Sprains are injuries to ligaments, the strong bands of connective tissue that connect bones to one another. As our hands and wrists are among the most used ligaments in our bodies, wrist sprains are among the most common. The wrist contains multiple ligaments that can be easily stretched or torn, which happens when the joint is forcefully bent – during a fall for example.
Wrist sprains vary widely in severity. As such, they are graded on a scale of 1 to 3 based on the severity of damage to the ligaments.
- Grade 1 – This is the mildest form of sprain, and occurs when the ligaments are stretched but do not tear.
- Grade 2 – Moderate sprains such as these occur when the wrist ligaments are partially torn but do not separate completely. There may be some loss of function.
- Grade 3 – This is the most severe form of a wrist sprain, and involves complete tearing of a ligament. Something this severe will require medical care, and in some cases can tear a small amount of bone away when the ligament separates. This is known as an avulsion fracture.
Wrist sprains are typically caused by falling onto an outstretched hand and can happen during anything from sports and outdoor recreation to an unexpected trip and fall at home.
Depending on which ligaments are injured, a wrist sprain can vary in location and severity. Common symptoms include:
- Wrist swelling
- Pain at the moment of injury
- Lingering or persistent pain when moving the wrist
- Bruising or discoloration in the affected area
- Tenderness at the site
- Popping or tearing feelings within the wrist
- Warmness in the area surrounding the wrist
Even if a sprain feels mild, an important ligament that becomes injured can require surgery to avoid issues in the future. Alternatively, a fracture can sometimes be mistaken for a sprain, and if left untreated can require surgery.
To determine whether you have a sprain or fracture, your doctor may order an imaging test.
- X-ray – Though it won’t show a ligament injury, an X-ray will help determine if your injury is fracture-related.
- Other testing – Typically either an MRI scan or CT scan will be ordered in order to examine wrist ligaments.
Mild wrist sprains are often treatable using the RICE method.
- Rest the joint for at least 48 hours.
- Ice the injury to reduce swelling.
Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice or a package of frozen vegetables. Apply ice for about 20 minutes at a time.
- Compress the swelling with an elastic bandage.
- Elevate the injury above the level of the heart.
Moderate sprains sometimes need to be immobilized with a wrist splint, accompanied by stretching exercises afterward to return full mobility to the wrist.
Severe sprains may require surgery under some circumstances in order to reconnect the ligament to the bone. Surgery will be followed by a period of rehabilitation to re-strengthen the wrist, and the entire process can take several months to return the wrist to original condition.