A wrist sprain is an injury to the ligaments that connect the small bones of the wrist (called the carpal bones). The ligament that most frequently undergoes this trauma is the scaphoid-lunate ligament that connects the scaphoid bone with the lunate one. The severity of wrist sprains varies greatly based on the level of stretch or tear in the tissues. The severity of the injury also determines whether you can treat it at home or if you need to see a doctor.
Steps
Part 1 of 3: Treating a Mild Sprain
Step 1. Rest your wrist and be patient
Minor sprains are often caused by repetitive movements or hyperextension of the joint due to falling onto the outstretched hand. Take a break from tasks that require constant movement if you think they are the cause of the injury. Talk to your boss to get you assigned different tasks for a week or so. If the sprain is related to physical activity, it means you have performed too hard or improperly - if so, ask a gym instructor for advice.
- A slight sprain is often classified as a first degree sprain; this means that the ligaments have been pulled a little too much, but not significantly.
- In this type of injury there are: tolerable pain, mild inflammation or swelling, some movement limitations and / or wrist weakness.
Step 2. Apply ice
It is an effective treatment for almost all minor musculoskeletal injuries, including wrist sprains. Place the cold pack on the most painful area to control swelling and pain. You should hold the ice pack for 10-15 minutes every 2-3 hours for a couple of days and then reduce the frequency as the pain and edema wear off.
- By compressing the ice pack on your wrist with an elastic band, you are able to control inflammation. Be careful not to over-tighten the bandage, as a complete disruption of blood circulation causes more damage to the hand and wrist.
- Always wrap the ice or frozen gel pack in a thin cloth to avoid chilblains.
Step 3. Use a basic support device
By wrapping the wrist with an elastic bandage, kinesiology tape, or a simple neoprene cuff, you provide some support to the joint and can keep the ice pack compressed on the wrist with greater ease. However, the greatest benefit is psychological: the bandage is a reminder not to strain your wrist for a short period of time.
- Bandage the wrist starting from the knuckles up to the middle of the forearm, partially overlapping each coil of elastic bandage on the previous one as you go.
- The bandage, neoprene cuff, or kinesiology tape should be snug but not cut off blood circulation - make sure your hand doesn't turn blue, cold, or start tingling.
Step 4. Do some light hand stretching exercises
Once the pain has subsided, you can do some gentle stretching if you feel joint stiffness. This type of exercise benefits sprains and mild jerks because it can relieve tension, improve circulation, and increase flexibility. Generally, hold the stretch position for about 30 seconds and repeat 3-5 times a day until your wrist is fully mobile.
- You can stretch both wrists at the same time by bringing your hands into the "prayer position": palms resting together in front of the face and elbows bent. Apply pressure to your hands by lifting your elbows, until you feel a gentle stretch in your injured wrist. If you need other exercises, ask your doctor, trainer or physical therapist for advice.
- Consider applying moist heat to the joint before stretching it - this will make the tendons and ligaments more elastic.
Part 2 of 3: Treating a Moderate Sprain
Step 1. Take an over-the-counter medication
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or aspirin, are a short-term solution for treating fairly severe pain or inflammation. Remember that these medicines are quite aggressive on the stomach, kidneys and liver; therefore do not take them for more than two weeks at the most. Do not give aspirin to children and young people under the age of 18.
- Ask your doctor for advice before starting a new drug therapy, if you have any medical condition, are already taking other medicines or have any drug allergies.
- Alternatively, you can apply pain-relieving creams or gels directly to the injured wrist.
- By keeping the joint elevated, you can control swelling.
- Moderate sprains are typically considered second degree and involve fairly severe pain, inflammation, and often a hematoma from a torn ligament.
- This type of injury causes a greater feeling of wrist instability and more severe hand weakness than first degree sprains.
Step 2. Be more consistent with ice application
Second-degree or moderate trauma involves greater edema because the ligament fibers are torn even if not completely broken. For this reason, it is necessary to apply ice with greater diligence, in addition to taking some anti-inflammatory drugs. The sooner you treat a second-degree sprain with ice the better, because the caliber of the blood vessels is reduced by decreasing the blood supply and the swelling that results from it. In severe cases, the cold pack should be applied for 10-15 minutes every hour for the first day or two; then the frequency is lowered as the pain and edema fade away.
