ANATOMY OVERVIEW OF THE WRIST
The human wrist is a complicated mix of three primary and multiple small joints making it more complex than the hip or knee joint. Two rows of eight (8) small bones (carpals) radiate from the joints of the larger ulna and radius (forearm bones). The ends of the bones are coated with cartilage that allows the joints to glide. Nine (9) flexor tendons travel through a “tunnel” created by the carpal bones. These tendons allow the fingers and thumb to bend.
In addition to joints, bones and tendons, the wrist houses three (3) nerves: the ulnar, radial and median. These nerves provide “power” to the muscles that control sensation and flexibility in the wrist, fingers and thumb. The median nerve supplies all forearm flexor muscles allowing the wrist and fingers to bend. This nerve can become compressed as it passes through the carpal tunnel in the wrist, as condition known as carpal tunnel syndrome.
INJURIES TO THE WRIST
Wrist injuries can be quite painful and disabling. Without full sensation and movement in the joints, tendons and muscles, injuries can limit the ability to use your hands, thumb and fingers for many daily activities and functions. Typical injuries to the wrist include arthritis (osteoarthritis and rheumatoid), damage or compression to nerves, ligament sprains and fractures from falls.
COMMON WRIST CONDITIONS
Carpal tunnel syndrome – caused by the narrowing of the carpal tunnel and the compression of the median nerve on the palm side of your hand, resulting in pain, numbness, weakness and tingling in the hand and arm
Distal radius fracture (broken wrist) – a break close to the wrist at the end of the bone and the most commonly broken bone in the arm
Scaphoid fracture of the wrist – caused when this small carpal bone breaks, typically from a fall onto an outstretched hand
Wrist sprain – an injury to a ligament within the wrist, most commonly the scapholunate ligament
WHEN TO SEE A WRIST SPECIALIST
- Seek medical treatment if you are experiencing any of the following symptoms:
- Numbness, tingling, burning and pain primarily in the thumb, index, middle and ring fingers
- Occasional shock-like sensations that radiate to the thumb and index, middle and ring fingers
- Pain or tingling that may travel up the forearm toward the shoulder
- Chronic (intractable) wrist pain
- Weakness and clumsiness in the hand which may make it difficult to perform fine movements such as buttoning a shirt
- Dropping things due to weakness, numbness or a loss of awareness of where your hand is (proprioception)
TREATMENT OPTIONS
Your doctor will discuss all treatment options with you. The best treatment for your injury or condition will be determined in combination with your overall health.
There are several nonoperative treatment options for wrist pain. These might include occupational hand therapy or pain management in the form of over-the-counter or prescribed medications and/or anti-inflammatories, injections and splinting. If surgery is necessary, PSO wrist specialists can perform a wide variety of procedures ranging from minimally invasive to major reconstruction.
