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Sprained Wrist: Types, Symptoms And Treatment

A wrist sprain is a common injury (more so for all sorts of athletes). A loss of balance is sufficient for you to slip and stick your hand out to prevent your fall. However, the moment your hand hits the ground, the force with which it hits makes it bend back towards your forearm causing a wrist sprain.

A wrist sprain is nothing but tiny tears (or in worse cases, a break to the ligament) that occur when the ligaments connecting the wrist and the hand bones are stretched beyond the limit. Two of the most common ligaments in the wrist that tend to get sprained are the scapholunate ligament in the middle of the wrist (between the scaphoid and lunate bones) and the TFCC (triangular fibrocartilage complex) on the outside of the wrist.

At times, the wrist sprain also includes a pull in a tiny piece of bone. This is called an avulsion fracture.[1]

Apart from falls, wrist sprain can also occur when[3]

• you get hit behind the wrist, or
• you exert extreme pressure on the wrist or twist it too hard.

Athletes who commonly suffer wrist sprains are as follows:[4]

• Baseball players
• Basketball players
• Gymnasts
• Skaters
• Divers
• Skiers
• Inline skaters
• Skateboarders

Symptoms Of A Wrist Sprain[5]

• Swelling
• Severe pain
• Bruising
• The feeling of tearing in the wrist
• Tenderness around the injury
• The injured site gets warm to touch

Types Of Wrist Sprains[6]

Sprains can, in general, be divided into the following three grades:

• Grade I: Minor damage to the ligament with moderate pain
• Grade II: Ligament damage that is severe than Grade I, increased pain
• Grade III: Severe pain, completely torn ligament, loss of function with the extreme looseness of the joint

Diagnosis Of A Wrist Sprain[7]

Usually, your doctor will be able to determine the severity of the wrist pain just by a thorough physical examination. However, in some cases, the following might be advised:

• X-ray
• Arthroscopy [8] : It's a minimally invasive surgical procedure wherein a tiny camera is inserted into the wrist.
• Arthrogram[9] : A kind of X-ray or MRI that is done after injecting a dye into the wrist.

Treatment For A Wrist Sprain

Minor to moderate wrist sprains are usually not a cause of worry and they can heal on their own (it would just need about a week's time to be completely healed). However, to speed up the healing, you can do the following[10] :

Ice your wrist: This is highly effective for reducing the swelling as well as the pain. Do it for about 20 minutes every 3 hours for a minimum of two days (or until the pain is gone).

Rest: Let your sprained wrist rest for at least 48 hours.

Compress: Provide compression to the sprained wrist using a bandage.

Keep your wrist elevated: As often as you can, ensure that your sprained wrist is kept elevated (the elevation should be above your heart level). You can use a pillow or the back of a chair for the elevation.

Use of anti-inflammatory painkillers: Non-steroidal anti-inflammatory drugs work great in reducing the swelling and the pain of the sprained wrist. However, it is always important to know that these drugs could have side effects (such as increased risk of bleeding and ulcers). Restrict their usage to minimal. Also, consult with a medical practitioner before you take any medicines.

Use a cast or a splint[11] : It is important to keep the sprained wrist immobile for as long as possible. Using a cast or splint could help you with this. However, most people use the cast/splint only for a short duration (sometimes till one can go see a doctor). You can even consult with your doctor whether you can start/continue using the cast or splint. Nevertheless, it is essential to note that using a splint for too long can result in stiffness and muscle weakness for some people.

Exercise: Practice strengthening and stretching exercises (but only after your doctor's approval). Also, depending on the condition of your wrist, an occupational therapist would be able to guide you with a specific exercise routine.

Note: Grade III wrist sprains are extremely severe and cannot be cured using the above methods. It is necessary that in such cases, you consult a doctor immediately. Grade III wrist sprains (in which the ligament is snapped) might require surgery to repair.

