Arthritis of the Wrist
As with all joints, movement of the wrist is permitted by smooth cartilage that allows for minimal friction when moving the wrist. Your hands and wrists are essential in allowing you to work, play sports, and perform daily essential activities. As a result of injury, wear and tear, and other conditions, arthritis can develop when that cartilage breaks down. Cartilage doesn’t heal when damaged, so the body attempts to heal by making more bone, resulting in irregular joints and/or bone spurs. Arthritis is often accompanied by dull pain with motion or activity, which may progress over time, as well as stiffness and swelling. In order to relieve pain and restore function, we start with conservative approaches like physical therapy or steroid injections. If these treatments fail to provide relief, surgery may be necessary.
Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve, which travels from the forearm to the hand through the wrist, is squeezed or compressed. The median nerve is covered by the carpal tunnel, a narrow passageway of ligament and bone. Tendons also pass through the carpal tunnel, and if those tendons swell, can press on the median nerve. Thought to be causes of carpal tunnel are frequent, repetitive, small movements like typing, or grasping movements such as with sports like tennis. Carpal tunnel symptoms get worse over time, so early diagnosis and treatment are important. Early on, symptoms can often be relieved with simple measures, like wearing wrist splint. Symptoms of carpal tunnel can include numbness, tingling, or burning, pain, weakness or clumsiness in the hand, and dropping things. Additional non-surgical treatment options can include medication or steroid injections. Carpal tunnel release surgery can reduce pressure on the affected nerve by severing the band of the ligament that surrounds the wrist, making more space for the nerve and tendons.
A wrist fracture involves a broken or cracked bone in the wrist. The wrist is made up of two forearm bones – the radius and the ulna – and eight carpal bones at the base of the hand. Fractures can occur in any of these bones, often from a fall onto an outstretched arm. It’s important to treat a broken wrist as soon as possible; a delay in treatment may result in poor healing, decreased range of motion, and decreased grip strength. Signs of a broken wrist include severe pain that worsens when gripping or squeezing with the wrist, swelling, tenderness, bruising, and obvious deformity, such as a bent wrist. Depending on the severity of the fracture, your doctor may need to do a reduction, manipulating any bones that may have fallen out of alignment back into position. In order to assist in the healing process and reduce pain, you’ll likely need to immobilize the wrist with a splint or cast, along with medication and/or physical therapy. Surgery may be necessary if you have an open fracture, if the bones have moved before healing, if loose bone fragments are present that could enter a joint, if the surrounding ligaments, nerves, or blood vessels are damaged, or if the fracture has extended to a joint.
Wrist tendonitis occurs when a tendon becomes inflamed or irritated, resulting simply from overuse and everyday activity. Wrist tendons connect forearm muscles to bones in the hand, and can be divided into two groups with extensors in the back of the wrist and flexors in the front. Often, wrist tendonitis occurs at points where the tendons cross each other or pass over a bony prominence. These are common possible sites of irritation and can lead to discomfort when moving the wrist joint. Tendonitis is marked by pain in and around the wrist, and usually worsens with activity. Other symptoms can include swelling around the wrist joint, warmth and redness of the tendons, and grinding sensations with movement of the tendons. Your doctor may begin with conservative treatment to control inflammation and allow tendon healing, which can include immobilization, anti-inflammatory medications, injections, or physical therapy for the hand. When these treatment options fail to provide relief, surgery may be done to release tension in the affected tendon and remove any inflamed tissue.