Common Wrist Injuries

1. Carpal Tunnel Syndrome

• Area of Pain / Sensation: Numbness, tingling, and a "pins and needles" sensation in the thumb, index, middle, and ring fingers, often accompanied by a dull ache radiating up into the forearm. Pain typically worsens at night.

• Affected Anatomy: The median nerve as it passes through the carpal tunnel—a narrow passageway on the palm side of the wrist bounded by carpal bones and the transverse carpal ligament.

• Explanation: Caused by chronic pressure or swelling on the median nerve inside the tunnel due to repetitive hand motions, fluid retention, or anatomical narrowing.

2. Triangular Fibrocartilage Complex (TFCC) Tear

• Area of Pain: Sharp or aching pain concentrated on the ulnar side (pinky side) of the wrist, which worsens when gripping objects, pushing up from a chair, or rotating the forearm (pronation/supination).

• Affected Anatomy: The TFCC, a cushioning structure composed of cartilage and ligaments located on the pinky-finger side of the wrist that stabilizes the distal radioulnar joint.

• Explanation: Typically caused by a fall onto an outstretched hand (FOOSH), heavy axial loading, or severe repetitive wrist rotation (e.g., in racquet sports or golf).

3. De Quervain's Tenosynovitis

• Area of Pain: Pain and tenderness on the thumb side of the wrist, directly over the radial styloid process, which sharpens when making a fist, grasping objects, or bending the thumb.

• Affected Anatomy: The tendons of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscles, along with their surrounding synovial sheath.

• Explanation: Caused by irritation or inflammation of the thumb tendons as they slide through their narrow tunnel, frequently triggered by repetitive gripping, typing, texting, or new childcare tasks (lifting infants).

4. Scaphoid Fracture

• Area of Pain: Pain and localized tenderness right in the "anatomical snuffbox" (the small hollow depression on the thumb side of the back of the wrist) after an impact.

• Affected Anatomy: The scaphoid bone, one of the small carpal bones bridging the two rows of the wrist joint.

• Explanation: Usually occurs from falling onto an outstretched hand. Because blood supply to the scaphoid enters from top to bottom, fractures near the waist of the bone are notorious for slow healing or non-union risks if left untreated.

5. Scapholunate Ligament Tear

• Area of Pain: Pain centered on the top back side (dorsal aspect) of the wrist, slightly toward the thumb side (radial side), just distal to the bony bump on the radius (Lister's tubercle). Pain is often aggravated when placing weight on the palm (e.g., pushing up from a chair or doing push-ups) or bending the wrist backward.

• Affected Anatomy: The scapholunate interosseous ligament (SLIL), a crucial C-shaped ligament that binds the scaphoid and lunate carpal bones together.

• Explanation:

  • This ligament stabilizes the central carpal joint.

  • It typically tears during a high-impact fall onto an extended, rotated wrist.