Wrist pain Health Article

What to expect at your health care provider's office

Your doctor will perform a physical examination, which may include an examination of the wrists and hands, and ask questions such as the following:

• When did the wrist pain begin?
• Did it occur suddenly and severely or gradually and mildly?
• Is the pain constant, or does it come and go?
• Is the pain worse in the morning or at night?
• Does it go away without self care?
• Is the pain sharp, throbbing, or burning? Is there numbness or tingling in any of your fingers?
• Where exactly is the pain? Is it in both wrists? Does it extend into the fingers?
• Does the pain occur only with certain movements or positions?
• Does the pain prevent normal use of the wrist, hand, or arm?
• Is the pain worse with movement?
• What helps it? Is it better with immobilization to prevent movement? Does splinting the wrist or applying heat help?
• Do any medications help?
• Is there joint pain elsewhere?
• Is there pain elsewhere, such as the neck?
• What medications are you taking?
• Have you had any recent injuries or illnesses?
• Are you involved in activities requiring repetitious hand and wrist movements, such as sewing, knitting, computer keyboard use?

Diagnostic tests that may be performed include an x-ray. If your doctor suspects that you have an infection, gout, or pseudogout, he or she may draw fluid from from the joint to examine under a microscope.

Anti-inflammatory drugs may be prescribed. Injection with a steroid medication may be performed. Surgery or medications may be needed to treat some conditions.

Prevention

To prevent carpal tunnel syndrome:

• Adjust your keyboard so that you do not have to bend your wrist upward while typing.
• Take frequent breaks from activities that require wrist movement.
• Work with an occupational therapist.

To prevent gout attacks:

• Limit alcohol.
• Lose weight if you are overweight.
• Drink plenty of water.
• Eat lower amounts of liver, anchovies, sardines, and herring.
• Your doctor may prescribe medication.

References

Viera AJ. Management of carpal tunnel syndrome. Am Fam Physician. 2003; 68(2): 265-272.

Padua L. Carpal tunnel syndrome in pregnancy: Multiperspective follow-up of untreated cases. Neurology. 2002; 59(10): 1643-1646.

American Academy of Orthopaedic Surgeons (AAOS). AAOS clinical guideline on wrist pain - phase I. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2002.