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Anatomy of Wrist

Wrist pain is an extremely common condition. The wrists are used in a variety of different sports such as badminton, tennis, boxing and are also extensively used when we type and in certain occupations. This repetitive motion of certain activities makes some people more susceptible to wrist pain.

Anatomy of the Wrist

Hand AnatomyThere are 15 bones that form connections from the end of the forearm to the hand. The wrist itself contains eight small bones, called carpal bones. These bones are grouped in two rows across the wrist. The proximal row is where the wrist creases when you bend it. Beginning with the thumb-side of the wrist, the proximal row of carpal bones is made up of the scaphoid, lunate, and triquetrum. The second row of carpal bones, called the distal row, meets the proximal row a little further toward the fingers. The distal row is made up of the trapezium, trapezoid, capitate, hamate, and pisiform bones.

The proximal row of carpal bones connects the two bones of the forearm, the radius and the ulna, to the bones of the hand. The bones of the hand are called the metacarpal bones. These are the long bones that lie within the palm of the hand. The metacarpals attach to the phalanges, which are the bones in the fingers and thumb.

All of the nerves that travel to the hand cross the wrist. Three main nerves begin together at the shoulder: the radial nerve, the median nerve, and the ulnar nerve. These nerves carry signals from the brain to the muscles that move the arm, hand, fingers, and thumb.

Two important ligaments support the sides of the wrist. These are the collateral ligaments. There are two collateral ligaments that connect the forearm to the wrist, one on each side of the wrist.

 

Symptoms of Wrist Injury

The location and severity of wrist pain may vary, depending on the cause of the problem. Signs and symptoms that sometimes accompany wrist pain include:

  • Pain
  • Swelling and stiffness
  • Redness and warmth to the touch
  • Weakness or instability
  • Popping or crunching noises
  • Inability to fully move the wrist
  • Pins and Needles
  • Numbness

For patients suffering from wrist pain, the first step to recovery is to receive a proper diagnosis so the cause of the symptoms can be determined.

If you feel you have a potential infection in the wrist or a fracture, urgent medical attention should be sought.

Causes of Wrist Pain

There are two principle reasons for wrist pain. A sudden event or an acute injury can break a bone or tear a ligament. Less apparent, but more slowly developing insidious causes of wrist pain are repeated patterns of activity (repetitive strain injuries or RSI), which over time may cause undue strain on the wrist. Other potential causes of wrist pain include diabetes, thyroid disease, arthritis, and pregnancy (which can cause severe swelling and other wrist problems).

The healing process which results from the traumatic stress of a sudden injury often causes arthritis. An accident occurs, and the bone or the connecting ligaments are broken or torn. After the broken bone fragments are realigned, even if the realignment appears to be perfect, there will still be some distortion. Over time, the broken bones will settle, increasing the distortion, and the surfaces of the bones will tend to rub and wear out.

Wrist pain can happen to anyone whether you’re very sedentary, very active or somewhere in between. But your risk may be increased by:

  • Sports participation. Wrist injuries are common in many sports, including bowling, golf, gymnastics, snowboarding and tennis.
  • Repetitive work. Almost any activity that involves your hands and wrists if performed forcefully enough and often enough can lead to disabling wrist pain.
  • Diseases and conditions. Your risk of developing wrist pain is increased if you have diabetes, leukemia, scleroderma, lupus or an underactive thyroid gland.

Common wrist injuries and conditions include:

  • Fracture
  • Sprain
  • Strain
  • Dislocation
  • Osteoarthritis
  • Rheumatoid Arthritis
  • Psoriatic Arthritis
  • Carpal Tunnel Syndrome
  • Tendinitis
  • De Quervain’s Syndrome
  • TFCC Tear
  • Ganglion Cyst
  • Complex Regional Pain Syndrome (CRPS)

 

Investigations for Wrist Pain and Injury

Like every joint evaluation, the start to a diagnosis is a consultation followed by a physical examination. Your specialist will inspect your wrist for swelling, pain, tenderness, warmth and visible bruising. A visual assessment is followed by evaluation of the movement and specific orthopaedic tests to determine integrity.

After a provisional diagnosis is made by your specialist, it may be suggested you have the joint imaged by:

  • X-ray
  • MRI Scan
  • CT Scan
  • Ultrasound

If your specialist suspects an infection or arthritis you may be recommended a series of have blood tests .

On rare occasions your specialist may request a nerve conduction study to look for nerve injury and compression.

Treatments for Wrist Pain

Throughout your diagnosis, treatment, and rehabilitation, dedicated team members will continue to work hard to ensure you can get back to enjoying life with the most comfort, mobility, and functionality possible.

Healthplus Clinics has assembled a group of Wrist Pain Specialists to provide complete surgical and non-surgical treatments. Our team of Wrist Specialists includes: Wrist Surgeons, Plastic Surgeons, Pain Specialists, Podiatrists, and specially trained Wrist Physiotherapists.

Non-Surgical Wrist Treatments and Procedures

  • Specialist Wrist Physiotherapy
  • Shockwave Therapy
  • Wrist Acupuncture
  • Electrotherapy

Wrist Pain Management Procedures

  • Joint Injection

Surgical Wrist Treatments and Procedures

  • Carpel tunnel release
  • Dupuytren’s contracture fasciectomy
  • Ganglion removal
  • Knuckle (MCP joint) replacement
  • Surgical release of de quervains syndrome
  • Tendon repair: flexor and extensor repair
  • Trapeziectomy (removal of the trapezium)
  • Trigger finger release
  • Wrist fracture fixation
  • Wrist fusion
  • Wrist joint replacement
Complications of Wrist Pain and Injury

Chronic pain

Once your ligaments are stretched or torn, they need about eight weeks to be fully healed and are pain free. But other problems might go undiagnosed, like a bone fracture, tear in the cartilage, nerve damage or a torn tendon. Delaying treatment of these other conditions leads to continued pain, weakness, and disruption of your normal daily activities.

Instability of the Joint in the Wrist

An injury in the wrist can heal incorrectly, leaving your ligaments permanently stretched. This causes your hand joints to be weak, frequently resulting in abnormal movement. If this happens, you will are likely to recurrently injuries causing swelling and pain.

Stiffness

Stiffness usually happens because of severe inflammation swelling at the site of the injury and scar tissue. Stiffness most often results in pain and even osteoarthritis.

Swelling

When the wrist does not heal properly, localized swelling occurs causing a limited range of motion and an inability to participate in your usual routine.

Deformity

The relationship of wrist to a number of arthritic conditions can lead to deformity and reduced functional ability to grip and create fine movements.

Early onset arthritis in the Wrist Joint

When a joint functions incorrectly following injury there is a possibility that over a period of time premature arthritis can occur.

Most patients will not encounter problems after orthopaedic surgery. As with any surgery, however, there are potential risks, including: reaction to anesthesia, bleeding, infection, blood clots, nerve damage, lack of full range of motion, development of arthritis, scar formation, or re-injury of the joint or soft tissue.

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