Wrist pain can be very unbearable, as it is usually felt when the patient is at rest not using his/her wrist and increases and becomes even sharper with wrist use. Because, we use our wrists in all everyday’s normal activities, wrist pain worsens and makes it almost impossible for the patient to perform daily tasks or sports.

The pain may be manifested as aching, numbness, burning sensation, tingling in the wrist, palm, or fingers. The thumb muscle may be affected due to the wrist pain which makes it difficult for the patient to hold things easily. Wrist pain is seen in individuals of all ages and most commonly affects males and females of middle age or older.

Wrist pain can be caused by one or more disorder; these include:

1. Carpal Tunnel Syndrome:

This condition occurs when the median nerve (that runs through the forearm to the palm of the hand connecting the thumb and all fingers except for the little finger) becomes pressed at the wrist.

– The carpal tunnel is a thin passageway located in the wrist where the median nerve, tendons and certain muscles of the hands pass through. When this tunnel becomes narrowed it compresses the median nerve, causing a painful, progressive condition called “Carpal Tunnel Syndrome”.

– This syndrome results in sharp and piercing pain in the wrist and hand and could even radiate to the arm. The condition may also cause weakness and sometimes numbness in the wrist and hand.

2. Tendonitis:

It’s caused by the irritation and inflammation of one or more of the many tendons surrounding the wrist joint which causes swelling and results in pressuring the wrist nerves.

– This condition causes wrist pain as well as pain in the fingers that increases with using the hand and thumb. The pain may appear gradually or suddenly and sometimes radiate to the forearm hindering the patient’s ability to perform daily tasks involving the wrist.

– With some patients, swelling might be seen at the thumb side of the wrist. Numbness can also be felt on the index finger or the back of the thumb. Stiffness can be present as well which along with the pain and swelling restricts the patient’s ability to move his/her wrist.

– The most common type of tendinosis is called de quervain’s tenosynovitis, involving the first extensor compartment.

3. Arthritis:

Arthritis is a disease that affects the cartilage in joints and occurs due to the inflammation of a joint and the soft tissue around it. Arthritis of the wrists and hands is very common amongst a big number of patients. It mostly affects elderly and is more common in females than it is in males. Most wrist pain is caused by two main types of Arthritis, these are:

– Osteoarthritis: this progressive condition destroys the smooth articular cartilage covering the bone ends resulting in cartilage loss. This causes the bones to rub against each other with no cartilage cushioning which results in pain, stiffness, and weakness in the wrist and hand.
– Rheumatoid arthritis: this chronic autoimmune disease attacks several joints throughout the body starting with the smaller joints like in the hand and wrist. This causes joint deformation in the wrist and /or fingers making it very difficult to do normal daily activities.

4. Fracture:

A wrist fracture or break may occur in any of the wrist bones if the wrist is forcefully blown or hit such as in a car accident or a high fall. Also when the patient has Osteoporosis (a condition where the bone becomes thinner and fragile) he/she becomes more susceptible to fracturing the wrist. Breaking one of the wrist bones causes severe pain and swelling and is generally diagnosed with an x-ray and requires placing a cast on the wrist.

5. Sprain:

There are many ligaments in the wrist that connect one wrist bone to the other. Sometimes one or more ligament can be stretched or torn commonly known as a “sprain”. There are three grades of wrist sprains according to the degree of injury caused to the ligaments. The higher the grade, the worse the pain is and the bigger the function loss becomes.

This technique uses FDA approved medication, which is injected, directly into the pain area under ultrasound guidance. This technique has the following benefits:

– Helps the radiologist to accurately identify the inflamed tendon or bursa, which is important to confirm the clinical examination.

– Allows the radiologist to accurately localize and effectively administer the medicine to one or more compartments of the painful area “if necessary” resulting in better and faster pain relief.

– The patient benefits the most by having the medication in the right spot without pain or complications.

– The patient is injected a numbing local anesthetic. A mild burning sensation can be felt due to the numbing anesthetic.

– The radiologist then uses an ultrasound probe to guide the needle to the painful area.

– The medication is then injected in the exact location.

– The injection needle is then removed.

– The patient can leave immediately after the injection. Some patients may be asked to wait for re assessment.

– After the procedure the patient may experience complete relief of pain.

– The maximum effect of the medications may take up to 2 weeks to show the maximum effect.

-The patient is instructed to use painkillers during the first few days if needed.