Ulnar wrist pain, Ulnar-sided wrist pain
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Ulnar wrist pain refers to discomfort or pain experienced on the outer side of the wrist, which is the side closest to the little finger or pinkie finger. This kind of wrist pain can have many causes, like bone issues, tendon problems, or ligament injuries.
It is called ulnar wrist pain because it is near the ulna, one of the two bones in the forearm. Many injuries and medical condition can cause this, such as arthritis, overuse, infection, nerve injuries or compression, among others. Treatments are often administered depending on the cause.
Symptoms
Ulnar wrist pain can happen whether a person is resting or moving. Common symptoms include:
- A popping or clicking sound with sharp pain during movement
- Pain that gets worse when the wrist is twisted or gripped
- Reduced wrist mobility, especially when rotating the forearm or moving the wrist toward the pinkie side
- Loss of grip strength due to pain
Causes
Ulnar wrist pain can be challenging to diagnose because there are many potential causes. However, the most common causes are:
- Arthritis: involves inflammation and stiffness in the wrist joint and can result from osteoarthritis (wear and tear), rheumatoid arthritis (an autoimmune condition), or gout/pseudo-gout (caused by crystal deposits).
- Sudden impacts: Fractures can lead to ulnar wrist pain, either from recent breaks or old injuries to specific wrist bones like the ulnar styloid or pisiform. Falling onto an outstretched hand is a common way for wrist injuries to occur.
- Nerve injuries or compression: This may cause ulnar wrist pain if there is damage or pressure on nerves, such as the ulnar nerve, either in the wrist or higher up in the arm or neck.
- Repetitive stress: Overuse injuries due to repetitive motions or excessive strain can damage tendons and ligaments, leading to pain. Repeated wrist motion exercises can lead to stress fractures or inflammation of the surrounding tissues.
- Infection: Often from previous injuries or underlying health issues, can also lead to ulnar wrist pain.
Risk factors
Several risk factors can increase the risk of having ulnar wrist pain, such as:
- Engaging in sports: Some sports, like football, golf, tennis, and pickleball, can lead to wrist injuries due to either impact or repetitive stress.
- Other medical conditions: Individuals who have gout, osteoarthritis, rheumatoid arthritis, or loose ligaments in general are susceptible.
- Repetitive work: Work that requires awkward wrist positioning like carpentry or plumbing, and jobs that involve constant use of a computer mouse or keyboard, can increase the risk of ulnar wrist pain.
Diagnosis
Diagnosing ulnar wrist pain typically involves a comprehensive approach that includes reviewing the individual’s medical history, conducting a thorough physical examination, and performing various tests. The healthcare provider may inquire about relevant medical conditions such as gout, diabetes, or previous infections that could be associated with wrist pain. Additionally, they may explore any past wrist injuries and whether the pain onset was sudden or gradual.
During the physical examination, the healthcare provider will palpate the wrist area to assess for signs of swelling, redness, masses, scars, tenderness, or deformities. They will also evaluate the wrist’s range of motion, strength, and pinpoint specific areas of discomfort to gain insight into the underlying cause of the pain.
Tests that may be ordered include:
- X-ray: These show the alignment of bones in the wrist and forearm. They can help identify fractures, arthritis, deformities, signs of infection, or tumors. This is the most frequently used test for this condition.
- MRI: Rather than using whole-body MRI equipment, one might be able to place the arm within a smaller equipment for a wrist MRI. This test can check at soft tissues like tendons, ligaments, blood vessels, and nerves. It can also detect abnormal growths.
- CT scan: CT scans provide more detailed images and can detect subtle fractures, check how fractures are healing, assess bone alignment, evaluate ligament tears, and examine blood flow in arteries for blockages.
- Ultrasound: This test is helpful for finding foreign objects in the wrist, examining tendons for ruptures or tendinitis, detecting compressed nerves, checking blood flow, and assessing unusual growths.
Treatment
The treatment for ulnar wrist pain varies depending on what is causing it. Treatment options include:
- Pain relievers: Common approaches to reduce pain include taking anti-inflammatory medications like naproxen or ibuprofen or getting steroid injections. Some are available over the counter, while stronger ones require prescription.
- Physical therapy: In certain cases, a cast, brace, or splint is used to immobilize the wrist so that the damage can heal. Strengthening tendons and ligaments can be achieved with physical therapy. One might also need to adjust how they use their hands during repetitive tasks for better ergonomics.
- Surgery: If the pain is due to a more serious issue like growth, nerve compression, tendon or ligament tears, fractures, or arthritis, surgery might be required. This could involve open or minimally invasive (arthroscopic) surgery, and sometimes even joint replacement.
There are variety of techniques in minimally invasive surgery that entails less physical harm than in open surgery. This may result in less discomfort, a quicker hospital stay, and fewer issues.
