Wrist/Hand Sprain/Strain

A wrist/hand sprain or strain involves an injury to the soft tissues of the wrist, hand or fingers.    Sprains involve injury to ligaments (the bands of tissue that connect bones together) within the joint and commonly occur in the wrist or fingers.  Strains refer to injuries of muscles and tendons and are less likely to occur than sprains in this region.  


What causes a Wrist/Hand Sprain/Strain?

Most wrist or hand sprains occur from an accident or traumatic impact, such as a fall or direct and forceful contact, causing the hand or wrist to twist sharply or bend in an unnatural motion.  Wrist and finger sprains are common injuries due to the fact that when an individual slips or falls, the natural reaction is to put a hand out to stop the fall and when this occurs, the force of the impact can bend the wrist or finger in such a way that the ligaments stretch or tear.  Strains can also occur from a sudden impact such as a fall, but are also likely to occur due to repetitive overuse, such as in the case of sports or occupations that require constant gripping of objects or a repeated hand or wrist motion.


What are the symptoms of a Wrist/Hand Sprain/Strain?

Symptoms of wrist or hand sprains may include pain, swelling, tenderness, bruising, stiffness and decreased motion.  In cases of more severe sprains, you may feel a tearing or popping of the ligaments when injury occurs.  Strains cause symptoms such as pain, swelling, inflammation, muscle spasm, cramping, and loss of strength.


How is a Wrist/Hand Sprain/Strain diagnosed?

A medical professional will perform a physical exam and will ask questions related to when the symptoms began, what activities caused the symptoms, what worsens or relieves symptoms, and the relative severity of symptoms.  Pressure will be placed on the areas of suspected injury to identify swelling, tenderness, bruising and pain.  Patients may be asked to perform certain movements to determine range of motion limitations, stability of the joint, muscle strength, and to identify what increases or decreases pain.  The injured wrist or hand will also be compared to the healthy one.  X-rays may be ordered to rule out fractures.  Magnetic resonance imaging (MRI) and arthrograms can provide a better view of the ligaments, tendons and muscles within the wrist or hand.


When should I seek care for a Wrist/Hand Sprain/Strain?

If you fall on an outstretched hand, receive a direct impact to the wrist or hand that causes continued pain and swelling, or if you have pain, stiffness, muscle spasm or limited mobility following any activity that does not improve with home treatments (rest, ice, over the counter medications), you should seek the advice of a medical professional.  If the injury is severe, is accompanied by a loss of function of the joint or muscle, or you suspect that a bone fracture may have occurred, you should seek immediate medical attention.


What will the treatment for a Wrist/Hand Sprain/Strain consist of?

Treatment for mild and moderate wrist and hand sprains and strains (grades I and II) begins with rest, application of ice, compression, elevation, and avoidance of activities that exacerbate pain.  Nonsteridal anti-inflammatory medications can be taken to reduce pain and swelling.  The hand, wrist or arm may be immobilized temporarily with a splint, bandage, or soft cast.  For more moderate sprains and strains, physical therapy is recommended and may include massage, therapeutic ultrasound and heat therapy, followed by stretching, range of motion and strengthening exercises as the injury improves.  More severe sprains and strains (grade III) involve a complete tearing of the ligament, tendon or muscle and typically require surgery followed by a rehabilitation program to regain strength and flexibility.


Which muscle groups/joints are commonly affected by a Wrist/Hand Sprain/Strain?

Wrist and hand sprains and strains affect the ligaments, tendons and muscles in the wrist, hand and fingers.


What type of results should I expect from the treatment of a Wrist/Hand Sprain/Strain?

Most patients with mild or moderate wrist or hand sprains and strains (grades I and II) will completely heal with conservative treatments (or no treatment other than temporary rest of the area) within a few weeks to a couple of months.  For more severe injuries, surgery may be required, but is generally successful as long as the proper course of rehabilitation is followed after surgery.  If injuries are not allowed to heal completely before resuming regular activities, there is a risk of re-injury.  In the case of strains, a modification may need to be made in daily activities to avoid additional repetitive overuse of the area so that injury does not recur.

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