If you don't have ice or a cold pack, you can use a pack of frozen vegetables - pea or corn are perfect
Step 3. Put on a brace or splint
Since joint instability and weakness are more problematic in a second degree sprain, it is necessary to use a splint or brace that offers more support. In this case, it is not primarily psychological help, because these devices reduce movement and offer important support, should you need to use your hand for some task.
- Ask your doctor what type of brace or splint you should wear.
- Be sure to keep your wrist in a neutral position as you squeeze the device around the joint.
- Second degree sprains should be immobilized with a brace or splint for 1-2 weeks, after which there is often stiffness and reduced range of motion in the wrist.
Step 4. Plan a rehabilitation path
When the injury begins to heal after a few weeks, you need to do exercises to regain strength and mobility. You can do this at home or have a physiotherapist show you specific and personalized movements to strengthen your wrist and hand.
- Try squeezing a stress ball to increase muscle strength after your wrist has healed: keep your arm outstretched with your palm facing up, squeeze a rubber ball (racquetball is perfect) for 30 seconds at a time and repeat 10-20 times throughout the day.
- Other suitable activities are light weight lifting, bowling, racket sports, and gardening (weeding and so on). Do not engage in these physical exercises until you obtain the consent of your doctor or physical therapist.
Part 3 of 3: Seeing a Doctor
Step 1. Go to the doctor
In situations where the wrist has suffered severe trauma with excruciating pain, swelling, hematoma and / or loss of motor function in the hand, it is best to go to the emergency room or at least to the family doctor immediately to get a correct diagnosis. Third-degree sprains involve a complete tear of the ligaments, which must be repaired with surgery. Your doctor might evaluate for a fracture, dislocation, inflammatory arthritic disease (such as gout or rheumatoid arthritis), carpal tunnel syndrome, infection, or severe tendonitis.
- Your doctor may use x-rays, bone scans, MRIs, and nerve conductivity studies to diagnose your wrist problem. He may also have a blood test to rule out gout or rheumatoid arthritis.
- You should also see your doctor if your symptoms get worse or haven't gone away after two weeks or more of home treatments.
- Other symptoms that may suggest a fracture are severe swelling, bruising, painful touch, deformity of the joint and the dynamics of the accident (trauma resulting from a sport or a fall on the wrist).
- Children are more prone to wrist fractures than sprains.
Step 2. Go to a chiropractor or osteopath
These professionals specialize in joint care, especially in restoring normal mobility and function of the spine and peripheral joints, including the wrist. If the trauma primarily involves a misaligned or slightly dislocated carpal bone, the chiropractor / osteopath will try to bring it back into the correct position with manipulation (or realignment). A "creak" or "crackle" can often be heard during the procedure.
- Although a single manipulation session can completely eliminate pain and restore the full range of motion, a few sessions are more likely to be required to notice significant results.
- Wrist manipulation is not suitable for fractures, infections or inflammatory arthritic diseases.
Step 3. Discuss wrist injections with your doctor
Administering corticosteroids directly into the ligament, tendon or joint can quickly reduce inflammation, as well as allow for normal, painless movement of the wrist. Cortisone injections are only indicated for severe or chronic sprains. The most used drugs are prednisolone, dexamethasone and triamcinolone.
- Potential complications of these therapies are: infection, haemorrhage, weakening of the tendon, localized muscle atrophy, nerve damage and irritation.
- If corticosteroid injections are not effective in resolving the problem, surgery should be considered.
Step 4. Discuss the possibility of an operation with your doctor
This is a last resort for chronic sprains and should only be considered when all other non-invasive therapies have proved ineffective. However, if you have suffered a third-degree sprain, the operation will be the first option to repair the torn ligaments. Wrist surgery involves rejoining the torn ligament to the corresponding carpal bone; Sometimes it is necessary to implant pins or plates to ensure stability.
- It takes 6-8 weeks to heal from this operation, although several months of rehabilitation are then required to regain strength and range of motion.
- Possible complications of surgery are local infection, anesthetic allergy, nerve damage, paralysis, and chronic pain / swelling.
Advice
- If you have had a new injury or the symptoms are more than mild, it is best to go to the doctor for a check-up before starting treatment.
- Chronic and recurring wrist sprains, caused by past injuries to poorly treated ligaments, can eventually lead to arthritis.
- Wrist sprains are usually the result of a fall; so be careful when walking on wet or slippery surfaces.
- Skateboarding is a high risk activity for wrist injury, always wear protective gear.
