Wrists and hands are important parts of the body. They allow us to interact and manipulate our environment. Unfortunately, wrist and hand pain are common complaints, and can seriously affect our way of life.

Because of the complexity of the tasks that can be performed by our wrists and hands, the internal structure is very complex, with multiple tendons, muscles, nerves, blood vessels, ligaments, bones and joints. This means that wrist and hand pain can sometimes be very difficult to diagnose and treat.

Causes of hand and wrist pain

Broadly, hand and wrist pain can stem from injury or non-injury causes. Our hands are frequently first to encounter the environment, putting them at a higher risk for injury.

Injuries to the hand and wrist include:

• Falls onto the hand and wrist, which can result in broken bones (fractures)
• Workplace injuries, which can be penetrating (sharp/piercing) or blunt
• Motor-vehicular accidents
• Fights and assaults

Non-injury causes of hand and wrist pain generally stem from overuse, affecting mainly tendons and joints. Overuse results in wearing out of the joints and tendons and can precipitate swelling. This causes pain, and sometimes the swelling can result in compression of other structures nearby.

Some examples of overuse include:

• Tendon overuse around the wrist resulting in wrist pain
• Triggering of fingers and the thumb, which is frequently due to overuse
• Nerve compression syndromes in wrist (carpal tunnel syndrome for example), which frequently stem from keyboard usage
• Painful joints especially at the base of the thumb are frequently due to worn out thumb joints

Symptoms associated with hand and wrist pain

In addition to pain, patients with problems of the hand and wrist often complain of other symptoms.

This includes:

• Joint stiffness, and inability to fully move joints. This includes triggering, where the finger or thumb gets stuck in one position and needs to be pushed, whereby it returns to its original position with a sudden “triggering” motion
• Swelling and deformity of the affected part
• Loss of hand function, which can include manipulating small objects, pinch, grasping and using items such as chopsticks
• Numbness of the fingers (can also be related to neck problems)
• Wasting of hand muscles (muscles becoming smaller)

How are hand and wrist problems diagnosed

Your doctor will conduct a medical interview, where he/she will pick up clues to the underlying condition. He will then perform a focused examination of the affected part and associated areas. This may often include an examination of the neck as well.

Based on the information gained during this process, the doctor may offer you radiological investigations such as plain X-rays. These are used mainly to diagnose problems with bones and joints. An MRI scan may also be necessary if the underlying problem is one of soft tissues such as tendons, ligaments or nerves. 

What treatments can I expect?

In general, there are non-surgical and surgical treatment options available for hand and wrist conditions. These will be carefully curated to treat your underlying problem.

Such treatments may include:

• Medications to treat pain and manage swelling and numbness
• Hand therapy for splints, movement exercises, and hand strengthening
• Tendon injections to treat tendon pain and degeneration
• Joint injections for pain relief in worn out joints
• Surgery for broken bones
• Surgery to repair torn tendons or ligaments
• Surgery to treat worn out joints

References:

Related Articles by Dr Yong Ren

• Understanding Forearm Fractures: Causes, Symptoms, and Treatment Options
• Understanding the Different Bones in Your Hand
• Why does the Side of my Wrist Hurt?