The goals of treating wrist sprains are to reduce pain and restore normal function of the wrist. Non-surgical treatments are usually adequate. A doctor may recommend surgery if the sprain is severe or non-surgical treatments have not achieved treatment goals.
Patients who do not get adequate treatment for traumatic wrist ligament injuries may get osteoarthritis of the wrist. 1 Gella S, Giuffre JL, Clark TA. Management of complications of ligament injuries of the wrist. Hand Clin. 2015;31(2):267-75.
Factors to be Considered Before Wrist Sprain Treatment
Before initiating treatment of a sprained wrist, the following factors are usually assessed:
- Condition of the ligament. Treatment options vary depending on the condition of the injured ligament. While some injuries may be treated with casts or braces, others may require minimally invasive or open surgeries to reconstruct or secure ligaments. 2 Pulos N, Kakar S. Hand and Wrist Injuries: Common Problems and Solutions. Clin Sports Med. 2018;37(2):217-243.
- Healing capacity of the ligament. If the ends of the injured ligament do not heal uniformly or if the ligament tissue gets inadequate blood supply, the healing potential of the ligament is considerably reduced. 2 Pulos N, Kakar S. Hand and Wrist Injuries: Common Problems and Solutions. Clin Sports Med. 2018;37(2):217-243.
- Status of surrounding structures. Healing is typically easier if the other ligaments in the wrist and the carpal bones are not injured. 2 Pulos N, Kakar S. Hand and Wrist Injuries: Common Problems and Solutions. Clin Sports Med. 2018;37(2):217-243.
- Condition of cartilage. The cartilage in the wrist may be injured at the same time as the ligament. Cartilage may also get damaged as a result of stresses on the joint following the ligament injury. 2 Pulos N, Kakar S. Hand and Wrist Injuries: Common Problems and Solutions. Clin Sports Med. 2018;37(2):217-243.
- Patient factors. Different treatment recommendations may be selected based on a patient’s health, age, activity level, biology (for example, being loose jointed), profession and recreational activities.
After considering all the factors, a doctor will make a recommendation for non-surgical or surgical treatment.
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Non-Surgical Treatments for Wrist Sprain
Certain mild wrist sprains may improve with non-surgical treatment. Common techniques to relieve pain from wrist sprains and promote healing are:
- The PRICE protocol. This protocol helps prevent further injury to the wrist by:
- Protecting the joint to avoid further injury and avoiding activities that put stress on the wrist
- Resting and giving time for the injury to heal
- Ice therapy to the injured area by applying ice packs at regular intervals with breaks in between to reduce swelling and numb the pain
- Compressing the wrist with a wrap or elastic bandage to minimize swelling and provide support
- Elevating the wrist above the level of the heart to prevent pooling of blood in the injured area
PRICE therapy is most effective shorty after an injury, especially in the first 24 to 72 hours.
- Wrist splint. Wearing a wrist splint or brace may help reduce excessive joint movement and sudden or unintended use of the wrist that may aggravate the sprain.
- Non-steroidal anti-inflammatory drugs (NSAIDS). NSAIDs are available over-the-counter (OTC) and may help relieve pain and swelling at the injured site following a wrist sprain. Examples of NSAIDs include ibuprofen (Advil) and naproxen sodium (Aleve). While not common, prescription strength NSAIDs may be recommended to maximize anti-inflammatory effects.
- Physical therapy. Physical therapy exercises help build strength, improve flexibility, and enable functional movements in the wrist. Exercises must always be performed within tolerated limits. A trained physical therapist can help design a treatment plan for sprained wrists depending on the level of injury.
- Return to work or play. It is advisable to not return to work or play until advised to do so by a doctor. Extra stress on a healing ligament may prevent complete healing or lead to further injury.
It is advisable to discuss self-care and use of over-the-counter medications with a doctor to prevent the risk of side-effects and other factors that may adversely affect the healing of wrist ligaments.