Clinically reviewed by What is wrist pain
The wrist is a stack of eight small bones with tendons running over them in tight sheaths. Pain there is usually a tendon, the joint surface, or the after effects of an old injury. In Urdu it is kalai mein dard.
This page is about wrist pain. If your main complaint is numbness and tingling in the thumb and first two fingers at night, that is more likely carpal tunnel syndrome, a nerve problem with its own page.
The useful distinction here is pain on movement and loading, which is mechanical, versus numbness and tingling, which is nerve. They are treated differently.
Symptoms you might have
- Pain on the thumb side of the wrist when gripping, lifting or wringing out cloth
- Pain that spikes when you tuck the thumb into your palm and bend the wrist down towards the little finger, which points to De Quervain's
- Pain on the little finger side when twisting a tight lid
- Deep, aching pain across the whole wrist with stiffness and loss of bending, which fits joint wear
- Weak grip and difficulty taking weight on the hand, such as pushing up from a chair
Why it happens
- Repetitive gripping, wringing and twisting: washing clothes by hand, kneading dough, tailoring, carpentry, salon work
- De Quervain's, irritation of the thumb tendons, very common in new mothers from lifting a baby with the thumbs out
- Wear in the wrist joint, usually years after a fracture rather than from age alone
- An old fracture of the forearm or the small wrist bones that healed slightly out of line
- Inflammatory arthritis, where both wrists swell with long morning stiffness
- Motorbike riding for long periods, with the wrist loaded and extended
When you should see a physiotherapist
Come in once wrist pain has lasted two or three weeks, or sooner if it is stopping you working. Wrist tendon problems respond well to a splint, a change in load and graded strengthening, and drag on when those are missed.
See a doctor for an X-ray before treatment if the pain started with a fall onto the hand, especially if there is tenderness in the hollow at the base of the thumb. A small bone there, the scaphoid, is often broken in that fall, is easy to mistake for a sprain, and does not always show on an early X-ray. Missing it causes long term damage.
Go to a hospital now if the wrist is out of shape after an injury, if the hand is pale, cold or numb, or if the wrist is hot, red and swollen with fever.
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How it is treated
Treatment depends on which structure is painful, and most of the result comes from reducing the load on it while strengthening what can take load.
- Splinting and bracing, a thumb splint for De Quervain's or a wrist splint for a painful joint, usually worn for a few weeks rather than permanently
- Exercise therapy, tendon gliding first, then graded grip and forearm strengthening, which is what stops the problem returning
- Manual therapy, mobilisation of stiff wrist joints and soft tissue work to the forearm muscles
- Dry needling for tight bands in the forearm muscles, not used where the skin is numb or if you are on blood thinners
- Activity and tool changes, including how you lift a baby, hold a phone and set up a keyboard, which often matters more than anything done in the clinic
Most wrist pain settles without surgery. A steroid injection for stubborn De Quervain's is a doctor's decision. Surgery is for a displaced or non healing fracture, or a problem that has not responded over months. See also our page on fracture rehabilitation.
Exercises, and what to avoid
What helps
- Tendon gliding, moving the fingers through fist, hook and straight positions, several times a day
- Forearm strengthening with a very light weight, wrist resting over the edge of a table, slow up and slow down
- Gentle wrist bending and straightening within comfort
- Grip work with a soft ball once pain has settled, building over weeks
What to avoid
- Wringing out clothes by hand, which is the single worst movement for thumb side wrist pain
- Lifting a baby or a heavy pot with the thumbs out. Scoop from underneath with flat hands instead
- Taking body weight through a bent back wrist, such as push ups or pushing up from the floor
- Wearing a splint all day for months. It eases pain and then weakens the wrist
What you can do at home
Wear the splint at the times that hurt, usually during gripping work and at night, rather than around the clock.
Ice suits a freshly irritated tendon better than heat. Ten minutes over the painful spot, with a cloth against the skin. Heat is better for a stiff, aching wrist before exercises.
Change the grip, not just the amount. Wider handles, two hands, a jar opener and a lighter pot reduce load without reducing what you get done.
Keep the wrist straight rather than bent back when using a phone, a mouse or a motorbike handlebar. Raising a chair or lowering a desk often does more than any gadget.
How long it takes
De Quervain's usually settles over six to twelve weeks with a thumb splint, load changes and graded strengthening. In new mothers it can take longer, simply because the lifting cannot stop, so technique changes matter most.
Other wrist tendon problems follow a similar six to twelve week course.
Wrist pain from joint wear or an old fracture is managed rather than cured. Most people get useful improvement in strength and comfort over eight to twelve weeks and then maintain it.
It is faster when the aggravating grip is identified and changed. It is slower when the splint is worn constantly without any strengthening, which is the commonest reason wrist pain lasts a year.
Urdu / Roman Urdu
Choose your reading script / اپنی پسند کا رسم الخط منتخب کریں
اردوUrdu script
کلائی کا درد اکثر ٹینڈن، جوڑ کے گھسنے یا پرانی چوٹ کی وجہ سے ہوتا ہے۔ اگر اصل شکایت انگوٹھے اور پہلی دو انگلیوں کا سن ہونا ہے، تو وہ کارپل ٹنل ہے۔
انگوٹھے کی طرف کا درد اکثر دے کوروینز ہوتا ہے، جو نئے بچے والی ماؤں میں عام ہے۔ کپڑے نچوڑنا اس درد کو سب سے زیادہ بڑھاتا ہے۔
علاج میں اسپلنٹ، ٹینڈن کی ورزش، مینول تھراپی، الٹراساؤنڈ اور کام کے طریقے کی تبدیلی شامل ہے۔ اسپلنٹ صرف کام کے وقت اور رات کو پہنیں، پورے دن نہیں، ورنہ کلائی کمزور ہو جاتی ہے۔
ہاتھ پر گرنے کے بعد انگوٹھے کے نیچے والے گڑھے میں درد ہو تو ایکس-رے ضروری ہے۔ وہاں کی چھوٹی ہڈی کی ٹوٹ اکثر نظر انداز ہو جاتی ہے۔
Roman Urdu
Kalai ka dard aksar tendon, jor ke ghisne ya purani chot ki wajah se hota hai. Agar asal shikayat angoothe aur pehli do ungliyon ka sun hona hai, to wo carpal tunnel hai.
Angoothe ki taraf ka dard aksar De Quervain's hota hai, jo naye bachay wali maaon mein aam hai. Kapre nichorna is dard ko sab se zyada barhata hai.
Ilaj mein splint, tendon ki warzish, manual therapy, ultrasound aur kaam ke tareeqe ki tabdeeli shamil hai. Splint sirf kaam ke waqt aur raat ko pehnen, pooray din nahi, warna kalai kamzor ho jati hai.
Haath par girne ke baad angoothe ke neeche wale gaddhe mein dard ho to X-ray zaroori hai. Wahan ki chhoti haddi ki toot aksar nazar andaz ho jati hai.
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Questions people ask
Is my wrist pain carpal tunnel?
What is De Quervain's and how do I know I have it?
Should I wear a wrist splint all day?
I fell on my hand and it still hurts weeks later, is it just a sprain?
Can old wrist fractures cause pain years later?
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