WRIST PAIN

Wrist Pain

Wrist pain is usually caused by sprains or fractures sustained from sudden injuries. It can also result from long-term arthritis, repetitive stress, and carpal tunnel syndrome. Since wrist pain is caused by many factors, the exact cause of the pain is often difficult to diagnose. An accurate diagnosis of wrist pain is important to administer the right treatment for the injury to heal as quickly as possible.

The specialists at Medical City Children’s Orthopedics and Spine Specialists are trained to treat issues with the wrist, whether neuromuscular, congenital, or trauma-related.

Causes of Wrist Pains

Most children sustain wrist injuries during sports or from accidental falls. Any injury that occurs at the end of a long bone around a joint can affect the growth plate and as such an evaluation should occur by an experienced pediatric orthopedic doctor.

Some of the causes of wrist pain include the following:

Sudden injury

A sudden injury can occur from a penetrating injury, direct blow, a fall, or the abnormal bending of a limb among others. The pain can occur suddenly and become severe. Such injuries can cause bruising and swelling. Examples of sudden injuries include:

• Bruising (which can extend to the fingers due to the effects of gravity)
• Injured ligaments
• Injured tendons
• Pulled muscles
• Injured joints (sprains)
• Fractures (wrist fracture)
• Compartment syndrome, caused by crushing injury

Overuse injuries

Overuse injuries are a result of excessive stress mounted on a joint or tissue. This usually occurs from doing an activity in excess. Examples of overuse injuries include:

• Tendon pain
• Carpal tunnel syndrome (caused by pressure on a nerve)
• De Quervain’s tenosynovitis (occurs in the wrist when the tendon covering the thumb side swells and becomes inflamed)

Wrist sprain

A wrist sprain can occur after a fall. It occurs when the ligaments are stretched beyond their limits. Ligaments are those connective tissues found in the body. In the wrist, we have ligaments that connect the bones in the arm to the bones in the hand. Sprains can be minor (whereby small tears occur in the ligament) or severe (whereby the ligament breaks).

Symptoms of a wrist sprain include swelling, pain, bruising, and tenderness around the injury. The child may also feel weakness in his or her wrist.

Wrist sprains are usually diagnosed clinically or through the use of an X-ray. If the sprain appears minor, the doctor can suggest the RICE treatment protocol (i.e. rest, icing the injured spot, compression of the injured area, and elevation of the wrist to reduce swelling). For severe sprains, the doctor may recommend a splint to stabilize the wrist for it to heal properly. If the wrist pain does not improve after 3 to 5 days, the sprain must get re-evaluated because a fracture might exist in the growth plate.

Buckle fracture

When a child’s wrist gets fractured, the child is usually diagnosed with a buckle fracture of the wrist. In this case, the bone gets compressed. Children’s bones are more flexible and also softer than those of adults. As a result, the bones may compress rather than break when sudden pressure becomes exerted.

Symptoms of a buckle fracture can appear similar to a sprain. Thus, proper evaluation, coupled with a high level of suspicion, is required. Watch out for pain, impaired mobility of the wrist, and bruises on the wrist. The doctor will likely ask for X-rays to ascertain the cause of the pain and swelling.

Buckle fractures in a child’s wrist can get treated with a cast or splint. Each of these treatment methods has its benefits and drawbacks. The doctor is in the best position to determine the best treatment option for the child’s condition. Casts are effective for completely immobilizing the injury and can help to reduce the pain. Splints may make it difficult to bathe and can also give room for some limited movement. Once the injury heals, the splint should get placed in the trash.

Scaphoid fracture

A scaphoid fracture refers to a condition in which the scaphoid bone is broken. The scaphoid bone is one of the carpal bones that is found at the joint of the hand and wrist. This fracture usually occurs when a child falls onto an outstretched hand; a common event on the playground. While it’s possible for the child to fall without sustaining an injury, if the child lands with his or her palm flat on the ground with the wrist bending backward, there is a high chance of having a scaphoid fracture.

