Here’s everything you need to know about this common injury.
What is the cause?
Wrist sprains are commonly caused by a fall onto an outstretched hand. It can also occur after sudden twisting, bending or impact injury that forces the wrist into a position beyond its usual range of motion.
Wrist sprains can range in severity of the injury. A simple classification is:
Mild (Grade 1): The ligament is stretched or has microscopic tears. Mild wrist sprains will heal in a few days with proper treatment.
Moderate (Grade 2): The damage is more severe; the ligament may be partially torn.
Severe (Grade 3): The ligament is completely torn or torn away from where it normally attaches to bones. Occasionally, an avulsion fracture occurs when a small piece of bone is fractured off with the ligament. Severe wrist sprains occasionally result in residual long-term pain, stiffness and swelling despite optimal treatment.
The most common ligament to be injured in the wrist is the scapholunate (SL) ligament. This is the ligament between the scaphoid and lunate carpal bones. Another ligament frequently injured is the triangular fibrocartilage complex (TFCC). There are many other ligaments in the wrist but they are less commonly injured.
How do you know if it is a sprain?
The symptoms vary in intensity, depending on the severity of the injury and the ligament injured. Pain occurs at the time of the injury. It may become more painful during certain movement of the wrist. The wrist will swell and may show bruising due to bleeding. The wrist may feel loose or ‘pop’. The patient may also present with chronic recurring symptoms. Wrist pain occurs during strenuous activities or during certain movements of the wrist. There may be mild swelling but most patients will feel that their wrist seems weak. There may be ‘popping’ or clicking noise from the wrist. Some patients may recall sustaining an injury to the wrist in the past.
Get it diagnosed
Your doctor will carry out a thorough examination of your wrist to identify the location of the injury, the structure injured, and to check how it moves. Wrist X-rays are taken to check for broken bones and displaced or dislocated joints. MRI may be required for detailed study of suspected damaged ligaments.
What is the treatment?
A minor wrist sprain will heal on its own. First aid treatment with the RICE protocol will be helpful. RICE stands for ‘rest, ice, compress, elevate’.
- R Rest the wrist for at least 48 hours.
- I Ice the wrist to prevent pain and swelling. Wrap a towel around some ice and apply over the painful, swollen area; 20–30 minutes every three to four hours for the next two to three days, or until the pain goes away.
- C Compress the wrist with a bandage to limit swelling.
- E Elevate the wrist above the heart or on a pillow.
Your doctor may prescribe non-steroidal anti-inflammatory medication (NSAID) such as Synflex or Arcoxia to relieve the pain and limit the swelling. Avoid further aggravating activities in the hand and wrist and immobilise the wrist with a splint or brace to aid recovery. Hand therapy may be needed if the injury is more significant and results in stiffness and weakness of the wrist.