Wrist Sprain
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Wrist Sprain

(Sprain, Wrist)

En Español (Spanish Version)

Definition

A wrist sprain is stretching or tearing of the ligaments that support the wrist. Ligaments are strong bands of tissue that connect bones to each other. Repetitive motion can also lead to these types of injuries.

Wrist Sprain

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Causes

The most common cause of wrist sprain is falling on an outstretched hand.

Risk Factors

These factors increase your chance of developing a wrist sprain. Tell your doctor if you have any of these risk factors:

  • Playing sports
  • Poor coordination
  • Poor balance
  • Inadequate flexibility and strength in muscles and ligaments
  • Loose joints
  • Not wearing wrist guards during activities such as in-line skating

Symptoms

If you have any of these symptoms do not assume it is due to a wrist sprain. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Pain, tenderness, and swelling around the wrist
  • Redness, warmth, or bruising around the wrist
  • Limited ability to move the wrist

It can be hard to tell the difference between a wrist sprain and a fracture or dislocation of one of the small wrist bones. See a doctor if there is any obvious deformity, swelling, or inability to move the wrist or hand.

Diagnosis

The doctor will ask about your symptoms and how you injured your wrist. The doctor will examine your wrist to check the stability of the joint and the severity of the injury.

Tests may include:

  • X-ray—a test that uses radiation to take a picture of structures inside the body, especially bones
    • This is done to make sure no bones are broken. Sometimes fractures may not become visible on x-ray until several weeks have passed. X-rays can also show bones that move out of place because the ligaments that stabilize them have been torn.
  • MRI scan—a test that uses magnetic waves to make pictures of structures inside the body
  • CT scan—a type of x-ray that uses a computer to make pictures of structures inside the body
  • Arthroscopy—a thin, lighted tube inserted through a small incision to look at structures inside the body
  • Bone scan—a test that detects areas of increased or decreased bone turnover
    • This is sometimes needed to reveal hidden fractures.

Wrist sprains are graded according to their severity:

Grade 1

  • Stretching and microtearing of ligament tissue

Grade 2

  • Partial tearing of ligament tissue
  • Mild instability of the joint
  • May affect function of the hand and wrist

Grade 3

  • Severe or complete tearing of ligament tissue
  • Significant instability of the joint
  • Can be associated with avulsion fractures

Treatment

Treatment includes:

RICE

  • Rest—Do not use your injured wrist and hand.
  • Ice—Apply ice or a cold pack to the wrist for 15-20 minutes, 4 times a day for several days. This helps reduce pain and swelling. Wrap the ice or cold pack in a towel. Do not apply the ice directly to your skin.
  • Compression—Wrap your wrist in an elastic compression bandage (eg, Ace bandage). This will limit swelling and support your wrist.
  • Elevation—Keep the injured wrist raised above the level of your heart for 48 hours (such as up on a pillow). This will help drain fluid and reduce swelling.

Medication

The following medicines may help reduce inflammation and pain:

  • Ibuprofen (Motrin, Advil)
  • Naproxen (Aleve, Naprosyn)
  • Acetaminophen (Tylenol)
  • Aspirin

Other

  • Brace—You may need to wear a brace to immobilize your wrist. If you play sports, you may need to wear a wrist brace or tape your wrist when you return to play.
  • Cast—If you have a severe sprain, your doctor may recommend a cast for 2-3 weeks.
  • Rehabilitation exercises—Begin exercises to restore flexibility, range of motion, and strength in your wrist as recommended by your doctor.
  • Surgery—Surgery is rarely needed to repair a wrist sprain. However, surgery may be needed to repair a ligament that is torn completely, or if there is an associated fracture.

Prevention

Wrist sprains usually occur from accidents that cannot be prevented. However, wearing protective wrist guards when in-line skating will help prevent wrist sprains caused by falling while skating.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org/

American College of Sports Medicine
http://www.acsm.orged.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Canadian Orthopaedic Foundation
http://www.canorth.org/

References:

Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation.1st ed. Philadelphia, PA: Hanley and Belfus; 2002.

Parmelee-Peters K, Eathorne SW. The wrist: common injuries and management. Primary Care: Clinics in Office Practice. 2006 March 32(1).

Renström P; IOC Medical Commission, International Federation of Sports Medicine. Sports Injuries: Basic Principles of Prevention and Care. Boston, MA: Blackwell Scientific Publications; 1993.

Sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Sprains_Strains/default.asp. Published May 2004. Accessed July 10, 2008.

Wrist injury. eMedicine Consumer Journal. 2001 Feb 7.

Wrist sprains. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00023. Updated October 2007. Accessed July 10, 2008.



Last reviewed January 2008 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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