Wrist and Hand Pain

The anatomy of the wrist and hand is complex with 8 small carpal bones in the wrist joint held together by ligaments and 5 meta-carpal bones in the hand leading down to the fingers. The wrist joint and hand have multiple axes of movement to provide mobility for hand function.

Acute injuries to the hand and wrist joints occur mainly from falls on an outstretched hand i.e fracture or dislocation of the distal end of radius/scaphoid or ligament sprains/ or triangular fibro cartilage tears.

What are the Signs & Symptoms?

  • Obvious deformity of wrist/hand on observation with changes in colour, temperature, muscle wasting, scars and normal arches of hand.
  • Pain and reduced mobility on wrist/ hand movements
  • Tenderness and swelling on palpation over the area of pathology in wrist joint or hand
  • Unusual sounds (clicks, clunks and snaps) on wrist joint and hand movements

Subacute and Chronic

Sub acute and chronic wrist pain can be caused by an overuse condition i.e tenosynovitis or from an acute injury that has not been diagnosed or treated correctly. The location of the wrist pain helps to narrow down the diagnosis i.e front, back medial and lateral side of the hand/wrist. A thorough history of the onset of pain will provide important information to a previous acute injury. Factors that aggravate the pain provide useful information as to which structures are involved in chronic wrist pain. It is important to palpate the wrist to detect tenderness and to determine if the pathology appears to be soft tissue or articular (bone/joint).

Some Common Causes of Wrist & Hand Pain:

Tenosynovitis

What are the Signs & Symptoms?

  • Pain after repeated movements
  • Restricted wrist movements
  • Pain on passive stretching of tendons of wrist
  • Stiffness after a period of rest
  • Swelling and local tenderness over the superficial tendon with or without crepitis

Bone or Joint Problem

What are the Signs & Symptoms?

  • Pain aggravated by weight bearing activities

Wrist/Carpal Instability

What are the Signs & Symptoms?

  • History of joint clicking can be associated with carpal instability, triangular fibrocartilage tears or subluxation of a tendon

Carpal Tunnel Syndrome

What are the Signs & Symptoms?

  • Night pain with or without paresthesia
  • Difficulty holding things (often due to numbness)