Wrist Pain, Wrist Joint Pain

What Does Wrist Joint Comprise Of?

Wrist joint includes bones, cartilages, ligaments, tendon, synovial membrane and connective tissue. Wrist joint is the link between radius and ulna with carpal bones.

What is Wrist Joint Pain?

Wrist joint pain is caused by inflammation, infection, ischemia or injury of bones, cartilages, ligaments, tendon, synovial membrane and connective tissue included in wrist joint.

What is Wrist Pain?

Wrist Pain, Wrist Joint Pain



Wrist pain is spread beyond wrist joint. Wrist pain is caused by wrist joint diseases, nerve injuries, neuritis and referred pain. Wrist pain is in wrist joint and around the wrist joint. Wrist pain is known as acute pain if pain last less than 3 months and pain is known as chronic pain if pain continues beyond 3 to 6 months.

What Are The Causes Of Wrist Pain Or Wrist Joint Pain?

Following Diseases and Injuries Can Cause Wrist Pain or Wrist Joint Pain:

  • Inflammation- Inflammatory Wrist Joint Pain.
  • Trauma- Traumatic Wrist Joint Pain.
  • Ischemic Injury- Ischemic fracture or injuries to cartilage and ligaments.
  • Infection- Septic Arthritis.

Which Are The Wrist Joint Inflammatory Diseases?

Following Are the Wrist Joint Inflammatory Diseases:


  • Osteoarthritis- Pain is secondary to inflammation of joint cartilages.
  • Rheumatoid Arthritis- Pain is caused by inflammation of synovial membrane
  • Psoriatic Arthritis- Pain is secondary to inflammation of cartilage and ligaments of wrist joint.
  • Gout– Pain is caused by uric acid crystal deposit in the joint. In gout, body over produces uric acid resulting in higher blood concentration.
  • Pseudogout- Pain is secondary to calcium pyrophosphate dihydrate (CPPD) deposits within the joint. Joint is swollen and inflamed resulting in pain.

Tendonitis- Inflammation of flexor or extensor Tendon is known as wrist joint tendonitis.

Wrist Joint Sprain- Inflammation of ligaments supporting wrist joint is known as wrist joint sprain.

Inflammation of Ganglion Cyst- Inflammation of ganglion cyst causes severe pain in wrist joint.

What Causes Traumatic Wrist Joint Pain?

Following Injuries Can Cause Traumatic Wrist Joint Pain

Dislocation of Wrist Joint

  • Dislocation of Radius
  • Dislocation of Ulna
  • Dislocation of Carpal Bones

Fracture of Wrist Joint Bones

Fracture Carpal Bones

  • Fracture of Radius
  • Fracture of Ulna
  • Fracture of Radius and Ulna
  • Fracture of Carpal Bones

Wrist Joint Tendon Rupture

  • Fracture of Flexor Tendons- Pain is localized on anterior side of wrist and palm.
  • Fracture of Extensor Tendons- Pain is localized over extensor surface of wrist joint and back of hand.

Wrist Joint Ligamental Tear

  • Joint ligament injury such as laceration or tear causes sprain of the wrist joint.

What is Ischemic Wrist Joint Bone Necrosis Resulting In Wrist Joint Pain?

Avascular necrosis of wrist joint bone is one of the rare causes of the wrist joint pain. Progressive ischemia or collapsing of the peripheral blood vessels to carpal bone in young patient causes necrosis of small carpal bone. Condition is known as Kienbock's disease.

What is Septic Necrosis?

Infection of wrist joint following trauma or local spread of cellulitis causes infection of wrist joint known as septic necrosis.

Describe Wrist joint Tendonitis?

Tendonitis is an inflammation of tendons. Laceration or tear of the wrist joint tendon often results in inflammation of tendon resulting in tendonitis. DeQuervain's disease is example of wrist joint tendonitis.

What is DeQuervain's Disease?

DeQuervain's disease is a disease caused by wrist joint tendonitis involving tendon located at lateral side of wrist joint.

What is Wrist Joint Sprain?

Wrist joint sprain is caused by inflammation of ligaments supporting wrist joint. Inflammation of soft tissue around wrist joint following injuries or spread of cellulitis causes inflammation of ligaments supporting wrist joint.

What Is Wrist Joint Ganglion?

Wrist joint ganglion is a soft cyst located between tendon and ligament. Presence of Ganglion lubricates and prevents laceration of tendon or ligaments when tendon or ligaments rest against the bone.

