Hand and Wrist problems

The wrist is the most complex joint in the body. In fact, the wrist is actually composed of multiple joints. These are comprised of multiple bones and ligaments (fibrous tissues that hold the bones together). Multiple muscles attach to these bones to move the wrist. The wrist is commonly injured by a fall onto the ground. In this injury the wrist is hyperextended or bent backwards. This means that all of the ligaments are stretched causing microscopic tears. These microscopic tears can take weeks to months to heal. In a wrist sprain none of these ligaments are fully torn and none of the bones are broken. They vary in severity with the most minor injuries simply requiring rest and painkillers for a few days and the more severe injuries taking months to recover.

How are wrist sprains treated?

Wrist sprains are treated like other injuries to joints in the body. The first thing to do is to elevate the wrist to reduce the swelling. Next comes painkillers such as paracetamol and ibuprofen taken regularly until pain subsides. The wrist should be rested and this means modifying work activities and avoiding sports that use the wrist. A mild wrist sprain does not need medical attention but if pain is severe or prolonged then it is recommended that you seek medical attention. It's likely an x-ray will be taken to look for broken bones. In a wrist sprain the x-ray will be normal and there will no evidence of the ligaments been completely torn. You may well be given a wrist splint to help rest and protect the wrist and over time you should gradually wear it less and less as the symptoms improve. Ice can be applied to the wrist for the first 24 hours to reduce the swelling. The ice should not be applied directly to the skin and there should be a towel or cloth between the icepack and the skin. Wrist sprains don’t require or benefit from surgery.

Wrist splints

There are different types of wrist splints because there are different types of wrist injuries. The “Futura” splint is the one you will most commonly be given. It immobilizes the wrist but leaves the fingers and thumb free to move. This is the ideal splint for most wrist sprains. If the thumb is also injured, then a wrist splint with a thumb extension is helpful. If the TFCC (triangular fibrocartilage complex) if injured, the I recommend a “wrist widget”. This looks like two watch straps. It allows the wrist to move fully and supports the little finger side of the wrist.

What is the outcome?

Most wrist sprains gradually get better over days, weeks and occasionally months. You should respect a return to a completely normal range of motion that is pain-free. Occasionally an injury that initially appears to be a wrist sprain doesn't get better. This may indicate a more significant injury. In this case I may want to undertake further x-rays or an MRI or CT scan. If a more serious injury or broken bones are discovered, surgery may be required.