A wrist sprain is an injury to one or more of the wrist ligaments. It can be a mild injury due to a stretch, or it can be severe in which the ligament is completely torn.
A ligament is a strong, fibrous tissue responsible for connecting the various bones of the wrist, keeping them stable, holding them in place, and limiting excessive movements.
A wrist sprain commonly happens when an individual tries to break a fall during a slip or a trip by extending or straightening the arm and using the hand to prevent the body from heavily impacting the ground.
The wrist may become twisted or may suddenly bend, causing the ligaments to stretch or possibly tear. Also, sports-related activities and motor vehicular accidents or any activity that heavily impacts the wrist may result in a wrist sprain.
Types of Wrist Sprain
Wrist sprains are graded based on the degree of severity of the injury. The following are the types of wrist sprain:
- Grade I or Mild: The ligament is stretched, causing microscopic tears.
- Grade II or Moderate: The ligament is partially torn, and some difficulty moving the wrist may be felt.
- Grade III or Severe: The ligament is completely torn, and the wrist will be very difficult and painful to move.
Symptoms of Wrist Sprain
- Wrist sprain usually presents with the following symptoms:
- Pain in the wrist which may extend up to the fingers
- Swelling and inflammation
- Warm to the touch
- A pop or tear can be felt at the time of injury
- Weakness of wrist muscles
- Limited wrist movements
A mild wrist sprain usually gets better, and the pain lessens with proper home management, even without the help of a doctor or a physical therapist. If it does not improve within 2 to 3 days or the pain and swelling worsen and there is extensive bruising, it may indicate serious damage that needs immediate medical care.
A severe wrist sprain can be very painful, especially during movements, because the ligaments are completely damaged, and multiple structures may also be affected. In some cases, the ligament may separate from its bony attachment.
Wrist Sprain vs. Wrist Fracture
Wrist sprain and wrist fracture are sometimes difficult to distinguish because they almost have the same symptoms. A wrist fracture occurs when one or multiple bones of the wrist break or crack. An individual suffering from a fractured wrist will usually have the following:
- Extreme pain, especially when squeezing or clenching with the hand.
- The wrist may look deformed or out of place.
- There may be an open wound where a part of the broken bone protrudes.
A wrist sprain can also be distinguished from a wrist fracture based on the activity involved at the injury time. Basketball, gymnastics, skating, and skateboarding are common sports that result in a wrist sprain.
Meanwhile, wrist fractures frequently occur in individuals who participate in horseback riding, hockey, football, and skiing.
Mild wrist sprain may not need medical attention and may start to heal independently and get better within 48 hours after home treatment.
An individual with moderate wrist pain may have difficulty moving the affected wrist, such as bending or moving it from side to side.
A splint or a brace may be needed to immobilize the joint. It is used to stabilize after a joint injury to limit movements by placing the area in a safe, resting position to allow the injured part to repair and heal.
Home Management to Let Wrist Heal on Its Own
Resting the injured wrist, putting a compression bandage, placing alternate ice and warm compress to facilitate healing, and elevating the area above the heart can be done at home during the first three days after a mild to moderate injury to manage the pain and swelling.
Over-the-counter pain medications may also be taken, such as Ibuprofen.
Physical Rehabilitation and Gradual Strength Training – Crucial to Regain Fitness
When the pain and swelling subside, mild exercises can prevent joint stiffness, restore joint flexibility, and improve strength.
- The intensity of the exercises should be increased in a slow and controlled manner.
- The exercises should not also worsen the pain as it may further damage the healing tissues.
- The help of a physical therapist must be sought to guide and help the individual during the exercises.
A severe wrist sprain or a sprain that does not heal may need surgical intervention to reattach the ligaments together or its bony attachment.
Arthroscopic surgery, a minimally invasive procedure, is usually done for severe wrist injuries.
After surgery, it will need to be immobilized, and the individual would need to undergo strict physical therapy rehabilitation
An untreated sprained wrist may result in serious consequences…
A wrist sprain that is left untreated or is improperly treated may cause severe and permanent damage over time. It may need surgery that could have been evaded if adequate treatment was provided.
- A previously untreated wrist sprain may also result in a more serious injury, such as a wrist fracture. It can also become a chronic or a long-term wrist sprain, causing wrist instability, weakness of wrist muscles, and long-standing pain resulting in difficulty moving the wrist and difficulty grasping or holding objects.
- Arthritis may also develop, which is characterized by damaged joint cartilage. It is caused by the change in the orientation and movement of the bones due to trauma such as a ligament tear. The joint becomes inflamed, making it very stiff, limiting its movements.
A mild wrist sprain may fully heal in one to two weeks, while a moderate wrist sprain may recover within six to eight weeks.
A splint or a brace needs to be worn at most times. For a severe wrist sprain, healing time may take eight to twelve weeks, and full recovery and return to function may take six to 12 months.
During healing, the individual must stay away from activities that aggravate the pain or produce excessive wrist movement. Normal physical activities must only be done until:
- There is no pain in the injured wrist at rest.
- Gripping or holding objects do not produce any pain.
- The hand, wrist, and arm of the affected side should be felt and moved as strong as the uninjured side.
Dr Aarti is an MBBS (Bachelor of Medicine and Surgery) from Baroda Medical College (The Maharaja Sayajirao University, Baroda). Dr. Aarti has also completed her Masters of Medical Science and Technology from the prestigious Indian Institute of Technology, Kharagpur.