Wrist

Carpal Tunnel Syndrome (CTS) is one of the most common nerve compression disorders affecting the wrist. It occurs when the median nerve, which travels through the carpal tunnel, becomes compressed due to swelling or inflammation.

Symptoms Include:

• Numbness or tingling in the thumb, index, middle, and part of the ring finger 
• Weak grip or dropping objects 
• Pain that may radiate up the arm 

Risk Factors:

• Repetitive hand motions (e.g., typing, using tools) 
• Rheumatoid arthritis 
• Hormonal changes during pregnancy or menopause 
• Diabetes and thyroid dysfunction 

Treatment Approaches:

• Conservative: Wrist splints, ergonomic modifications, nonsteroidal anti-inflammatory drugs (NSAIDs) 
• Injections: Corticosteroids to reduce inflammation 
• Surgical: Carpal tunnel release, a minimally invasive procedure to decompress the nerve 

Left untreated, CTS can lead to permanent nerve damage and muscle atrophy. Diagnosis is typically confirmed through clinical exams and nerve conduction studies. Early intervention greatly enhances recovery, and modern surgical techniques allow for reduced downtime and faster healing. With proper ergonomics and preventive care, recurrence rates can also be minimized.

Wrist sprains and fractures often result from falls onto an outstretched hand. These injuries range from mild ligament overstretching to complete bone breaks and require prompt attention to avoid long-term dysfunction.

Types of Wrist Fractures:

• Distal Radius Fracture: Most common type, especially in older adults 
• Scaphoid Fracture: Often missed initially but critical due to limited blood supply 
• Ulnar Styloid Fracture: Occurs in conjunction with radius fractures 

Sprain Classifications:

• Grade I: Mild stretching of ligaments 
• Grade II: Partial tear 
• Grade III: Complete rupture 

Symptoms May Include:

• Swelling and bruising 
• Limited range of motion 
• Pain when moving or bearing weight 

Management Options:

• Immobilization using splints or casts 
• Ice application and elevation 
• Surgical fixation with plates or screws for complex fractures 
• Physical therapy post-healing 

Accurate diagnosis using X-rays or MRI is vital to differentiate between sprains and fractures. Inadequate treatment can lead to chronic instability or reduced wrist function. Proper rehabilitation ensures full recovery and minimizes complications such as stiffness or post-traumatic arthritis.

Tendonitis in the wrist arises when tendons become inflamed due to repetitive strain, overuse, or sudden trauma. It often affects individuals whose occupations or activities involve repetitive wrist movements, such as athletes, office workers, or manual laborers.

Common Conditions:

• De Quervain’s Tenosynovitis: Affects tendons near the base of the thumb 
• Extensor Tendonitis: Inflammation of the tendons on the back of the hand 
• Flexor Tendonitis: Pain and swelling along the palm side of the wrist 

Typical Symptoms:

• Pain during movement 
• Swelling or warmth over the affected area 
• Difficulty gripping or twisting objects 

Treatment Protocols:

• Rest and immobilization using wrist braces 
• Cold compresses to reduce inflammation 
• Anti-inflammatory medications (NSAIDs) 
• Targeted physiotherapy and ultrasound therapy 
• In severe cases, corticosteroid injections or surgical intervention 

Ignoring tendonitis can lead to tendon degeneration and rupture. Early recognition and modification of contributing activities are crucial to avoid chronic injury. Stretching routines and ergonomic adjustments help prevent recurrence. Comprehensive rehabilitation focuses on restoring strength, reducing inflammation, and gradually reintroducing load-bearing activities.

Wrist arthroscopy is a minimally invasive surgical procedure used to diagnose and treat a variety of joint issues. Using a small camera (arthroscope), surgeons can view internal wrist structures and perform repairs without the need for large incisions.

Indications for Arthroscopy:

• Chronic wrist pain 
• Ligament tears or ganglion cysts 
• Carpal bone instability 
• Removal of loose bodies or inflamed tissue 

Advantages of Wrist Arthroscopy:

• Minimal soft tissue damage 
• Faster recovery time 
• Reduced postoperative pain and infection risk 
• Precise diagnostic capability 

Surgical Procedures May Include:

• Ligament reconstruction 
• Bone realignment (osteotomy) 
• Arthrodesis (joint fusion for severe arthritis) 
• Carpal tunnel release 

Postoperative Care:

• Short immobilization followed by guided rehabilitation 
• Pain management with oral medications 
• Gradual return to activity under supervision 

Wrist surgery is typically considered when conservative treatments fail. High-resolution imaging and real-time arthroscopic visuals allow for accurate and targeted interventions. With skilled surgical execution and adherence to postoperative protocols, most patients regain substantial wrist function and experience lasting pain relief.

Recovery from wrist conditions, especially post-surgery or after severe injury, involves a structured rehabilitation plan tailored to individual needs. Occupational therapy plays a vital role in regaining strength, flexibility, and functional use of the hand and wrist.

Key Goals of Therapy:

• Restore joint range of motion 
• Rebuild muscle strength and tendon mobility 
• Improve dexterity for daily tasks 

Common Rehabilitation Techniques:

• Passive and active stretching 
• Grip-strengthening exercises 
• Fine motor skills training 
• Use of adaptive tools for daily living 
• Electrical stimulation and ultrasound therapy 

Stages of Recovery:

• Early Phase: Focuses on pain management and swelling reduction 
• Middle Phase: Emphasizes mobility and light strengthening 
• Late Phase: Targets return to work and normal function 

Monitoring & Progress:

• Regular assessments by a therapist 
• Customized home exercise programs 
• Adjustments based on pain, healing rate, and mobility 

Timely rehabilitation can significantly impact long-term wrist performance. Delayed or inadequate therapy may lead to stiffness, weakness, or re-injury. A multidisciplinary approach—combining physician oversight, physiotherapy, and occupational guidance—ensures optimal outcomes and a smoother transition back to routine activities.

The wrist is a small yet vital structure, central to hand function and overall upper limb mobility. Its intricate anatomy makes it susceptible to a variety of disorders, from mild sprains to complex degenerative conditions. Timely diagnosis, supported by imaging and clinical assessment, allows for personalized treatment—whether through conservative management or advanced surgical interventions. Rehabilitation plays an equally important role in restoring motion and preventing long-term complications. 

At Kannappa Memorial Hospital, we combine expert evaluation with cutting-edge treatment protocols to deliver comprehensive wrist care. Every case is approached with precision, empathy, and evidence-based medicine to ensure optimal recovery and sustained comfort. Choosing the right care pathway can make all the difference in quality of life, independence, and productivity.