Ligament Injuries
Causes
Wrist sprains are usually caused by falls or sudden twisting motions where the wrist is bent backwards or into an abnormal position.
Thumb sprains are common in sports and falls when the thumb is either jammed into another player, the ground or a ball, or when the thumb is bent into an extreme position. One or more ligaments can stretch or tear.
Signs and Symptoms
A sprained wrist is often swollen and painful, especially with motion. There may be bruising. Pain and swelling can develop over several days and may last anywhere from a few days to a number of weeks.
The thumb or hand usually swells and may bruise. Pain might last for only a week or two. After that, the usual problem is function. You might have trouble writing, turning a doorknob, or holding a drinking glass. Sometimes this is felt as pain and sometimes weakness.
Diagnosis
Your doctor will examine your wrist to see where it hurts and to check how it moves. X-rays are often taken. The purpose of the exam and X-rays is to make sure there are no broken bones, dislocated joints, or signs of a full ligament tear (Figure 3). In some cases, if a wrist sprain does not improve after a period of waiting, your doctor may order additional imaging to see if there are injuries that cannot be seen on X-ray or during a physical exam.
Treatment
Wrist sprains are usually treated without surgery. Ice and a splint or gentle wrap may be helpful for the first few days after a wrist sprain. Treatment typically involves resting the injured wrist and wearing a splint as needed until symptoms improve, which may take up to 6 weeks. Prescription pain medications are not usually recommended. If symptoms don't improve after a reasonable period of time, additional imaging may be ordered to look for a more serious injury.
X-rays can show whether the bones of the thumb and hand are broken. Your doctor will examine the thumb to determine whether the ligament is torn. Some tears can be treated using a splint or a cast. Other tears need to be fixed surgically.
If the injury is chronic, the ligament might not be able to heal even with treatment. In these cases, a new ligament sometimes is created using a tendon. If there is arthritis at the joint, fusing the joint so that it does not move at all might be the best option.
Associated Injuries
Sometimes, a small piece of bone can be pulled off one of the wrist bones, called an avulsion. These small fractures frequently do not require surgery and may heal on their own.
Prognosis
Wrist sprains typically heal well, with minimal or no long-term symptoms. Healing can often take several weeks, but recovery is usually excellent.