Wrist Pain

The wrist and hand is very intricate and a detailed assessment can determine the source of the pain. Be warned that an injury to these areas can cause long standing problems if not addressed correctly. If you struggle with activities like gripping, lifting, writing, gardening, typing or knitting it can be an indication that your injury is worse than you thought. All of these tasks are low load activities meaning that it does not take a lot of effort to perform them.

It is extremely important to determine the source of the pain as injuries to the wrist can cause long term problems if not treated correctly. Carpal Tunnel Syndrome is one of the most common causes of wrist pain.

Force of impact like Racket sports, heavy landings/falls or the wrist bending backwards by a fall are common causes of wrist pain. All of these can cause significant pain and discomfort in the wrist making it difficult or even impossible to do anything. The small bones in the wrist doesn’t need much to crack, dislocate, or break.

Wrist Pain, sprained wrist, wrist fracture, wrist injuries, wrist pain treatment

Why is your wrist pain lasting longer than it should?

Does this sound like you?

If any of these have happened to you – we would love to help you. The fact that you’ve tried any or all of these things already is actually a good thing, because when you know what doesn’t work – you are closer to finding the thing that does!

We invite you to come and see us. Why? Because we do things differently. We’ll do a thorough assessment and test all the possible causes. After we’ve diagnosed your problem, and explained what it’s going to need to heal, we’ll make sure you understand why this is happening.

What you can do to get rid of your wrist pain quickly?

Decide to get help

So many people rest for weeks, hoping that the pain will ‘just go away with time’, but 6 weeks down the line they’re still putting up with it, and nothing’s changed… Or the pain & swelling gets even worse. You may even cause other problems. Lack of treatment could end up costing you more time & money the longer you wait.

Do the right exercises

One of the best things to help ease your wrist pain is to do the right series of progressed exercises – as advised by a Hand expert. The right kind of activities can reduce your pain, and help your healing. Above all, exercises ensure that problems don’t come back. However, the wrong kind of exercises have the potential to increase the pain in your wrist even more.

Get hands-on treatment

Hand therapy is proven to improve pain & accelerate healing of people suffering from wrist pain. Wrist pain could be affecting your physical performance in a professional or private capacity, you may not even notice. It could even threaten your work or get in the way of spending quality time with your family & friends. Annoying wrist pain can leave you frustrated, irritated & miserable. We can enable you to live the life you desire as quickly as possible.

If you’re looking for solid advice on how to start solving your problem, you might not know if our treatment is the right thing for you, we encourage you to give us a call. This is an opportunity to get an expert’s advice about your situation. Our goal is to help you make the right decision about what to do next.

Get rid of your wrist pain in the next few days!

SymptomsStructurePossible Cause
Pain, swelling and bruising, difficult to move wrist or grip anythingLigamentSprained Wrist
Pain, swelling and stiffness at the base of the finger that lasts a long time, may be hard to move fingers and thumb, may have a lumpTendonTendonitis – de Quervain’s tenosynovitis
Aching pain that’s worse at night, numbness or pins and needles, a weak thumb or difficulty grippingNerveCarpal Tunnel Syndrome
Smooth lump near a joint or tendon, may be painfulJoint CapsuleGanglion cyst
Sudden, sharp pain, swelling, a popping or snapping sound during the injuryBoneCarpal bone fracture

Scaphoid Fracture

Dull ache, worse after using it, difficult to turn the handMuscleMuscle strain
Thick feeling around wrist that gets worse after being active, and stiff in the morningsJointArthritis


Muscle pain

Technically there are no muscles in the wrist itself, there are merely tendons that crosses the wrist, and their muscle bellies are located in the fore

Tendon pain

Tendons on the Palm side of your wrist

On the palm side of the hand there are a group of tendons that bend the wrist forward, then there are a group of tendons that run across the wrist further up to the fingers. The tendons that mainly bend the wrist are the Flexor Carpi Ulnaris and Flexor Carpi Radialis, these anchor directly onto the small carpal bones. One tendon assists with bending the wrist called the Flexor Palmaris longus.

