The wrist joints are a collection of bones, nerves, ligaments, tendons and blood vessels. As a consequence, there are multiple causes of wrist pain, with most stemming from trauma of some sort. The most common causes of wrist pain are ligament sprains and tendon strains, although there are more serious causes.
Ligament Sprains
Ligament sprains are the most common injuries to the wrist, but are also the quickest to heal. Ligament tears are more serious and can cause carpal bone instability and dislocation between the distal radius and ulna bones. Common causes include sports trauma, especially gymnastics, boxing, martial arts, accidental falls and repetitive movements.
Tendon Strains
Wrist tendinitis is another common cause of pain due to strain and inflammation of tendons which move the bones of the wrist and hand. DeQuervain's disease affects the tendons that move the thumb and is a type of tenosynovitis, which is inflammation of the tendon sheaths. Causes of strain can include sports trauma, especially racket sports, weight lifting, arm wrestling, accidental falls and repetitive movements.
Nerve Impingement
The median nerve is the most commonly impinged and injured nerve in the wrist, primarily due to carpal tunnel syndrome, which is chronic wrist inflammation leading to compression of nerves and blood vessels. Such inflammation can occur from repetitive motions such as typing on a keyboard, painting or writing. The pain is usually accompanied by weakness and numbness. The other nerves of the wrist, the ulnar and radial, are usually injured through severe sprains, strains and fractures. Pain can also be felt in the wrist as a result of brachial plexus injuries. This pain originates in nerve roots at the base of the neck.
Bone Fractures
Fractures of the wrist are the most common fracture in people younger than age 75. Wrist fractures are caused by trauma, especially contact sports, but also from car accidents and accidental falls. Severe osteoporosis can lead to fractures more readily. Avascular necrosis, which is tissue death due to lack of blood, can be a complication of fractures and cause pain if the blood supply to the bone is disrupted.
Osteoarthritis
Osteoarthritis, which is fairly common in the hands and wrist, is a type of arthritis caused by years of wear-and-tear. The pain is achy and there is usually a grinding feeling with wrist movement. Repetitive sprains, strains, unhealed fractures and joint dislocations and subluxations can all lead to abnormal wear.
Inflammatory Arthritis
Inflammatory conditions such as rheumatoid arthritis usually affect both wrists and can cause deformity as well as severe pain. Psoriatic arthritis can also affect the wrist and cause inflammation, although psoriasis of the skin is the more common symptom.
Ganglions
Ganglions are small, benign, fluid-filled cysts within tendon sheaths that usually occur over the back of the hand or wrist due to fluid blockage. Ganglions do not spread, although they can grow to the size of a pistachio with time. They cause pain by putting pressure on surrounding bones, tendons and nerves.
Reflex Sympathetic Dystrophy
Reflex sympathetic dystrophy is a disorder of the peripheral nervous system which regulates the blood vessels of the hand and wrist. When active, the blood vessels can inappropriately constrict then dilate, causing various types of pains and sensations.
References
- Medline Plus: Wrist Pain
- "Clinical Sports Medicine"; Peter Brukner et al; 2006
- "A Clinical Approach to Diagnosing Wrist Pain"; American Family Physician; Todd A. Forman, M.D. et al; November 2005
