The Facts About Wrist Sprains
Whether you are an active athlete or just on a routine walk, a wrist sprain is a common injury for anyone. All it takes is just one momentary loss of balance for you to slip — you automatically stick your hand out to break your fall. Once your hand hits the ground, the force of impact bends it back toward your forearm. This can stretch the ligaments that connect the wrist and hand bones a little too far. The result is tiny tears or — even worse — a complete break to the ligament.
What causes a wrist sprain?
The wrist is made up of eight small bones within the base of the hand, which are attached to the five lower bones in our hand (metacarpals) and the two bones of the forearm (radius and ulna). These 15 bones are connected and surrounded by numerous ligaments and cartilage, which allow for movement and cushion the bones from rubbing against each other. Any of the ligaments in the wrist can be damaged by a movement — such as an extreme twist, bend or direct impact — that forces the wrist into a position beyond its normal range of motion.
The excessive force that leads to a wrist sprain can come about in many different ways, but in most cases a fall is responsible. Any time we experience a fall, there is a natural instinct to outstretch our hand(s) to soften the impact, but the weight of our body on the wrist is usually more than it can withstand. This is why athletes of various sports in which falls are common often experience wrist sprains, including football, cycling, skiing, snowboarding, basketball, diving and gymnastics. Wrist sprains may also occur in weightlifting or boxing, especially in athletes with poor lifting or punching techniques. In rare cases, a sprained wrist may develop as an overuse injury from activities that put too much strain on the wrist over a period of time.
Grades of Wrist Sprains
Sprains are graded, depending on the degree of injury to the ligaments:
Grade 1 sprain (mild). The ligaments are stretched, but not torn.
Grade 2 sprain (moderate). The ligaments are partially torn. This type of injury may involve some loss of function.
Grade 3 sprain (severe). The ligament is completely torn or the ligament is pulled off of its attachment to bone. These are significant injuries that require medical or surgical care. If the ligament tears away from the bone, it may take a small chip of bone with it. This is called an avulsion fracture. These small fractures frequently do not require surgery and may heal on their own.
Treatment
Wrist sprains are usually treated without surgery but should be treated immediately with ice and rest. Ice is recommended for the first couple of days following injury to relieve pain and inflammation, and should be used for 15 to 20 minutes every 2 to 3 hours. Do not apply chemical ice packs directly against the skin as they may cause frostbite.
Treatment also typically involves resting the injured wrist and wearing a splint as needed until symptoms improve, which may take up to 6 weeks. Prescription pain medications are not usually recommended. If symptoms do not improve after a reasonable period of time, additional imaging may be ordered to look for a more serious injury.
An ace/compression wrap can help to alleviate pain by providing light pressure and reducing swelling in the area. It is important to begin the wrap at the base of the fingers and work up the hand to approximately mid-forearm. The wrap should be snug but comfortable and will help minimize movement at the wrist. Any increase in pain, tingling or coldness of the fingers is a sign the wrap may be too tight. Elevating the wrist above the level of the heart will also help to reduce swelling.
X-rays may be ordered to rule out a fracture. In this case, a wrist splint or a cast may be applied to immobilize the joint to allow proper healing. In some rare cases surgery may be needed if a ligament is torn.
Prevention
A wrist sprain usually occurs during an accidental fall and cannot fully be prevented. However, in sports such as rollerblading, skate boarding, ice skating, gymnastics or even skiing, a wrist guard can be worn to protect the wrist in case of a fall.
It is important to maintain a safe playing environment to prevent wrist injuries. All playing fields should be checked prior to any practice or game for unnecessary equipment, large holes or ruts, sharp or hard objects, and wet or icy surfaces. Being aware of your surroundings may help to prevent falls as well.
Prognosis
Wrist sprains typically heal well, with minimal or no long-term symptoms. Healing can often take several weeks, but recovery is usually excellent.
When Should You Be Concerned
If there is an obvious deformity, persistent loss of sensation or numbness or tingling to the hand, wrist, or forearm consult a physician immediately. It is important to consult your physician if your pain lasts more than two weeks or worsens. This may be a sign of a more severe injury.
For more information or to request an appointment, please contact Dr. Patrick McDaid, M.D. at www.mcdaidorthohand.com/contact