What is Wrist Joint Ganglion Cystitis?

Inflammation of Ganglion cyst is known as ganglion cystitis. Ganglion around wrist joint often gets inflamed following manual work involving wrist joint or repeated wrist joint movements while using computer keyboard or typing.

What is Peripheral Neuropathy?

Peripheral neuropathy is a systemic disease of peripheral nerve caused by irritation of the nerve or nerve damage. Peripheral neuropathy causes symptoms in multiple areas of the body.

What Are The Causes Of Peripheral Neuropathy?

Causes of Peripheral Neuropathy Are As Follows:

  • Degenerative Disease of Peripheral Nerve.
  • Irritation of Peripheral Nerve.
  • Laceration or Tear of Peripheral Nerve.

What Are The Symptoms Of Peripheral Neuropathy?

Peripheral Neuropathy Can Cause The Following Symptoms:

  • Wrist Joint Pain.
  • Tingling.
  • Numbness.
  • Weakness of Wrist Joint.

Which Illnesses or Medical Conditions Can Cause Peripheral Neuropathy Resulting In Wrist Pain Or Wrist Joint Pain?

Following Illnesses Cause Peripheral Neuropathy:

What Are The Causes Of Peripheral Nerve Injury That Results in Wrist Pain?

Peripheral nerve is the bundle of sensory and motor nerves outside spinal cord that communicates with peripheral organ. Causes of injury to the peripheral nerve that can cause wrist pain are:

  • Direct injury like laceration or deep cut of the nerve proximal or distal to wrist joint.
  • Nerve injury following wrist joint dislocation.
  • Nerve injury following wrist joint fracture.
  • Pinch or compression of peripheral nerve as in carpal tunnel syndrome.

What Can Cause Traumatic Wrist Joint Injury?

The causes of traumatic wrist joint injuries are as follows-

  • Direct Impact- Direct impact by heavy or accelerating object to the wrist joint is mostly seen following auto or work accident.
  • Exaggerated Twist and Turn- Exaggerated twist and turn of wrist during fall off the slippery surface or ice causes fracture of the wrist joint.
  • Sports Injury- Twists and turns of the wrist joint during contact sport causes wrist joint injury.
  • Repetitive Motion Injury- Repetitive motion injuries can cause ligament and tendon injuries.

What Are The Risk Factors Involved In Inducing Wrist Joint Pain?

Risk Factors are as follows:

  • Repetitive Use of Wrist Joint- Recurrent use of wrist joint in activities like typing, drawing, writing, or sewing can cause inflammation and tear of ligaments of the wrist joint.
  • Overweight- Obesity is associated with osteoarthritis2 and carpal tunnel syndrome resulting in severe wrist joint pain
  • Pregnancy- During pregnancy, endocrine gland secretes abundant quantity of relaxing hormone, which causes joint laxity and pain.
  • Post Menopausal Joint Pain- Multiple joint pain including wrist pain is caused by hormonal changes and arthralgia following menopause.1
  • Diabetes- Joint pain is often seen in patient suffering with diabetes secondary to diabetic neuropathy, vasculitis and obesity.
  • Hypothyroidism- Hypothyroidism causes hypertrophy of the ligament of the wrist joint resulting in nerve compression such as carpal tunnel syndrome and restricted painful joint movements.3 Hypothyroidism also causes tendonitis.4
  • Alcohol- Regular consumption of alcohol causes inflammatory tendonitis and neuropathy resulting in wrist joint pain.

Wrist and Finger Joint Bones

Describe the Symptoms of Wrist Joint Pain?

Wrist Joint Pain Symptom Are-

  • Intensity of Pain- Pain intensity is mild, moderate or severe.
  • Occurrence of Pain- Pain is either sudden or gradual in occurrence.
  • Frequency of Pain- Frequency of occurrence of pain is either constant or intermittent.
  • Daily Incidence of Pain- Pain is worse in the morning or at night.
  • Character of Pain- Pain is sharp, throbbing, or burning.

Describe The Other Symptoms Associated With Wrist Joint Pain?

  • Sensory Nerve Neuropathy- Tingling and numbness in wrist joint and hand.
  • Motor Nerve Neuropathy- Weakness of wrist joint and hand.

Describe Abnormal Signs Associated With Wrist Joint Pain?

Bruises- Associated with hematoma or blood clot.

