A wrist sprain is the stretching and/or tearing of one or more ligaments in the wrist. A wrist sprain may cause pain, swelling, and reduced flexibility at the front, back, and/or either side of the wrist.
Wrist sprain injuries often result from the wrist bending back too far. This can happen falling on an outstretched hand, playing certain types of sports, or in motor vehicle accidents. 1 Andersson JK. Treatment of scapholunate ligament injury: Current concepts. EFORT Open Rev. 2017;2(9):382-393.
Ligaments of the Wrist
Ligaments are fibrous bands of tissue that connect two bones. Ligaments of the wrist connect the wrist’s carpal bones with each other or with the bones of the forearm (radius and ulna) or hand (metacarpals).
Depending on their location, the ligaments of the wrist can be broadly grouped into:
- Extrinsic ligaments that connect the carpal bones to the long bones of the forearm (radius and ulna) or the bones between the wrist and finger bones (metacarpals). Extrinsic ligaments include several volar radiocarpal ligaments, volar ulnocarpal ligaments, and dorsal ligaments.
- Intrinsic ligaments that connect the carpal bones to each other. Intrinsic ligaments include several proximal row ligaments, distal row ligaments, and palmar midcarpal ligaments.
Some of these ligaments also web together to form a capsule around the wrist joint, and provide strength, flexibility, and support to the wrist.
Commonly diagnosed wrist ligament injuries include 2 Chen NC, Jupiter JB, Jebson PJ. Sports-related wrist injuries in adults. Sports Health. 2009;1(6):469-77. :
- Triangular fibrocartilage complex (TFCC) injury. The TFCC is a small piece of cartilage that lies on top of the ulna bone (long bone of the forearm) and cushions the carpal bones. TFCC injuries result in damage to the radioulnar and ulnocarpal ligaments of the wrist.
- Scapholunate ligament injury. The most common type of wrist sprain results from damage to the scapholunate ligament, which connects the scaphoid and lunate bones. 1 Andersson JK. Treatment of scapholunate ligament injury: Current concepts. EFORT Open Rev. 2017;2(9):382-393. These injuries happen on a spectrum from partial injuries to complete tears depending on severity.
Wrist sprains may also result from injury to other extrinsic and/or intrinsic ligaments of the wrist.
Wrist Sprain Severity
Sprained wrists may involve one or more ligaments. Depending on the severity, wrist sprains are classified as follows:
- Stretch injury. This injury means the ligament has been stretched but not torn.
- Partial tear. This injury means the ligament is partially torn.
- Complete tear. This injury means the ligament is completely torn.
While most stretch and partial sprains may be treated with self-care and medications, other wrist sprains may need medical treatment to avoid long-term complications.
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Complications and Long-Term Outlook of Wrist Sprain
Severe ligament injury may cause damage to other ligaments, carpal bones, and cartilage in the wrist. 3 Biswas S, Philbin M. The Wrist Injury That Never Got Better. Eplasty. 2016;16:ic19. Published 2016 May 24. , 4 McCArty C, Goyal K. SCAPHOID NONUNION ADVANCED COLLAPSE: A REVIEW. Medical Research Archives. 2015; 3:1-8 For example, a piece of bone may get pulled off with the overstretched or torn ligament, resulting in an avulsion fracture. For the majority of avulsion fractures, the injury is managed based on the ligament injury rather than the bone injury.
See Is My Wrist Broken or Sprained?
In most cases, however, a wrist sprain may be well managed if treated appropriately without delay. If left untreated, severe wrist sprains may develop into wrist osteoarthritis over time.
See What to Do When a Wrist Injury Occurs
Both non-surgical and surgical treatments are used to treat wrist sprains.
When to Seek Medical Attention
Certain symptoms of wrist sprains may indicate serious conditions and require immediate medical attention. A few examples include:
- Severe swelling or bruising
- Sudden increase in pain and abnormal shape (deformity) in the wrist, hand, and/or forearm
- Inability to move or put pressure on the wrist that lasts several days
- Persistent numbness and/or tingling in the fingers, hand, and/or forearm
Such symptoms may indicate bone fractures or nerve injuries in the hand, wrist, or forearm region. Evaluation by a medical professional can help accurately diagnose wrist sprains and initiate appropriate treatment.