(65) 64712744|info@boneclinic.com.sg

Wrist Pain Specialist Clinic

Wrist pain is a common complaint. Many types of wrist pain are caused by sudden injuries that result in sprains or fractures. But wrist pain also can be caused by more long-term problems — such as repetitive stress, arthritis and carpal tunnel syndrome.

Because so many factors can lead to wrist pain, diagnosing the exact cause of long-standing wrist pain sometimes can be difficult. An accurate diagnosis is crucial, however, because proper treatment depends on the cause and severity of your wrist pain.

DeQuervain's Tenosynovitis

DeQuervain’s Tenosynovitis

SYMPTOMS OF WRIST PAIN

Wrist pain may vary, depending on what’s causing it. For example, osteoarthritis pain is often described as being similar to a dull toothache, while tendinitis usually causes a sharp, stabbing type of pain. The precise location of your wrist pain also can give clues to what might be causing your symptoms.

When to see a doctor
Not all wrist pain requires medical care. Minor sprains and strains, for instance, usually respond to ice, rest and over-the-counter pain medications. But if pain and swelling last longer than a few days or become worse, see your doctor. Delays in diagnosis and treatment can lead to poor healing, reduced range of motion and long-term disability.

CAUSES OF WRIST PAIN

Your wrist is a complex joint made up of eight small bones arranged in two rows between the bones in your forearm and the bones in your hand. Tough bands of ligament connect your wrist bones to each other and to your forearm bones and hand bones. Tendons attach muscles to bone. Damage to any of the parts of your wrist can cause pain and affect your ability to use your wrist and hand.

Injuries

  • Sudden impacts. Wrist injuries often occur when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures. A scaphoid fracture involves a bone on the thumb side of the wrist. This type of fracture may not show up on X-rays immediately following the injury.
  • Repetitive stress. Any activity that involves repetitive wrist motion — from hitting a tennis ball or bowing a cello to driving cross-country — can inflame the tissues around joints or cause stress fractures, especially when you perform the movement for hours on end without a break. De Quervain’s disease is a repetitive stress injury that causes pain at the base of the thumb.

Arthritis

  • Osteoarthritis. In general, osteoarthritis in the wrist is uncommon, usually occurring only in people who have injured that wrist in the past. Osteoarthritis is caused by wear and tear on the cartilage that cushions the ends of your bones. Pain that occurs at the base of the thumb may be caused by osteoarthritis.
  • Rheumatoid arthritis. A disorder in which the body’s immune system attacks its own tissues, rheumatoid arthritis is common in the wrist. If one wrist is affected, the other one usually is, too.

Other diseases and conditions

  • Carpal tunnel syndrome. Carpal tunnel syndrome develops when there’s increased pressure on the median nerve as it passes through the carpal tunnel, a passageway in the palm side of your wrist.
  • Ganglion cysts. These soft tissue cysts occur most often on the top of your wrist opposite your palm. Smaller ganglion cysts seem to cause more pain than do larger ones.
  • Kienbock’s disease. This disorder typically affects young adults and involves the progressive collapse of one of the small bones in the wrist. Kienbock’s disease occurs when the blood supply to this bone is compromised.

RISK FACTORS

Wrist pain can happen to anyone — whether you’re very sedentary, very active or somewhere in between. But your risk may be increased by:

  • Sports participation. Wrist injuries are common in many sports, including bowling, golf, gymnastics, snowboarding and tennis.
  • Repetitive work. Almost any activity that involves your hands and wrists — even knitting and cutting hair — if performed forcefully enough and often enough can lead to disabling wrist pain.
  • Diseases and conditions. Your risk of developing wrist pain is increased if you have diabetes, leukemia, scleroderma, lupus or an underactive thyroid gland.

TREATMENTS

Treatments for wrist problems vary greatly, depending on the type, location and severity of the injury, as well as on your age and overall health.

Medications
Over-the-counter pain relievers may help reduce wrist pain. Stronger pain relievers are available by prescription.

Therapy
If you have a broken bone in your wrist, the pieces will need to be aligned so that it can heal properly. A cast or splint can help hold the bone fragments together while they heal.

If you have sprained or strained your wrist, you may need to wear a splint to protect the injured tendon or ligament while it heals. Splints are particularly helpful with overuse injuries caused by repetitive motions.