Recovering After A Wrist Sprain

The recovery time is dependent on the severity and seriousness of the sprain. It usually takes 2 to 10 weeks to heal completely. However, this still remains to be a rough estimate. Every person heals at a different rate. Also, one should indulge in activities that wouldn't strain their affected wrist [12] . Especially for athletes, it is important that one rests for a while and does not worsen the condition of the sprained wrist by participating in sports that can aggravate the injury.

Remember that you can return to your old level of physical activity only after you can agree with the following:

• There is no pain in your wrist when it is at rest.
• You are able to work out easily, without any pain.
• You can grip and move objects easily, without any pain.
• Your injured wrist (along with your hand and arm) feels as strong as your uninjured wrist (including the hand and arm).

If you begin using your wrist extensively even before it has completely healed, then there is a possibility of suffering permanent damage.

Prevention Of Wrist Sprains

It's extremely hard to practice a habit which could certainly confirm that one would not slip or fall. Light accidents are unavoidable at times and most often are not due to acts of carelessness. Specifically, wrist sprains are quite hard to prevent. Even the most well-trained athlete can slip.

However, it is important that one is always careful. It is necessary that you follow a safe exercise regime. Indulge in the ones that you know that you can carry out perfectly without hurting yourself. For athletes, it is recommended that they use wrist guards[13] or tapes (used to prevent the backward bending of the wrist during a fall).

View Article References
  1. [1] Forman, T. A., Forman, S. K., & Rose, N. E. (2005). A clinical approach to diagnosing wrist pain.Am Fam Physician,72(9), 1753-1758.
  2. [2] Pulos, N., & Kakar, S. (2018). Hand and wrist injuries: common problems and solutions.Clinics in sports medicine,37(2), 217-243.
  3. [3] Avery, D. M., Rodner, C. M., & Edgar, C. M. (2016). Sports-related wrist and hand injuries: a review.Journal of orthopaedic surgery and research,11(1), 99.
  4. [4] Fufa, D. T., & Goldfarb, C. A. (2012). Sports injuries of the wrist.Current reviews in musculoskeletal medicine,6(1), 35-40.
  5. [5] van Vugt, R. M., Bijlsma, J. W., & van Vugt, A. C. (1999). Chronic wrist pain: diagnosis and management. Development and use of a new algorithm.Annals of the rheumatic diseases,58(11), 665-674.
  6. [6] Bayoumy, M. A., Elkady, H. A., Said, H. G., El-Sayed, A., & Saleh, W. R. (2015). Arthroscopic grading of common wrist disorders and its role in management.Journal of orthopaedics,12(Suppl 2), S244-250.
  7. [7] Forman, T. A., Forman, S. K., & Rose, N. E. (2005). A clinical approach to diagnosing wrist pain.Am Fam Physician,72(9), 1753-1758.
  8. [8] Mohamadi, A., Claessen, F. M., Ozkan, S., Kolovich, G. P., Ring, D., & Chen, N. C. (2016). Diagnostic Wrist Arthroscopy for Nonspecific Wrist Pain.Hand (New York, N.Y.),12(2), 193-196.
  9. [9] Zinberg, E. M., Palmer, A. K., Coren, A. B., & Levinsohn, E. M. (1988). The triple-injection wrist arthrogram.The Journal of hand surgery,13(6), 803-809.
  10. [10] Einhorn, T. A., & Gerstenfeld, L. C. (2014). Fracture healing: mechanisms and interventions.Nature reviews. Rheumatology,11(1), 45-54.
  11. [11] Carruthers, K. H., O'Reilly, O., Skie, M., Walters, J., & Siparsky, P. (2017). Casting and Splinting Management for Hand Injuries in the In-Season Contact Sport Athlete.Sports health,9(4), 364-371.
  12. [12] Koman, L. A., & Poehling, G. C. (1990). Fractures and ligamentous injuries of the wrist.Hand clinics,6(3), 477-491.
  13. [13] Russell, K., Hagel, B., & Francescutti, L. H. (2007). The effect of wrist guards on wrist and arm injuries among snowboarders: a systematic review.Clinical Journal of Sport Medicine,17(2), 145-150.
Story first published: Tuesday, April 2, 2019, 17:30 [IST]
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