Diagnosis
During the physical exam, your healthcare professional may:
- Check your wrist for tenderness, swelling or deformity.
- Ask you to move your wrist to check for a decrease in your range of motion.
- Check your grip strength and forearm strength.
Imaging tests
Imaging tests may include:
- X-ray. This is the most commonly used test for wrist pain. Using a small amount of radiation, X-rays can reveal bone fractures or signs of osteoarthritis.
- CT. This scan can provide more-detailed views of the bones in the wrist. CT may spot fractures that don't show up on X-rays.
- MRI. This test uses radio waves and a strong magnetic field to produce detailed images of the bones and soft tissues. For a wrist MRI, you may be able to insert your arm into a smaller device instead of a whole-body MRI machine.
- Ultrasound. This simple, noninvasive test can help examine tendons, ligaments and cysts.
Arthroscopy
If imaging test results do not provide enough information, you may need an arthroscopy. This procedure uses a pencil-sized instrument called an arthroscope. The arthroscope is inserted into the wrist through a small incision in the skin. The instrument contains a light and a tiny camera, which projects images onto a television monitor. Arthroscopy is considered the gold standard for evaluating long-term wrist pain. In some cases, an orthopedic surgeon may repair wrist problems through the arthroscope.
Nerve tests
Your healthcare professional might order an electromyogram (EMG) if carpal tunnel syndrome is suspected. The EMG test measures the tiny electrical discharges produced in the muscles. A needle-thin electrode is inserted into the muscle, and its electrical activity is recorded when the muscle is at rest and when it's contracted. Nerve conduction studies also are performed to check whether the electrical impulses are slowed in the region of the carpal tunnel.
Treatment
Treatments for wrist problems vary greatly based on the type, location and severity of the injury. Your age and overall health also may play a role in treatment.
Medicines
Nonprescription pain relievers, such as ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), may help reduce wrist pain. Stronger pain relievers are available by prescription. Injections of corticosteroid medicine also may be considered for some conditions.
Therapy
A physical therapist can implement specific treatments and exercises for wrist injuries and tendon problems. If you need surgery, your physical therapist can help with rehabilitation after the operation. You may benefit from having an ergonomic evaluation to talk about workplace factors that may be contributing to wrist pain.
If you have a broken bone in your wrist, the pieces typically need to be aligned so that the bone can heal properly. A cast or splint can help hold the bone fragments together while they heal.
If you have sprained or strained your wrist, you may need to wear a splint to protect the injured tendon or ligament while it heals. Splints are particularly helpful with overuse injuries caused by repetitive motions.
Surgery
In some cases, surgery may be necessary. Examples include:
- Bone fractures. In some cases, you may need surgery to stabilize bone fractures to permit healing. A surgeon may need to connect the fragments of bone together with metal hardware.
- Carpal tunnel syndrome. If your symptoms are severe, you may need to have a surgical procedure. During carpal tunnel release surgery, the ligament that forms the roof of the tunnel is cut open to relieve the pressure on the nerve.
- Tendon or ligament repair. Surgery is sometimes needed to repair tendons or ligaments that have ruptured.
Lifestyle and home remedies
Wrist pain doesn't always require medical treatment. For a minor wrist injury, apply ice and wrap your wrist with an elastic bandage.
Preparing for your appointment
Although you may first consult your family healthcare professional, they may refer you to a specialist. You may see an orthopedic surgeon, a physical medicine and rehabilitation expert, or a healthcare professional specializing in sports medicine. If arthritis is suspected, you may be referred to a specialist in joint disorders called a rheumatologist.
What you can do
You may want to write a list that includes:
- Detailed descriptions of your symptoms.
- Information about medical problems you've had or have.
- Information about the medical problems of your parents or siblings.
- All the medicines and dietary supplements you take.
- Questions you want to ask the healthcare professional.
What to expect from your doctor
Your healthcare team may ask some of the following questions:
- When did your symptoms begin?
- Do your symptoms seem to be connected to a recent injury?
- Does any specific wrist motion trigger your pain?
- Is there any numbness or tingling in your hand?
- Are you right-handed or left-handed?
- What is your occupation? Does it require a lot of wrist motion?
- Do you take part in any sports or hobbies that put stress on your wrist?