Tendons moving the wrist

Flexor Carpi Ulnaris & Radialis, are two tendons that anchor directly onto the wrist, with your palms facing upward, Ulnaris on the inside and Radialis on the outside, separately each one can pull the wrist more inwards (Ulnaris) or outwards using (Radialis). When they contract together their combined force bends the wrist forward.

Cut to these tendons may leave you unable to bend your wrist. If it happens in isolation, Ulnaris will have loss of movement inward, similarly when Radialis is cut you will lose the ability to move your hand outwards. Other pain in the wrist tendons may be caused by irritations to these tendons namely Flexor Carpi Ulnaris & Radialis Tendinitis.

Tendons running across the wrist to the fingers on the top side

The tendons that run to the fingers on the top side of the hand are called the Extensor Digitorum Communis tendons. Each finger has one tendon that runs across the wrist to straighten the finger. The index finger has an extra tendon called the Extensor indicis and the little finger (pinkie) has an extra tendon called the Digiti Minimi.

Tendons running across the wrist to the fingers on the palm side

The tendons that run to the fingers are a collection of ropes that forms 3 group.

  1. The first 4 tendons run at the top (called Superficialis) to the middle part of the finger. Flexor Digitorum Superficialis. You will be unable to bend the middle joints of your fingers when these tendons are cut.
  2. Deep to this group is another group of 4 tendons that run to the tips of your fingers, Flexor DIgitorum Profundus. You will be unable to bend the top joints of your fingers (tips) when these tendons are cut.
  3. Flexor Pollicis Longus runs to the thumb. You will be unable to bend the tip of your thumb when this tendon is cut.

Nerve pain

Carpal Tunnel syndrome is the most common nerve problem encountered in the wrist. This involves narrowing of the space inside your wrist that directly puts pressure on the Median nerve that supplies your thumb, index finger & middle finger.

Carpal tunnel syndrome is widely misunderstood and thousands of treatments and gadgets that claim to relieve the pain. Understanding what causes the pain will make you think for yourself. The carpal tunnel is an arch formed by the small bones in the wrist. Inside this tunnel, runs the tendons form the forearm to the hand as well as a nerve. When constant pressure is applied on the tendons and the nerve, they become irritated and swollen. The swelling in this confined space will lead to more compression and the pain doesn’t relieve.

The Ulnar nerve runs through its own tunnel called the guyon’s canal. Ulnar nerve damage & injury causes nerve pain radiating towards the little and ring finger.

Radial nerve runs over the thumb side of the wrist and mainly supplies the top part of the thumb, top of the whole hand up until the middle joint of the fingers. A drop wrist is the most common injury to the Radial nerve leaving you unable to lift your wrist & finger up.

Nerve pain in wrist

Joint pain

There are 8 small Carpal bones tightly arranged next to each other in two rows in the wrist, the Lunate bone connects to the Ulna and the Scaphoid connects to the Radius.

The most commons condition that affects these contact-points between the bones are joint degeneration or arthritis. Arthritis of the wrist joints are a combination of wear & tear and destruction of the cartilage (cushioning) where the bones meet. Different types of arthritis can also be a main cause of wrist pain which will appear to be worse in the mornings and improve as the day goes on. Stiffness can occurs after a period of rest (after a nights sleep). Burning and warm feeling over the joint is usually a very good indicator of arthritic pain.

Osteoarthritis is progressive wasting away of the bone, like the tires on your car that’s thread gets driven through. Rheumatoid arthritis is a autoimmune, inflammatory disease where your own immune system destroys the inner cushioning between the contact surfaces of the bone.

Then the normal alignment of the carpal bones are disrupted you may have dislocated your wrist. The Scaphoid and Lunate regularly dislocate, and is always accompanied by ligament strains or tears.

Ligament pain

Ligaments in your wrist must keep the bones in position and keep the joint stable. The ligaments that must keep the carpal bones stable are very tight & stiff. A very small amount of force is needed to tear these ligaments, due to this inability to have some leeway or ‘give. Thus it’s highly likely to tear these ligaments when the carpal bones are dislocated.

Fractures bring its own complications due to the ligaments that attach onto certain parts of the bone, segments of the bone that breaks away and leaves the rest of the bone vulnerable. These separated fragments will increase its likelihood to dislocate.

