Wrist strains and wrist sprains are common injuries affecting the muscles and ligaments. Most can be treated at home without seeing a GP.
A wrist sprain occurs when the strong ligaments that support the wrist stretch beyond their limits or tear. This occurs when the wrist is bent or twisted forcefully, such as caused by a fall onto an outstretched hand. Wrist sprains are common injuries. They can range from mild to severe, depending on how much damage there is to the ligaments.
Ligaments are strong, fibrous tissues that connect bones to other bones. The ligaments in the wrist help to keep the bones in proper position and stabilize the joint.
Sprains can range from a stretch or tiny tear in the fibres that make up the ligament to a complete tear through the ligament or its attachment to the bone.
Grade of wrist sprain
Sprains are graded, depending on the degree of injury to the ligaments:
-
Grade 1 sprain (mild)
The ligaments are stretched, but not torn -
Grade 2 sprain (moderate)
The ligaments are partially torn. This type of injury may involve some loss of function -
Grade 3 sprain (severe)
The ligament is completely torn, or the ligament is pulled off its attachment to bone. These are significant injuries that require medical or surgical care. If the ligament tears away from the bone, it may take a small chip of bone with it. This is called an avulsion fracture
Cause
Wrist sprains are caused most often by a fall onto an outstretched hand. This might happen during everyday activities but frequently occurs during sports and outdoor leisure activities. You may sprain your wrist if you fall onto an outstretched hand.
Symptoms
A sprained wrist is painful. Other symptoms may include:
- Swelling
- Bruising
- Tenderness to touch
- A feeling of popping or tearing inside the wrist
- A feeling of warmth around the wrist
- Muscle spasms or cramping – Where your muscles painfully tighten on their own
Even a wrist injury that seems mild with minimal swelling could still involve a torn ligament or a small fracture
Therefore, after treating at home if symptoms persist medical help should be sought out. If you believe your injury is severe seek out medical assistance as soon as possible.
Treatment
Treatment for a wrist sprain depends upon the severity of the injury.
Home Care
Mild wrist sprains will usually improve with home treatment that includes the RICE protocol:
- Rest. Try not to use your wrist for at least 48 hours
- Ice. Apply ice immediately after the injury to keep the swelling down. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly on the skin. • Compression. Wear an elastic compression bandage or a wrist brace to reduce swelling
- Compression. Wear an elastic compression bandage or a wrist brace to reduce swelling
- Elevation. As often as possible, rest with your wrist raised higher than your heart
Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, can help reduce pain and swelling. If pain and swelling persist for more than 48 hours, however, see a doctor.
Nonsurgical treatment
Moderate sprains may need to be immobilised with a wrist brace for one week or more. Because immobilization may cause some stiffness in your wrist, your doctor may recommend some stretching exercises to help you regain full mobility.
There are a variety of wrist braces on the market and although at first glance they look to be simple wrist braces, there are a lot of factors to take into consideration.
Material
- Elastic - Many wrist supports are made from elastic, this offers compression to treat a sprain and retains body heat which improves blood flow to the sprain to speed up healing. However, elastic supports can contain latex and some elastics may only stretch in 1 direction, reducing the conformability of the brace. Some people may also find the heat retention to be too hot and sweaty for their day to day lives.
- Neoprene - The material offers compression to treat a sprain and can stretch in all directions offering improved conformity and superior fit. Neoprene also retains body heat improving the blood flow to the injury. However the heat retention can be too hot and sweaty for some people, especially if they have a physical lifestyle
- Ventilated Neoprene - Allowing airflow, the ventilation holes make for a cooler option for those with a more active lifestyle that may find a heat retaining brace too hot and sweaty. The material offers the compression required to treat a sprain and the all direction stretch offers improved conformity and superior fit. Whilst not offering improved blood flow through heat, it may not speed up the healing process like other heat retaining materials, but will be a more comfortable option.
Elastic
Standard Economy 7″ Wrist Brace
Neoprene
Bea Brace 7” Wrist Brace
Ventilated Neoprene
Bea Cool Wrist Brace
Make sure you get an appropriate fit. There are two types of Wrist Braces, Wrist and Wrist/Thumb. If you have injured your wrist, you do not require a Wrist/Thumb brace. You only require a Wrist/Thumb brace when your thumb is affected by your injury.
Make sure the webspace (the space between the thumb and the index finger) is free to allow thumb and finger movement. Make sure the brace conforms well around the wrist and is contoured along the forearm. Cheap wrist braces will be the same circumference along the whole length meaning they will dig in on the forearm. Lastly, consider the length as most braces come in a standard length which means the support will be inadequate for people with longer arms.
Support Fit
Quality
As with anything be prepared to pay a little more for quality. Generally, they will fit better and last longer.
Colour
NHS wrist braces are beige to look as neutral and discreet as possible, however that does not mean your wrist braces needs to be. Look for suppliers who offer a variety of colours if that is what you want. Children are often happier to wear a wrist brace if it is a colour they have chosen, making it easier to for parents and carers to keep up with the treatment. Be sure that it is in the material you want, however not all materials will come in all colours and you want a brace that helps provide you with excellent support and stability.
Surgical treatment
If your injury is more severe you may require surgical treatment.
Severe sprains may require surgery to repair the fully torn ligament. Surgery involves reconnecting the ligament to the bone or using a tendon graft to reconstruct the injured ligament. Your doctor will talk with you about which option is best in your situation.
Surgery is followed by a period of rehabilitation that includes exercises to strengthen your wrist and restore range of motion. Although the ligament usually heals in 8 to 12 weeks, it can take from 6 to 12 months for a full recovery. The length of the recovery process and your outcomes will depend on the severity of the sprain. You may be required to wear a wrist brace during some of this phase as well.