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Wrist watch: Why it might hurt, and what you can do about it

Created date

January 29th, 2009

Between the hand and the arm lies a critical piece of real estate: the wrist. It gets so much wear and tear that when it hurts, you feel the effects in virtually every daily activity. Here are the most common wrist issues and what can help.

Joint pain

"People who have broken their wrist before may develop arthritis, depending on how well it healed," says Dimitri Cefalu, M.D. Arthritis is an inflammation of the joints (the tissue where two bones meet). Osteoarthritis, a condition affecting 21 million Americans, occurs when cartilage tissue that cushions the bones breaks down and the joints become inflamed. Where the thumb and wrist meet is the second most common location of osteoarthritis. Symptoms include stiffness, swelling, pain, and loss of motion/function. Bone spurs, or hard lumps, may also appear under the skin. While there is no cure for osteoarthritis, various remedies provide relief: range-of-motion exercises, heat or ice treatments, over-the-counter pain relievers, or doctor-prescribed medications. In people with rheumatoid arthritis, the autoimmune system attacks itself. Rather than just affecting one joint, rheumatoid arthritis strikes multiple joints simultaneously. Consequently, cartilage is destroyed, ligaments or tendons weaken, and bones may become misaligned. Within two years of diagnosis, two-thirds of the 1.3 million Americans diagnosed with rheumatoid arthritis have symptoms in the wrist. Symptoms include joint swelling, pain, tenderness, redness, and stiffness. While there is no cure for rheumatoid arthritis, over-the-counter pain relievers may help. Injectable treatments have proven effective in curbing long-term impacts.

Issues in the tissues

Here today, gone tomorrow. That s the way pain from gout works. This condition is caused by a chemical imbalance in the body, resulting in buildup of crystal-like deposits in joints and tissues. Joints become painful, tender, and/or red. Pain may come on suddenly and disappear within days. While the joint in the big toe is the most common place gout symptoms strike, they may also appear in the feet, ankles, knees, hands, and wrists. Over-the-counter pain relievers or doctor-prescribed medications may alleviate pain and decrease the likelihood of future occurrences. If a bubble (fluid-filled lump) is popping up on your wrist, it may be a ganglion cyst. Tendons (tissues that connect muscles to bones) and joints are surrounded by protective sheaths. When fluid leaks out from these sheaths, it creates ganglion cysts. These fluid-filled growths usually appear on the wrist or hand. While harmless, they may be painful. If the pain interferes with daily activities, doctors may recommend wearing a splint or undergoing surgery.

Tendon trouble

The tendons are a common culprit of wrist pain. They become inflamed, and the sheath surrounding them may constrict, resulting in wrist pain and swelling. How you sleep could be what s taking a toll on the tendons. "When people are sleeping, they have a tendency to flex or extend the wrist," says Cefalu. "In many cases, they come in complaining of pain, and they have mild tendonitis of the wrist. Prescribing a brace or immobilizer to use at bedtime will frequently help prevent pain as well as breaking or twisting the wrist while sleeping." Repetitive motions can also get the tendons to flare up. In de Quervain s tendonitis, these movements irritate the tendons at the base of the thumb, causing pain between the thumb and the wrist. The area over the thumb may swell, and pain increases when you use your hand for tasks like unscrewing lids. The first step in recovery is to stop doing the repetitive activity that agitated the tendons in the first place. Over-the-counter pain relievers, prescribed medications, thumb splints, and injections could alleviate pain and swelling. In extreme circumstances, surgery may be necessary to create room for the inflamed tendons.

On your nerves

If something s getting on your nerves, it could make your wrist hurt. When the tunnel that surrounds the nerve between the wrist and thumb experiences pressure, you may develop carpal tunnel syndrome. The nerve controls sensations in the hand, so when pressure is put on it, the fingers and palm could tingle or burn. Relief comes from resting the hands, using a splint, doing physical therapy, and applying ice. In some cases, surgery may be advised to reduce pressure on the nerve. Surgery to treat carpal tunnel syndrome is one of the most common procedures in the U.S.

Down to the bone

"The wrist is probably the second most common place for injury after the hip when people fall," Cefalu says. If you fall and bend or twist the wrist at an odd angle, you could sprain it. Swelling, tenderness, bruising, discoloration, and warmth are signs of a sprain. A splint may be necessary. In extreme cases, when the bone may have torn along with the ligament, surgery may be advisable. Fractures occur when the bone breaks. When someone falls on an outstretched hand, a common injury is a Colles fracture. This is a break in the bone just above the wrist, leading to swelling and pain there. Splints, casts, and sometimes surgery may be needed to help the bone heal.

Preventive measures

If people didn t fall, they wouldn t have to worry about spraining or breaking the wrist in the first place. So what s the secret? "The number one thing people can do to prevent falls is to remain as physically active as possible," says Cefalu. "During the process of an individual s activities of daily living maintaining their home, shopping, exercising, eating they re basically maintaining their body s ability to conserve balance and posture in various settings. And when you do all you can to prevent an individual from falling, you re doing a lot to protect the wrist."

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