Sprains and strains of the wrist are injuries caused by overstretching or tearing of the ligaments and tendons of the wrist. Wrist strains and sprains have similar signs and symptoms, but differ anatomically. The stretching or tearing of a tendon is referred to as a strain. If ligaments or the joint capsule are injured, the injury is called a sprain. The small wrist bones (carpals) are held in position by their shape (which aligns them in two rows) and by supporting ligaments and tendons. Injuries to the ligaments or tendons that surround the joints of the forearm (radius and ulna) and the carpal bones are known as wrist sprains or strains.Wrist sprains and strains usually result from a fall onto an outstretched hand. The hand’s position and/or rotation at impact determine the type and severity of injury. More severe (third-degree) injuries involve a disruption of the supporting structures and a dislocation of the carpal joint, or a fracture. A stretch injury to the ligaments around the joint of the radius, ulna, or carpal bones can lead to improper mechanics of the wrist joint and may result in permanent loss of stability.
The most common form of wrist sprain is called scapholunate dissociation and this usually presents following a fall with minimal swelling and pain localized over the top of the wrist centrally. Presentation is often delayed as the focus medically is on excluding a wrist fracture. Pain is increased by extending the wrist.
If the sprain or strain is minor (first-degree), there is no loss of stability and treatment can include gentle mobilization techniques and strengthening exercises to support the damaged ligaments. Additional treatments may include rest, ice, compressive bandage, and elevation (RICE), and the fitting of a splint or cast. Failure of the condition to respond to conservative treatment may indicate a referral to a hand surgeon and surgical repair of the ligaments may be necessary to preserve wrist stability.