The human wrist is a very flexible joint between the hand and the forearm, which is made up of two rows of polyhedral bones – 4 in one, many blood vessels, nerve pathways, tendons. There can be a lot of reasons for pain in the wrist – it is important to understand their nature in time and, if necessary, get timely medical assistance – diagnosis and treatment.
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Root causes of wrist pain – how is it diagnosed?
In diagnosing the cause of pain in the wrist, not only its presence is of great importance, but also the nature of the pain, a significant increase, for example, at night or with a load on the wrist, a feeling of numbness in the hand or forearm, the presence of crunching during movement, swelling, bruising that have occurred traumatic situations – falls, hits, etc.
- Fractures, sprains, dislocations in the wrist area
As a rule, a person knows exactly what caused the pain – it is a blow to the wrist, a sharp overstretching or a fall with support on it.
With a traumatic injury to the wrist, along with pain, you can observe:
- Swelling of the tissues of the wrist.
- Crunching crunch.
- Deformity of the hand in the wrist area.
- Restricted mobility.
To find out the nature of the injury X-ray is performed.
The most common injury is the scaphoid or lunate bones.
Diagnosis and treatment of a wrist injury is necessary even if symptoms are mild (for example, mild swelling and some limited movement). Old bone fractures can lead to a limitation or complete immobility of the hand at the wrist.
When stretching and dislocating the wrist, a person also has tissue edema and the inability to make certain movements with the hand.
- Pain in the wrist due to excessive stress on the arm.
Such pain occurs after strength sports or hard physical work.
Sports in which the wrist joints and ligaments are most often injured are tennis, rowing, javelin / shot throwing, boxing, golf.
As a result of repeated turns in the wrist, jerks, combined with a strong load, there is tendonitis – inflammation in the tendons.
Due to the anatomical nature of the wrist, the tendons in it pass through a narrow canal, and even a slight inflammation or swelling is enough for pain to appear.
Typically, tendonitis is accompanied by other symptoms:
- Inability to grasp or hold an object with your fingers.
- Crackling sensation in the wrist with finger movements.
- The pain occurs in the tendon area, on the back of the wrist, and spreads along the tendons.
There may not be swelling with tendinitis.
Diagnosis of tendonitis is based on the ascertaining of the symptoms characteristic of it – tendon crackling, the nature of the pain, weakness in the limb. To clarify the diagnosis and to exclude traumatic injuries, X-ray diagnostics are sometimes required.
- Pregnant woman’s wrist hurts
So-called carpal tunnel syndrome most often occurs when a person is prone to edema, with a rapid gain in body weight, as well as when this area is compressed by hematomas or tumors.
As known, pregnant women, especially in the second half of the waiting period for the baby, are often worried about edema – this is the reason for the occurrence of carpal tunnel syndrome in expectant mothers.
The swollen tissues compress the median nerve, causing discomfort and pain in the wrist. The pain may be accompanied by twitching of individual muscles of the hand (or fingers), sensations of pulsation, creeping, cold, itching, burning, numbness in the hands, inability to hold objects with the brush. Unpleasant sensations affect the surface of the palm under the thumb, forefinger and middle finger. Symptoms are worse at night.
These symptoms can be very mild and occur from time to time, or they can bring serious discomfort. For most expectant mothers, the syndrome disappears without a trace at the birth of a baby.
Diagnosing carpal tunnel syndrome based on the examination of the patient, for this the doctor taps the limb in the direction of the nerve, performs a test for the possibility of movement, flexion / extension of the arm in the wrist. Sometimes electromyography is necessary to make an accurate diagnosis.
- Wrist pain due to occupational diseases or certain systematic activities
1. Tunnel syndrome in people who work a lot on the computer, as well as in pianists, telegraphers, tailors.
When working at a computer, right-handers put their right hand on the table while holding the mouse. Compression of tissues in the wrist, constant tension in the arm, and lack of blood circulation lead to pain in the wrist and neurological sensations such as twitching of the fingers, tingling and burning sensations in the hand, numbness in the wrist and hand, and pain in the forearm.
At the same time, there is a weakening of the grip of objects with a brush, the inability to hold objects in the hand for a long time or carry, for example, a bag in hand.
Compression of the nerve of the carpal tunnel is also facilitated by intervertebral hernias and osteochondrosis.
You can avoid the occurrence of the above symptoms if you regularly do gymnastics while working at the computer.
2. Stenosing tenosynovitis or tenosynovitis in pianists, when working on a computer or mobile phone, when twisting wet clothes or washing floors by hand with a rag.
For the development of tenosynovitis, it is enough to regularly engage in the above activities.
Symptoms of tenovaginitis:
- Very severe pain in the wrist and hand, especially the thumb.
- Swelling of the palmar pad under the thumb, its redness and soreness.
- Inability to make movements with the thumb, grasp objects with a brush and hold them.
- Over time, scar tissue can be felt under the skin, which forms as a result of inflammation and becomes denser.
Diagnosis of tendovaginitis It is based on symptoms specific to it – there is no pain when abducting the thumb, but when clenching the fist, pain is felt in the styloid process and towards the elbow.
There is also soreness when pressing on the styloid area.
3. Kienbeck’s disease, or avascular necrosis of the bones of the wrist, as an occupational disease in workers with a jackhammer, ax, hammer, carpentry tools, as well as crane operators.
The cause of Kienbeck’s disease can be a previous injury to the wrist, or many micro-injuries over time, which interfere with the normal blood supply to the bone tissues of the wrist and, as a result, cause their destruction.
The disease can develop over the course of several years, sometimes exacerbating with pain, then completely fading away. In the active phase of the disease, the pain does not stop either during the day or at night, it intensifies with any work with the hand or movements.
To establish an accurate diagnosis, the following types of diagnostic procedures are performed:
- Pain in the wrist as a result of diseases or conditions of the body.
- Inflammatory processes in bone tissue and joints – arthritis, osteoarthritis, tuberculosis, psoriasis.
- Deposition of “salts” – gout or pseudogout.
- Diseases and injuries of the spine, spinal cord – fractures, intervertebral hernias, tumors, etc.
- Infectious diseases – brucellosis, gonorrhea.
- Anatomical features.
- Peyronie’s disease.
- Hygromas or cysts of the tendon sheath.
- Diseases of the cardiovascular system, radiating pain to the arm.
- Volkmann’s contracture, which disrupts the circulation in the hand.
When to see a doctor if your wrist hurts, and which doctor?
- Severe or persistent swelling of the wrist and hand.
- Deformity of the hand at the wrist.
- The pain lasts more than two days.
- Weakness in the hand, it is impossible to perform movements and hold objects.
- The pain is accompanied by pain behind the sternum, shortness of breath, respiratory failure, pain in the spine, severe headache.
- The pain intensifies at night, after exertion on the arm, any work or sports.
- Movement in the joint is limited, the arm at the wrist cannot be extended, rotated, etc.
Which doctor should i see for wrist pain?
- If you are sure that your wrist hurts as a result of injury and damage, then you need to go to surgeon…
- For chronic long-term pain in the wrist, understanding its causes should therapist…
- According to the indications, the therapist can refer for a consultation to a rheumatologist or arthrologist.
After all diagnostic procedures and when making a diagnosis, the therapist may also refer you to osteopath…
The Bologny.ru website warns: self-medication can harm your health! The diagnosis should be made only by a doctor after an examination. Therefore, if you find symptoms, be sure to contact a specialist!
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