Since scaphoid fractures are a form of breaking of the wrist, the patient will notice pain and swelling around the injured spot. It will also be difficult and there will exist some discomfort while articulating the wrist. Unlike a full break of the wrist, the scaphoid is a small and surrounded bone. As a result, the pain the child will feel will not be that severe. Many people usually detect the fracture when they visit a doctor weeks after sustaining the injury when the pain doesn’t subside.

The treatment for scaphoid fractures is similar to other wrist fractures. The procedure involves putting the arm in a cast for about 8 to 12 weeks so that the break can heal. If the fracture causes a bone to be displaced, then it needs surgery in order to move it back in place. The doctor will assess this by a CT scan or an X-ray.

Diagnosis of A Wrist Pain

The doctor will ask your child how he or she sustained the injury in his or her wrist. The specialist will also examine your child’s wrist and hand and ask about the signs he or she notices. The child may require X-rays, MRIs, or a CT scan to detect the actual problem. It is important to let the doctor know if the child is allergic to contrast liquid (since the liquid will be given to the child to make the pictures show up clearer during the scans). Since metals can cause painful injuries, let the doctor know if there is any metal in your child’s body.

Wrist Treatment

The treatment for wrist pain depends on the severity of the pain. The child may need any of the following treatment options:

NSAIDs

These include ibuprofen. They help in decreasing swelling, pain, and fever. This medicine is available at all drug stores.

However, NSAIDs can cause kidney problems and bleeding in some people. If the child takes blood thinner medicine, it is important to confirm with the doctor if NSAIDs are safe for the child. It is always advisable to read the label of the medicine and adhere to the instructions. NSAIDs should not be given to children that are below 6 months old without seeking the consent of a healthcare provider.

Acetaminophen

This decreases fever and pain. It is also available without a doctor’s order. Ensure you know the quantity to give your child and how to use it. Read the labels of the medicine and follow the instructions. You should also ask your child’s doctor about the right way to use the medicine. Acetaminophen is capable of causing liver damage if it is wrongly used.

Splint or cast

This supports the child’s wrists and prevents the injury from worsening.

Surgery

Surgery may be required if the injury is severe. Arthroscopy can be carried out to examine the interior of the child’s wrist joint and fix the ligament damage. The procedure uses a scope that is inserted into the wrist joint via a small incision. Open surgery may be required to reconnect torn ligaments to the bone.

Physical therapy

Physical therapy can be recommended so that your child can learn exercises that will improve the movement and strength of the wrist. The exercises will also reduce pain.

Prevention of Wrist Pain

Since wrist pains usually occur during an accidental fall, preventing them is basically impossible.  However, a wrist guard is usually worn in sports like rollerblading, ice skating, or skateboarding to protect the wrist in case the child falls.

A safe playing environment prevents sustaining wrist injuries. Ensure you check your child’s playing field before any game or practice to get rid of unnecessary equipment, sharp objects, large holes, or wet surfaces. You can prevent falls by being aware of your surroundings.

Schedule An Appointment For Your Child’s Wrist Pain Evaluation

If you think that your child has wrist pain, taking them to a specialist with X-ray capabilities is the right step to take. The specialist will check out the spot that is paining the child and will also carry out the necessary diagnosis. If you are in Arlington, Dallas, Frisco, or Mckinney areas, bring your child to Medical City Children’s Orthopedics and Spine Specialists where our state-of-the-art diagnosis system will help to detect the cause behind your child’s wrist pain.

Our board-certified physicians and fellowship-trained orthopedic surgeons will provide comprehensive care for your child’s wrist needs. Our specialists are adept at caring for children and they can provide your child with the required physical therapy, casting, splinting, or surgery that will tackle the wrist pain. We provide personalized wrist pain treatment that will address the specific needs of your child.

To learn more about how we can help with your child’s wrist pain, schedule a free consultation today by calling one of our specialists at 214-556-0590.