Weakness- Trouble making a fist or gripping the objects.

Swollen Wrist Joint- Seen in

  • Bleeding – Subcutaneous or intra-articular (within the joint).
  • Wrist Joint Dislocation.
  • Wrist Joint Fracture.
  • Wrist Joint Arthritis.
  • Wrist Joint Sprain.

Warm and Redness of Wrist Joint:

  • Septic arthritis.
  • Wrist Joint Abscess.


  • Septic Arthritis.
  • Infected Tendinitis.
  • Infected Ligaments- Sprained ligament.

What Are The Diagnostic Investigations?

Electromyography (EMG) Upper Extremity:

  • Evaluate Sensory And Motor Nerve Damage.
  • Evaluate Prognosis And Improvement Of Nerve Damage.

X-Ray Wrist Joint:

  • Evaluate Fracture.
  • Evaluate Wrist Joint Dislocation.

MRI Wrist Joint:

  • Evaluate Fracture.
  • Evaluate Wrist Joint Dislocation.
  • Evaluate Bleeding and Hematoma (Blood Clot).
  • Evaluate Nerve Laceration Or Tear.

CAT Scan Wrist Joint

  • Evaluate Fracture.
  • Evaluate Wrist Joint Dislocation.
  • Evaluate Bleeding and Hematoma (Blood Clot).

Ultrasound Wrist Joint

  • Evaluate Fracture.
  • Evaluate Wrist Joint Dislocation.
  • Evaluate Bleeding and Hematoma (Blood Clot).
  • Evaluate Abscess Or Infected Arthritis.

Blood Examination:

  • White Blood Cell Count (WBC) - Increase in infection.
  • Erythrocyte Sedimentation Rate (ESR) - Increase in infection.

How Can Wrist Pain Be Treated?

The Following Are the Choices for Wrist Pain Treatment-

  • Conservative Treatment.
  • Medications.
  • Physical Therapy.
  • Interventional Pain Therapy.
  • Surgery.

What is Conservative Treatment of Wrist Pain?

Conservative Treatment Is As Follows-

  • Wrist Brace or Splint to Reduce Swelling and Ease Wrist Pain.
  • Hot or Cold Compresses.
  • Try To Lose Weight If You Are Obese.
  • Exercise or Yoga Therapy of Upper Extremity.

Which Medications Are Used To Treat Wrist Joint Pain?

Wrist joint pain is treated with following medication-

  • NSAID.
  • Opioids.
  • Antidepressant Analgesics.
  • Antiepileptic Analgesics.
  • Anti-Rheumatoid Arthritis Medication.
  • Immunosuppressant.
  • Muscle Relaxants.

Which NSAIDs Are Used In Treating Wrist Joint Pain?

Most used Non-Steroidal Anti-inflammatory Medications (NSAIDs) are as follows-

  • Motrin.
  • Naproxen.
  • Celebrex.

When Are Opioids Prescribed To Treat Wrist Joint Pain?

Opioids are prescribed for severe intractable pain not responding to NSAIDs and NSAIDs are contraindicated because of severe side effects.

Which Opioids Are Prescribed For Wrist Joint Pain?

Acute wrist joint pain of less than 3 months duration is treated with short acting medication and pain lasting more than 3 months is treated with long acting opioids. Breakthrough pain is treated with short acting opioids.

What is Breakthrough Pain?

The pain is known as breakthrough pain when pain is induced by activities despite patient being treated with long acting opioids. You may suffer with severe sudden intractable pain while chronic pain is treated with long acting opioids.

Which Are The Most Commonly Used Long Acting Opioids?

Long Acting Opioids That Are Most Commonly Used Are As Follows-

  • Morphine- MS Contin.
  • Oxycodone- Oxycontin.
  • Fentanyl Patch.
  • Methadone.

Which Are The Most Commonly Used Short Acting Opioids?

Most common short acting opioids used are as follows-

  • Hydrocodone- Vicodin, Lortab and Norco.
  • Oxycodone- Percocet.
  • Morphine- Morphine ER.

Why Are Antidepressant Or Antiepileptic Analgesics Used To Treat Wrist Joint Pain?

Antidepressant or antiepileptic analgesics are used for following reason-

  • Chronic Pain Not Responding To Opioid or NSAIDs.
  • Neuropathic Pain.
  • Alternative Pain Medication If Patient Is Addicted To Opioids.

Which Anti-Epileptics Are Used To Treat Chronic Wrist Joint Pain?

