The wrist is a junction of multiple bones, ligaments, tendons, blood vessels and nerves. As such, the causes of wrist pain are numerous, but can be classified into 3 broad categories--mechanical, neurological and systemic. Regardless of the cause of wrist pain, those who suffer with it should check with a doctor in order to begin treatment.
Fracture
Wrist fracture is the most common fracture before the age of 75. Fractures are almost always caused by trauma, especially when falling, although severe osteoporosis can be a factor. Common fractures include a scaphoid bone fracture, which sits at the base of the thumb; Colles fracture, a transverse break across the end of the radius and/or ulna; and Golfer's fracture, a break to the hamate bone. When the blood supply to a bone is disrupted by a fracture, avascular necrosis develops and can also cause pain.
Tendonitis
Wrist tendonitis is due to strain and inflammation of tendons which move the carpal bones or fingers. Tenosynovitis is inflammation of the lining of the sheath that surrounds a tendon, such as DeQuervain's Disease, which affects the abductor pollicis longus and the extensor pollicis brevis tendons of the thumb. Causes of strain can include trauma from falls, weight lifting and repetitive movements such as racket sports.
Sprains
Wrist sprains are common injuries to the ligaments around the wrist joint. Ligament tears can cause carpal bone instability, dislocation, or subluxation between the distal radius and ulna bones. Common causes include repetitive movements, martial arts, boxing and gymnastics.
Osteoarthritis
Wrist osteoarthritis is the "wear and tear" type that causes stiffness and achy pain. Multiple sprain and strains, poorly healed fractures, and joint dislocations or subluxations can all lead to abnormal wear of cartilage and bone spur formation, which typically grinds and cracks with movement.
Ganglions
Ganglions are pea-sized swellings within tendon sheaths that usually occur over the back of the hand or wrist due to fluid blockage. These are benign, fluid-filled cysts that do not spread, although they can grow bigger with time. They cause pain primarily by putting pressure on surrounding tendons, ligaments and nerves.
Nerve Damage
The most commonly injured nerve in the wrist is the median nerve, usually caused by carpal tunnel syndrome, which is repetitive wrist inflammation leading to compression of nerves and blood vessels. Such swelling can occur with: repetitive motion like typing on a keyboard, painting, or writing. The other major nerves of the wrist, the ulnar and radial, are injured primarily through wrist trauma or brachial plexus injuries, which then can refer pain or numbness secondarily to the wrist.
Systemic Causes
Inflammatory conditions such as rheumatoid arthritis usually affect both wrists and can cause deformity as well as severe pain. Diabetes, due to high levels of glucose in the blood stream, destroys peripheral nerves in the feet and hands. Gout occurs when too much uric acid is produced and deposited in joints of the feet and hands as sharp crystals. Reflex sympathetic dystrophy is a mysterious disorder of the peripheral nerves which regulate the blood vessels of the hand and wrist. With flare-ups, the blood vessels can dramatically constrict then dilate, causing various types of pains and sensations.
