Wrist Sprain

All About Sprained Wrist Injuries

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Wrist injuries are common problems, and they can be quite an annoyance given how dependent we are on functional wrists and hands. When you begin to fall, your natural instinct is to put your hands out to catch or break your fall. In doing so, the wrist is often suddenly, and forcefully, torqued or twisted. This can cause a common injury called a wrist sprain.

When a wrist sprain injury occurs, the ligaments of the wrist are stretched beyond their normal limits.

A ligament is tough, fibrous tissue that controls the motion around a joint. The ligaments around the wrist joint help to stabilize the position of the hand and allow controlled motions.

Wrist sprains are graded according to the severity of the injury:

  • Grade I: Mild injury, the ligaments are stretched, but no significant tearing has occurred.
  • Grade II: Moderate injury, the ligaments may be partially torn.
  • Grade III: Severe wrist sprain, the ligaments are completely torn, and there may be instability of the joint.

Causes of Sprained Wrists

Wrist sprains are common injuries, especially in certain groups of people. Wrist sprains tend to occur after falls. In icy weather, wrist sprains are common as people fall to the sidewalk after slipping. Sporting activities are also common causes of wrist sprains. Sports in which wrist sprains commonly occur include football, basketball, skiing, snowboarding, rollerblading, and many other sports.

Some common symptoms of a wrist sprain include:

  • Pain with movement of the wrist
  • Swelling around the wrist joint
  • Bruising or discoloration of the skin
  • Burning or tingling sensations around the wrist

The diagnosis of a wrist sprain is made by knowing how the injury occurred, and looking at the physical examination findings.

There are other wrist problems that can have similar symptoms to a sprain, including wrist tendonitis and a wrist fracture or scaphoid fracture.

Your doctor will obtain an x-ray to ensure you have not broken the bones around the joint. In some cases a MRI can be helpful. This may be done if the diagnosis is unclear or if the symptoms do not resolve as expected.

Treatment of Wrist Sprains

Most individuals with wrist sprains find some simple treatments lead to relief of painful symptoms. Most people can find relief with R.I.C.E. treatment, consisting of rest, ice, compression, and elevation. It is rare for a wrist sprain to require any type of surgery.

  • Rest:
    The first 24-48 hours after the injury is considered a critical treatment period and activities need to be curtailed. Gradually use the involved wrist as much as tolerated, by try to avoid any activities that cause pain. Using a wrist splint in the early stages following injury will help control your symptoms.
  • Ice:
    For the first 48 hours post-injury, ice the sprained wrist 20 minutes at a time every 3-4 hours. The ice pack can be a bag of frozen vegetables (peas or corn), allowing you to be able to re-use the bag. Another popular treatment method is to fill paper cups with water then freeze the cup. Use the frozen cube like an ice cream cone, peeling away paper as the ice melts. Do NOT ice a wrist sprain for more than 20 minutes at a time!! You will not be helping heal the sprained wrist any faster, and you can cause damage to the tissues! Learn how to ice an injury here...
  • Compression:
    Use compression when elevating the sprained wrist in early treatment. Using an Ace bandage, wrap the wrist from the base of the fingers all the way up to the top of the forearm, overlapping the elastic wrap by one-half of the width of the wrap. The wrap should be snug, but not cutting off circulation to the hand and wrist. So, if your fingers become cold, blue, or tingle, re-wrap!
  • Elevate:
    Keep your sprained wrist higher than your heart as often as possible. Elevate at night by placing pillows under your arm.

More severe wrist sprain injuries, including complete tears of the ligaments and fractures of the bone may need different treatment and rehab than a simple sprained wrist. A broken wrist can lead to arthritis if not adequately treated, and joint instability can require surgery as well. It is important that you see your doctor before beginning treatment or if your symptoms do not steadily improve over time.

Preventing Sprained Wrists

Some activities are such that participants are at significant risk for sustaining a sprained wrist. Wearing protective splints in sports such as rollerblading, street hockey, and snowboarding can help prevent many sprained wrists. While skiing, use a pole that has a low-profile grip, and do not secure the poles in your wrists with tight straps.

Sources:

Morgan WJ, Slowman LS. Acute Hand and Wrist Injuries in Athletes: Evaluation and Management. J Am Acad Orthop Surg, Vol 9, No 6, November/December 2001, 389-400.

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