Anti-epileptics Used As Anti-Neuropathic Analgesics (Pain Meds) Are As Follows-

  • Neurontin.
  • Lyrica.

Which Anti-Depressants Are Used To Treat Chronic Wrist Joint Pain?

Anti-depressants used as anti neuropathic analgesics (pain meds) are as follows-

  • Cymbalta.
  • Elavil.

Which Other Medications Are Used For Treating Rheumatoid Arthritis?

Medications Used For Advanced Treatment of Wrist Pain Caused By Rheumatoid Arthritis Are As Follows-

  • Methotrexate (Trexall).
  • Leflunomide (Arava).
  • Hydroxychloroquine (Plaquenil).
  • Sulfasalazine (Azulfidine).

Which Immunosuppressant Are Used To Treat Wrist Joint Pain?

Immunosuppressant That Are Prescribed To Treat Wrist Pain Caused By Rheumatoid or Psoriatic Arthritis Are As Follows-

  • Azathioprine (Imuran, Azasan).
  • Cyclosporine (Neoral, Sandimmune, Gengraf).
  • Certolizumab (Cimzia).

Which Muscle Relaxants Are Used For Muscle Pain Or Muscle Spasm?

Muscle Pain or Muscle Spasm Are Treated With Following Medications-

  • Baclofen
  • Flexeril
  • Skelaxin
  • Robaxin

What Are The Indications For Physical Therapy (PT)?

  • Pain- Tendonitis, sprained wrist joint and post surgical pain.
  • Muscle Spasm- Associated with tendonitis, sprained wrist joint, or after surgery.
  • Joint Stiffness- Associated with tendonitis, sprained wrist joint, or after surgery
  • Joint Instability- After surgery or closed reduction.

Is Physical Therapy Useful Before Reduction Of Fracture Or Dislocation Of Wrist Joint?

No, physical therapy is not useful before fracture or dislocation is corrected and treated with close or open reduction.

Is Interventional Pain Therapy Useful To Treat Wrist Joint Pain?

Yes, interventional pain therapy using corticosteroid injection is useful to treat wrist joint pain caused by tendonitis, sprained wrist joint and postoperative chronic pain.

Is There Alternative Interventional Pain Treatment If Pain Is Not Responding To Corticosteroid Injection?

Chronic Pain Can Be Treated In Selective Patient By Following Advanced Therapy:

  • Stimulation of wrist joint by using Spinal Cord Stimulator, which is placed in epidural space in the neck.
  • Intrathecal morphine injection delivered through morphine pump. Morphine pump is placed under abdominal wall. Pain meds such as morphine is delivered through catheter into cerebrospinal fluid.

Which Are The Surgical Treatment Options For Wrist Joint Pain?

Surgical Treatment Options Are As Follows:

  • Open Reduction of Wrist Joint Dislocation.
  • Open Reduction of Wrist Joint Fracture.
  • Surgical Repair of Tendon Tear or Laceration.
  • Surgical Repair of Ligament Tear.

What Can I Do To Prevent Wrist Joint Pain?

Following Precautions Can Be Taken To Prevent Wrist Joint Injury-

  • Avoid Repetitive Injury- Adjust your keyboard typing machine or any equipment so wrist movement are performed with least stress on tendon and ligaments.
  • Take Frequent Breaks From Activities That Require Continuous Wrist Movement.
  • Avoid Alcohol.
  • Lose Weight If You Are Obese.
  • Drink Plenty Of Water If You Have any Symptoms Of Joint Pain, Gout Or Pseudogout.
  • Prevent Frequent High Blood Sugar By Taking Regular Anti-Diabetic Medication.
  • Get Treated As Soon As Possible For Hypothyroidism Or Amyloidosis.

When should I Contact a Doctor?

If you experience any of following symptoms you should consult doctor-

  • Wrist joint pain not responding to anti-inflammatory medications or lasting more than a week.
  • Tingling or numbness in the wrist or hand.
  • Weakness or inability to move wrist and hand.
  • Wrist joint bruises or bleeding.
  • Wrist joint swelling and fever over 100°F.
  • Wrist joint swelg, redness and pain.


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  2. The association of obesity with joint pain and osteoarthritis in the HANES data.

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Written, Edited or Reviewed By:


Last Modified On: October 12, 2016

Pain Assist Inc.

Pramod Kerkar

Views: 8365

  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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