There are many possible causes for wrist joint complaints. Pain may radiate from the hand to the arm or vice versa. In general, it must be noted that these complaints are usually associated with significant impairments in everyday life since the hands fulfil an essential function in most activities of daily life.
Wrist wear (osteoarthritis) is wear of the cartilage which covers the joint surfaces. Cartilage damage, and also bone damage in later stages, develops over time and is accompanied by painful wrist deformation and stiffening. Causes for wrist wear symptoms can include excessive strain on the joint, improper positioning of the joint, or a prior injury (trauma). The following symptoms may occur:
- Joint stiffness, especially in the morning
- Joint swelling
- Movement and resting pain
- Loss of strength
- Creaking in the joint
- Hyperthermia (excessive warmth)
- Local pressure pain
Rheumatoid arthritis is an autoimmune disorder; its causes are not yet known. It has been established that up to 2% of the European population suffers from it, and that women are affected three times as often as men. This disease involves inflammation of many joints, including the wrist joint. The synovial membrane is affected first, but the inflammation soon spreads to the bones, cartilage and ligaments. Rheumatoid arthritis generally occurs in phases and pain usually subsides in between phases. During an acute phase which can last weeks or even months, the wrist becomes swollen, hyperthermic and often reddened. Stiff joints in the morning, restricted mobility and more or less pronounced general symptoms are frequent as well.
Excessive strain often results in wrist joint irritation. Putting too much strain on the joint is one of the most frequent causes. Symptoms include reddening, swelling and pain when resting or moving. Tenosynovitis may even occur in some cases.
Inflammation of the tendon and tendon sheath is a very common disease that most people are familiar with today. The most frequent causes are chronic or acute excessive strain resulting from repetitive movements, as well as minor injuries (microtrauma). Affected individuals suffer from the following symptoms:
- Pressure pain along the course of the tendons and muscles
- Hyperthermia (excessive warmth), swelling and reddening
- Strain-induced pain
- Thickening of the affected tendon
An unstable sensation in the wrist primarily affects women between the ages of 20 and 40 and is the result of ligament instability or excessive strain. Applying strain to an unstable wrist joint can cause pain which radiates up into the forearm. In addition, clicking noises often occur during movement of the wrist joint.
Carpal tunnel syndrome
Carpal tunnel syndrome involves "pinched nerves" in the hand. This disease is caused by constriction of the carpal tunnel. The nerves which run through the carpal tunnel are constricted as a result of tissue swelling, for example due to inflammation or excessive strain. This primarily affects the median nerve.
A typical characteristic of this clinical picture is that the pain is especially severe at night. A constant numb feeling will develop as it progresses, affecting mainly the thumb, index finger, and middle finger. Clumsiness, a feeling of weakness, and loss of muscle strength in the hand – frequently in the ball of the thumb – often occur as well. Some 80% of carpal tunnel syndrome cases involve middle-aged women.
Wrist joint sprains, often caused by the application of indirect force such as falling on the outstretched hand, result in elongation of the ligamentous and capsular systems. Symptoms may include swelling, pain when moving, occasionally bruising, restricted function and reduced strength.
First of all, a doctor examines the wrist joints for swelling, deformation, gripping strength and mobility. The intensity of pain is discussed as well. Depending on the case, the following treatment and test methods may then be applied:
- Computer tomography (CT)
- Bone scan
- Magnetic resonance imaging (MRI)
- Nerve tests
Therapy depends on the cause of the wrist joint complaints. In many cases, it is sufficient to cool the hand for a while or keep it very still and avoid all movements. However, operating on the affected hand may also be required in some cases. Orthoses and supports can help alleviate pain and promote healing.
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