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Wrist Sprain

(Sprain, Wrist)

Definition

A wrist sprain is stretching or tearing of the ligaments that support the wrist. Ligaments are strong bands of tissue that connect bones to each other.
Wrist Sprain
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Causes

The most common causes for wrist sprains are falling on an outstretched hand and repetitive motion.

Risk Factors

Factors that may increase your chance of getting a wrist sprain include:
  • Playing sports
  • Job- or activity-related repetitive motion of the wrist
  • Poor coordination
  • Poor balance
  • Reduced flexibility and strength in muscles and ligaments
  • Loose joints
  • Not wearing wrist guards during activities, such as in-line skating

Symptoms

A wrist sprain may cause:
  • Pain, tenderness, and swelling around the wrist
  • Redness, warmth, or bruising around the wrist
  • Limited ability to move the wrist
It can be hard to tell the difference between a wrist sprain and a fracture or dislocation of one of the small wrist bones. See your doctor if there is any deformity, swelling, or if you are unable to move your wrist or hand.

Diagnosis

Your doctor will ask about your symptoms and how you injured your wrist. An exam of your wrist will be done to check the stability of the joint and the severity of the injury.
Imaging tests may include:
Wrist sprains are graded according to their severity:
  • Grade 1—Some stretching with micro-tearing of ligament tissue.
  • Grade 2—Partial tearing of ligament tissue.
  • Grade 3—Complete tearing of ligament tissue.

Treatment

Treatment includes:

Acute Care

Rest
Your wrist will need time to heal. Avoid activities that cause pain or put extra stress on your wrist.
Cold
Apply an ice or a cold pack to the area for 15-20 minutes several times a day after the injury. Do not apply the ice directly to your skin. Wrap the ice or cold pack in a towel.
Pain Relief Medications
Your doctor may recommend:
  • Over-the-counter medication, such as aspirin, ibuprofen, or acetaminophen
  • Topical pain medication—creams or patches that are applied to the skin
  • Prescription pain relievers
Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
Compression
Compression can help prevent more swelling. Your doctor may recommend an elastic compression bandage around your wrist. Be careful not to wrap the bandage too tight.
Elevation
Elevation can also help keep swelling down. Keep your arm higher than your heart as much as possible. A couple of days of elevation might be recommended for severe strains.

Recovery

Support may be needed to help protect, support, and keep your wrist in line while it heals. Supportive steps may include:
  • A brace—You may need to wear a brace to keep your wrist still as it heals. If you play sports, you may need to wear a wrist brace, or tape your wrist when you return to your sport after you are healed. Do not return to activities or sports until your doctor gives you permission to do so.
  • A cast—If you have a severe sprain, your doctor may recommend a cast for 2-3 weeks.
  • Rehabilitation exercises—Begin exercises to restore flexibility, range of motion, and strength in your wrist as recommended by your doctor or physical therapist.
  • Surgery—Surgery is rarely needed to repair a wrist sprain. However, surgery may be needed to repair a ligament that is torn completely, or if there is an associated fracture .

Prevention

Wrist sprains may not always be preventable. There are steps you can take to reduce your chance of getting a wrist sprain. These include:
  • Wearing protective equipment and using proper technique while playing sports
  • Keep wrists strong with regular exercises to absorb the energy of sudden physical stress

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.org

American College of Sports Medicine http://www.acsm.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Abraham MK, Scott S. The emergent evaluation and treatment of hand and wrist injuries. Emerg Med Clin North Am. 2010 Nov;28(4):789-809.

Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation.1st ed. Philadelphia, PA: Hanley and Belfus; 2002.

Parmelee-Peters K, Eathorne SW. The wrist: common injuries and management. Primary Care: Clinics in Office Practice. 2006 March 32(1).

Renström P; IOC Medical Commission, International Federation of Sports Medicine. Sports Injuries: Basic Principles of Prevention and Care . Boston, MA: Blackwell Scientific Publications; 1993.

Sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Sprains%5FStrains/default.asp. Updated July 2012. Accessed September 10, 2013.

Wrist sprains. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00023. Updated September 2010. Accessed September 10, 2013.

10/26/2010 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.

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