If you experience wrist pain that develops over time with no injury, a healthcare provider can help determine the cause and recommend appropriate treatments.
“Wrist pain that occurs without any preceding injury and worsens over time, can often be associated with arthritis,” says Cleveland Clinic orthopedic surgeon Youssra Marjoua, MD.
Causes of Wrist Pain
A variety of conditions can adversely affect the bones, cartilage, and soft tissues in the wrist over time:
- Osteoarthritis, or “wear and tear” arthritis, is the most common cause of wrist pain. Rheumatoid arthritis, a chronic autoimmune disease, commonly affects the wrist, as well as the hands.
- Gout or calcium pyrophosphate deposition (CPPD, formerly known as “pseudogout”), which are a build-up of different types of crystals in the joints, can cause pain in the wrist.
- Ganglion cysts, which are fluid filled lumps, can grow near the wrist joint and are a common cause of wrist pain.
- Inflammation of the tendons, common in people who perform repetitive motions, or damage to cartilage can also cause wrist pain.
- Lack of blood flow to one of the bones in the wrist can cause central wrist pain.
- Carpal tunnel syndrome, which occurs when nerves passing near the wrist become trapped and irritated, causes pain, as well as numbness or tingling in the hand.
Wrist Pain Location Matters
The location of your wrist pain can offer a clue to your provider about its cause. Pain on the thumb (radial) side of the wrist is commonly due to overuse injuries or arthritis. The pinky finger (ulnar) side of the wrist can develop pain due to ulnar impaction syndrome, caused by different-length bones that can damage the wrist joint.
Seek Care for Wrist Pain
Seek a medical evaluation if pain in your wrist persists for more than a week without improvement, or if you experience pain at rest, pain at night, or significant stiffness.
“If pain is also associated with stiffness, there should be a lower threshold to see a health-care provider, especially if the stiffness is different in the other wrist,” Dr. Marjoua says.
Jotting down your symptoms in a pain diary (see sidebar) can help your healthcare provider determine the cause of your wrist pain.
“Keeping a pain diary includes tracking activities, pain levels, and what helps or worsens symptoms,” Dr. Marjoua explains. “I find the pain diary the most helpful thing that allows patients to communicate more clearly and more accurately with their providers.”
A physical examination and imaging—which could include an x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound—can help your provider pinpoint the cause of your pain. Your physician may recommend a nerve conduction study to help diagnose nerve-related pain.
Nonsurgical Treatment Options
“When you first start to notice wrist pain, rest and modifying activities are the initial things to do,” says Dr. Marjoua. “Consider improving your ergonomics, such as using an ergonomic mouse on the computer, and performing gentle stretching.”
Avoid activities that make pain worse, and consider a wrist splint or brace to limit movements and reduce stress on the area that’s painful. “Ice and heat or contrast baths, which are basically alternating ice water and hot water, can address the inflammation. Heat can help with stiffness,” Dr. Marjoua says.
Other nonoperative treatments for wrist pain include:
- Medications, such as topical creams or gels and/or oral over-the-counter pain relievers like ibuprofen (Advil, Motrin), naproxen (Aleve), or acetaminophen (Tylenol). You might require prescription medications, depending on the cause of the pain.
- Therapy. You might benefit from occupational therapy, which can provide education about proper ergonomics and exercises to help with pain, strength, and mobility.
- Injections. Depending on the source of your pain, your physician may recommend injections of corticosteroid medications. “These injections can be placed either into joints or around inflamed tendons,” Dr. Marjoua says. “They reduce inflammation and pain in a way that is often temporary but can be helpful.”
Surgery for Wrist Pain
A variety of surgical techniques can be performed on the wrist. Surgery can be done to remove a painful cyst or repair certain structures in the wrist.
Total wrist replacement, although less common than other joint replacement operations, is a possibility for select patients.
“A total wrist replacement is less commonly employed as a treatment measure for wrist arthritis, as opposed to total hips and total knees, because the wrist moves in multiple planes,” Dr. Marjoua says. “That makes it difficult to be able to create a replacement system that mimics all of those movements.”
Current wrist replacement implants come with a low lifting limit and limits for grasping. They are a good option for people with low lifting demands on their wrist who need reduction in pain and stiffness while preserving their wrist motion.
