements over and over, will put you at a higher risk for a wrist injury.
- Athletes – Sports participation puts you at risk for both acute and chronic wrist injuries. Impact sports are more susceptible to acute injuries, while bowling, golf, and tennis are a few sports that are more likely to develop repetitive motion injuries.
- Other health conditions – pregnancy, diabetes, obesity, and rheumatoid arthritis are a small sample of conditions that could increase your chances of a wrist injury.
Now that you know some of the common wrist injuries, you might be wondering if your wrist injury or pain requires a visit with a doctor. As you’ve read above, some of these injuries are more severe than others. Persistent or worsening pain, visual deformity, and inability to move your fingers, wrist, or elbow are all indicators you should seek medical attention for treatment.
A common source of wrist pain is an injury sustained in a car accident. A car accident can put an incredible amount of force on your wrists, similar to a weight lifter using weights that are too heavy. AICA Lithia Springs has valuable experience treatment of car collision injuries, and our wrist specialists are ready to treat you.
Diagnosis
The first step after a wrist injury is a physical evaluation of the joint. At AICA Lithia springs, our wrist specialists will perform a physical exam looking for external signs of injury. Following this, our team will use medical imaging and/or nerve testing to establish a more detailed picture of your injury. Possible diagnostics include MRI, CT, and ultrasound to look for physical deformities or injuries. If necessary, nerve testing can also be performed to identify any nerve damage.
Treatment
Your course of treatment is going to depend on the diagnosis made by our specialists. After diagnosing your specific wrist injury, our orthopedic team will recommend appropriate treatments to ensure the best treatment plan for optimal healing. Depending on your wrist issues, our specialists will recommend non-invasive treatments or invasive treatments while taking into consideration short and long-term damage and outcomes.
Non-invasive treatments can include:
- Bracing your wrist to reduce movement
- Rest and anti inflammatories
- A curated exercise regime is overseen by our physical therapists to rebuild strength
- A chiropractor can assess the wrist and correct alignment to provide pain relief and release impinged nerves.
Invasive treatments can include:
- Injection of steroids to reduce inflammation
- Surgery such as carpel tunnel release surgery or a wrist arthroscopy.
Having a wrist injury can be painful and impact your daily life and even your job. We know that it can be frustrating to suffer pain and limitations in your daily tasks. Our goal at AICA Orthopedics is to develop a comprehensive plan to assess and treat the cause of your pain and get you back to your life pain-free! If you have wrist pain that persists, suffer a fall, or are in a car accident and are suffering wrist pain contact AICA Lithia Springs as soon as possible. We at AICA are staffed 24/7 to help begin your journey to a pain-free life. It is important to seek medical treatment as soon as possible for the best possible treatment outcomes.