Surgery
In some cases, surgery may be necessary. Examples include:

  • Severely broken bones. A surgeon may connect the fragments of bone together with metal hardware.
  • Carpal tunnel syndrome. If your symptoms are severe, you may need to have the tunnel cut open to relieve the pressure on the nerve.
  • Tendon or ligament repair. Surgery is sometimes necessary to repair tendons or ligaments that have ruptured.

CURE YOUR WRIST PAIN TODAY. CALL +65 6471 2744 or SMS to +65 92357641 for APPOINTMENT TODAY

Broken Wrist

A broken wrist is among the most common broken bones. In fact, wrist fractures are the most commonly broken bone in patients under 65 years of age (after that age, hip fracturesbecome the most common broken bone). About 1 of every 6 fractures treated in emergency rooms is a wrist fracture.Usually, when a doctor is describing a wrist fracture, he or she is referring to a fracture of the radius (one of two forearm bones). There are other types of broken bones that occur near the wrist, but a typical wrist fracture generally means the end of the radius bone has been broken. Other bones that can break near the wrist joint include the scaphoid and the ulna.

How is the diagnosis of a wrist fracture made?
A wrist fracture should be suspected when a patient injures their wrist joint and has pain in this area. Common symptoms of a wrist fracture include:

    • Wrist pain
    • Swelling
    • Deformity of the wrist

When a patient comes to the emergency room with wrist pain, and evidence of a possibly broken wrist, an x-ray will be obtained of the injured area. If there is a broken wrist, the x-rays will be carefully reviewed to determine if the fracture is in proper position, and to assess the stability of the bone fragments.What is the usual treatment for a wrist fracture?
Most often, broken wrists can be treated in a cast. The wrist is one area of your body that is very amenable to cast treatment. If the bones are out of proper position, then some light sedation or local anesthesia may be used so your doctor can reset the fracture. This is called ‘reducing’ a wrist fracture, and by performing specific maneuvers, your doctor may be able to realign the broken wrist.

Which wrist fractures need surgery for treatment?
This is a difficult question to answer, and must be addressed on a case by case basis. Even on an individual basis, orthopedists may differ on their opinion of optimal treatment for a given fracture.

Some of the following are important considerations in determining whether or not surgery is necessary for a broken wrist:

  • Age and physical demands of the patient
    If a patient is young and active, every effort will be made to restore the wrist to normal. In some wrist fractures, this may help prevent problems in the years ahead. However, if the patient does not require heavy demands of the wrist, or if the patient is elderly, perfect restoration of the broken bones may not be necessary.
  • Bone quality
    If the bone is thin and weak, meaning the individual has osteoporosis, then surgery may be less beneficial. If plates and screws are used to fix a fracture, the bone quality must be adequate to secure the screws. Surgery is traumatic to the bone, and sometimes the best course of action is to minimize further damage to the bone and treat in a cast.
  • Location of the fracture
    If the fracture involves the cartilage of the wrist joint, then surgery may be more likely. While bone can remodel over time, the cartilage surface of the wrist joint cannot. If the cartilage surfaces are not lined up sufficiently with a reduction (resetting) maneuver, then surgery may be considered.
  • Displacement of the fracture
    If the bones are severely misaligned, then surgery may be performed to properly position the fragments. This is usually attempted without surgery, but it is possible for muscle and tendon to become entrapped and block the resetting. Furthermore, some fractures may be unstable and not stay in position even with a well fit cast. These may need surgery to adequately position the fracture.
  • Adequacy of non-surgical management
    If a fracture is displaced, usually the patient will have an attempted reduction, or repositioning of the broken bone. Sometimes it is difficult to reposition the bones without surgery. Other times, the positioning is satisfactory, but casting may not hold the fracture in that position. Surgery can usually be performed any time in the first two weeks after a fracture to restore the bones to their proper position.

As stated earlier, surgery is not usually needed for a wrist fracture, but it may be considered in some situations. If surgery is performed, there are several options for treatment. Some fractures may be secured with pins to hold the fragments in place. Another option is anexternal fixator, a device that uses pins through the skin and a device outside the skin to pull the fragments into position. Finally, plates and screws may be used to position the fracture properly.