Wrist Pain When Moving: Causes, Symptoms, and Management

Why does my wrist hurt when I move it?

Wrist pain when moving is a common issue, often stemming from the complex interplay of bones, ligaments, tendons, and nerves in the wrist joint, and can indicate anything from a minor sprain to more significant underlying conditions.

Understanding Wrist Anatomy

The wrist is a marvel of biomechanical engineering, designed for both strength and intricate dexterity. It's not a single joint but a complex region comprising eight small carpal bones, which connect the two long bones of the forearm (radius and ulna) to the five metacarpal bones of the hand. This intricate bony structure is stabilized by numerous ligaments (connecting bone to bone) and moved by a network of tendons (connecting muscle to bone) that originate in the forearm. Additionally, major nerves and blood vessels pass through this region, making it susceptible to various forms of injury and irritation. Any disruption to this delicate balance – whether due to trauma, overuse, or degenerative changes – can manifest as pain, especially during movement.

Common Causes of Wrist Pain When Moving

Pain in the wrist when moving can arise from a multitude of causes, broadly categorized into acute injuries, overuse syndromes, and degenerative conditions.

Acute Injuries

• Sprains: These occur when the ligaments that stabilize the wrist are stretched or torn, often due to a fall onto an outstretched hand (FOOSH). Pain is typically immediate and localized, worsening with specific movements that stress the injured ligament. Common sites include the scapholunate ligament.
• Strains: Less common in the wrist itself, but can involve the tendons and muscles of the forearm that cross the wrist joint. Overstretching or tearing of these soft tissues can lead to pain, particularly during gripping or specific wrist movements.
• Fractures: A break in one of the wrist bones. The distal radius fracture (Colles' fracture) is very common after a FOOSH. A scaphoid fracture is another common wrist bone fracture, often subtle and easily missed, leading to persistent pain on the thumb side of the wrist, especially with gripping or radial deviation.

Overuse and Repetitive Strain Injuries (RSIs)

These conditions typically develop gradually due to repetitive motions, poor ergonomics, or excessive loading.

• Tendinitis/Tenosynovitis: Inflammation of a tendon or its protective sheath.
  • De Quervain's Tenosynovitis: Affects the tendons on the thumb side of the wrist (abductor pollicis longus and extensor pollicis brevis). Pain is worse with gripping, pinching, or moving the thumb.
  • Extensor Carpi Ulnaris (ECU) Tendinitis: Pain on the pinky finger side of the wrist, often exacerbated by twisting motions or ulnar deviation.
  • Flexor Carpi Radialis (FCR) Tendinitis: Pain on the palm side of the wrist, near the base of the thumb, worsened by wrist flexion and radial deviation.
• Carpal Tunnel Syndrome: Compression of the median nerve as it passes through the carpal tunnel in the wrist. This typically causes numbness, tingling, and weakness in the thumb, index, middle, and half of the ring finger. Pain can radiate into the wrist and forearm, often worsening at night or with repetitive hand activities.
• Ganglion Cysts: Non-cancerous, fluid-filled sacs that typically appear on the back of the wrist but can also form on the palm side. While often painless, they can cause pain if they press on a nerve or interfere with joint movement, especially during wrist flexion or extension.
• Triangular Fibrocartilage Complex (TFCC) Injury: The TFCC is a complex structure of cartilage and ligaments on the pinky side of the wrist, crucial for stabilizing the wrist and forearm bones. Tears or degeneration can cause pain, clicking, or instability, particularly with twisting motions, gripping, or pushing off a chair.

Degenerative and Inflammatory Conditions

• Osteoarthritis: "Wear-and-tear" arthritis, more common in older adults or after previous trauma to the wrist. It results from the breakdown of cartilage cushioning the joint surfaces. Pain is typically worse with activity and improves with rest, often accompanied by stiffness and reduced range of motion.
• Rheumatoid Arthritis: An autoimmune disease where the body's immune system mistakenly attacks its own tissues, including the lining of the joints (synovium). This can cause chronic inflammation, pain, swelling, and stiffness in multiple joints, often symmetrically, including the wrists.
• Gout/Pseudogout: Conditions caused by the buildup of crystals in the joints, leading to sudden, severe attacks of pain, swelling, redness, and tenderness. While more common in the big toe, they can affect the wrist.

When to Seek Medical Attention

While many minor wrist pains can resolve with self-care, certain symptoms warrant professional medical evaluation:

• Severe pain that prevents you from using your hand or arm.
• Deformity of the wrist or hand.
• Numbness, tingling, or weakness in the hand or fingers.
• Inability to move your wrist or fingers.
• Pain that worsens despite rest and self-care measures.
• Swelling, redness, or warmth around the joint that suggests inflammation or infection.
• Pain that doesn't improve within a few days to a week.
• Pain following a significant injury or fall.

A healthcare professional, such as a physician, physical therapist, or hand specialist, can accurately diagnose the cause of your wrist pain through physical examination, imaging (X-rays, MRI), and sometimes nerve conduction studies.

Initial Self-Care and Prevention Strategies

For minor wrist pain, these strategies can provide relief and aid recovery:

• RICE Protocol:
  • Rest: Avoid activities that aggravate your wrist pain.
  • Ice: Apply ice packs to the affected area for 15-20 minutes, several times a day, especially after activity or if there's swelling.
  • Compression: Use a compression bandage or wrist brace to reduce swelling and provide support.
  • Elevation: Keep your wrist elevated above your heart to help reduce swelling.
• Over-the-Counter Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help manage pain and inflammation.
• Activity Modification: Identify and modify the activities or movements that trigger your pain. This might involve adjusting your grip, changing your posture, or taking frequent breaks.
• Ergonomic Adjustments: For those who spend significant time at a computer, ensure your keyboard and mouse are positioned to keep your wrists in a neutral, straight position. Use wrist rests if helpful, but avoid resting your wrists directly on them while typing.
• Gentle Stretching and Strengthening: Once acute pain subsides, incorporate gentle wrist stretches and strengthening exercises to improve flexibility, stability, and prevent recurrence. Focus on movements through the full range of motion without pain, and use light resistance. Consult a physical therapist for guidance on appropriate exercises.
• Listen to Your Body: Pay attention to early signs of discomfort and address them promptly before they escalate into more severe conditions.

Conclusion

Wrist pain when moving is a complex issue with a wide range of potential causes. Given the wrist's intricate anatomy and its critical role in daily activities, understanding the underlying reason for your pain is paramount for effective treatment and long-term relief. While initial self-care can be beneficial for minor issues, persistent or severe pain warrants professional medical evaluation to ensure an accurate diagnosis and appropriate management plan, allowing you to return to pain-free movement and activity.