What Is a Sprained Wrist?
A sprained wrist is damage to a ligament in the wrist. Though they share many symptoms with fractures—including pain and limited range of motion—sprains are injuries to the soft tissue that connects bones to each other, while fractures are injuries to the bones themselves.
There are many ligaments of the wrist, but two of the more commonly sprained ones are the scapholunate ligament, which connects the scaphoid and lunate bones, and the triangular fibrocartilage complex on the outside of the wrist. Sprains, including wrist sprains, are classified into three grades depending on severity:
- Grade 1 – the ligament is stretched but not torn
- Grade 2 – the ligament is partially torn
- Grade 3 – the ligament is torn in two or it’s pulled off of one of the bones to which it attaches
Causes and Risk Factors
Almost all wrist sprains occur from a fall onto an outstretched hand. It is a natural reaction to try to catch oneself when falling, but the impact of an adult falling from standing height can easily injure the ligaments in the wrist. These falls can happen in everyday life or while playing sports.
Symptoms of a wrist sprain include:
- A popping or tearing sensation upon landing on the hand
- Limited wrist mobility
- Swelling or tenderness
Getting a diagnosis from a physician is especially important for a wrist injury because sprains and fractures share so many symptoms. Many wrist fractures are also caused by falls onto an outstretched hand. Wrist sprains and wrist fractures can be present at the same time. Additionally, wrist sprains can cause a type of fracture called an avulsion fracture, where a small piece of bone attached to the ligament is pulled away from the larger bone mass.
Doctors will usually start with a medical history and physical examination. An X-ray will often be the first imaging test ordered because X-rays can show fractures and abnormal relationships between bones. Additional imaging may be required such as an MRI or CT scan at the doctor’s discretion.
Treatment for a sprained wrist will depend on its grade. Often, grade I sprains can be treated with conservative care at home. Most sprains, no matter their grade, will benefit from the RICE (rest, ice, compression, elevation) protocol immediately following a fall onto an outstretched hand. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to control pain and swelling after a wrist injury.
Grade II sprains may need to be immobilized for a week or more after the injury. This immobilization is usually accomplished with a wrist splint or a brace.
Grade III sprains may need surgery to repair a fully torn ligament. This surgery may involve either reattaching the ligament to a bone from which it has pulled away, or using a tendon to reconstruct the ligament.
After surgery for a sprained wrist, physical therapy or hand therapy may be ordered to strengthen the wrist and return range of motion. The ligament will usually heal in two to three months, but it may take six months to a year for the wrist to return to its full functionality.