Wrist conditions

In general, these symptoms are usually associated with considerable limitations in everyday life, since the hands are essential in most activities of daily living.

Arthrosis

Wear and tear on the wrist (arthrosis) is the degeneration of cartilage covering the articular surfaces. Cartilage damage occurs over time – and is followed by bone damage – leading to painful deformations and ankylosis (stiffening) of the wrist. Possible causes include excessive strain on the wrist, a joint malposition or a prior injury (trauma). The following symptoms may occur:

• Contracture, especially in the morning

• Swelling of the joints

• Pain during movements and at rest

• Loss of strength

• Grinding in the joint

• Local overheating

• Local pressure pain

Rheumatoid arthritis

Rheumatoid arthritis is one of the autoimmune diseases for which the cause remains unclear. We know it affects 2 per cent of the population in Europe and is three times more common in women. The disease is associated with inflammation in numerous joints, including the wrist. The synovial (joint) membrane is affected first, but the inflammation spreads to the bone, cartilage and ligaments. Rheumatoid arthritis usually occurs in the form of attacks, and the pain generally decreases between the attacks. During an attack, which may last weeks or months, the wrist swells with local overheating, and reddening often occurs as well. Many people are also affected by stiffness of the joints in the morning, limited mobility and general symptoms with varying degrees of severity.

Excessive strain

Irritation of the wrist often occurs in response to excessive strain. Overstraining the joint is one of the most common causes. This takes the form of reddening, swelling and pain during movement but also at rest. Tenosynovitis may even develop in some cases.

Tenosynovitis

Inflammation of the tendons and synovial sheaths is a very common disease that just about everyone is familiar with. The most common causes are excess strain that is chronic or acute due to monotonous movement sequences as well as small injuries (micro trauma). Affected individuals have the following symptoms:

• Pressure pain along the course of the tendon and muscle

• Local overheating, swelling and reddening

• Movement-induced pain

• Thickening of the affected tendon

Instability

Women aged 20 to 40 are most often affected by a feeling of instability in the wrist due to ligament weakness and excessive strain. A feeling of instability may be accompanied by pain radiating into the forearm when strain is placed on the wrist. Clicking sounds often occur as well during movements of the wrist.

Carpal tunnel syndrome

Carpal tunnel syndrome is a “pinched nerve” in the hand. This disease is caused by a narrowing of what is known as the carpal tunnel. Swelling of the tissue caused, for example, by inflammation or excessive strain constricts the nerves that pass through the carpal tunnel. The median nerve – nervus medianus – is affected first and foremost.
With this condition, the pain is typically most severe at night. As the condition progresses, a permanent feeling of numbness develops, mainly affecting the thumb, index finger and middle finger. Other common symptoms include clumsiness, a feeling of weakness in the hand and reduced strength in the hand muscles – often the ball of the thumb. Middle-aged women account for 80 per cent of all cases.

Sprain

A wrist sprain occurs when the ligament and capsule system is overextended. It is often caused by force that is applied indirectly, such as falling onto the hand while it’s extended. Possible consequences are swelling, pain during movement, haematoma in some cases, function limitations and reduced strength.

The doctor starts by examining the wrists for swelling, deformations, gripping strength and mobility. The intensity of the pain is also discussed. The following healing and test methods may then be applied on a case-by-case basis:

• X-rays

• Computer tomography

• Bone scan

• Magnetic resonance imaging

• Joint endoscopy

• Arthroscopy

• Nerve tests

The therapy depends on the cause of the wrist pain. In many cases it is sufficient to cool the hand for a while or to keep it very still and avoid any movements. In some cases, however, it may also be necessary to operate on the affected hand. Orthoses and bandages can help relieve discomfort and promote healing.