Wrist fractures

Due to the small size of the carpal bones they are prone to fracture quite easily and any disruption or excessive force can crack and injure these vulnerable bones.

The Radius is more common to fracture first because it’s attachment to the wrist is bigger as compared to the Ulna. Pain on the side of the thumb is more prominent. The most clear sign of this type of wrist fracture is that you will have difficulty to lift the thumb up (like showing the OK or “sharp” sign)

An Ulna fracture is on the side of the pinky. Almost all of the fractures to the Ulna break off the Ulnar Styloid process. The Ulna Styloid process is a prominent knob that can be seen on the outside and top of your wrist. If you suspect a fracture, pressing on this knob may be extremely painful and our patients even report not being unable see the knob after it is broken.

Wrist fractures and dislocation almost always happen together.

Wrist pain in the …

  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley
  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley
  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley
  • Flexor Digitorum Superficial tendon avultion
  • Fractured finger
  • Flexor tendon rupture
  • Nerve pain in your fingers
  • Volar plate sprain
  • Torn Pulley

What causes my wrist pain

To understand where your wrist pain is coming from, you’d have to determine how you injured it, or if you can remember when it started. Some are outright obvious like when you break your fall with your hands, meanwhile others are subtle and creeps up on you – getting worse day by day. So, it’s easier to establish how your pain started and changed until now. Changes in your wrist pain gives us many clues to understand where your pain is coming from.

Our body consists of various types of tissue, some elastic like tendons, or strong like cables (ligaments), some tissue can generate movement & force like muscles. We rely on your wrist ligaments to keep joints stable, tendons to coordinate movements, and muscles to generate power to grip. The structures in your wrist are quite vulnerable to injury, especially trauma. There are more than 65 structures in your wrist that can get injured, some problems are more common than others, but just to be safe – we test them all.

Here’s a breakdown of a few structures that can get injured that gives you different types of wrist pain:

Get to the root of your wrist pain

Different structures, cause different types of wrist pain, although these are not concrete it’s a good guideline to which structure produces what type of pain

Muscle — Dull ache or stiffness, sharp pain with contraction
Nerve — Numbness, tingling, weakness, electrical stabbing feeling
Tendon — Burning pain with certain specific movements, pain comes & goes
Ligament — Pain at the end of range, unstable, clicking
Bone — Constant pain, sharp pain with certain movements
Joints — Cramp, constant stiff feeling, worse after rest, better with movement
Cartilage — Sharp pain when at certain point, painful arch of movement
Arteries — Pins & Needles, dead leg feeling, heavy feeling
Fat pad — Pinching pain, pressure increases or decreases pain immediately
Bursa — Pain only comes on after being active, better with rest
Referral from other joints — Difficult to pinpoint pain, vague painful area

Types of wrist pain and the structures they may relate to:

Nerve pain in your wrist

  • Burning pain

  • Pins & Needles

  • Tingling

  • Sharp stabbing, shooting pain

  • Electrical shock pain

  • Numbness

  • Unable to control movement

  • Dead feeling over skin

Muscle pain in your wirst

  • Pain gets worse during activity

  • Burning or cramp like pain

  • Stiffness and tightness

  • Dull pain when stretched

  • Pain only at the end of range

  • No loss of muscle strength

  • Able to move your hand through the full range of movement

  • Little swelling

Joint pain in your wrist

  • Sharp sudden pain

  • Worse when moving as compared to static positions

  • Pain when doing a specific moment

  • Muscle tightness surrounding sharp pain

  • Deep pulling feeling when stretched/ moved

  • With or without swelling

  • Pinching feeling at end of range

  • Unable to pinpoint it to one specific spot

  • Dull ache over a large area

  • Unable to find a pain-free position

Our professional experience

The biggest concern among patients are the time it will take to heal. This question can only be answered after we’ve actually tested & looked at of all the structures.

Our medical professionals treat muscles, tendons, nerve and joint problems. But first we must know what we’re dealing with.

Delay Healing

In our experience, one of the most common problems we encounter are wrist bone fractures. It doesn’t take much to fracture these bones. Many patients come in with pain that has been troubling them for more than a few weeks. When we take X-rays we usually find an old fracture still trying to heal.

Taking too long to seek medical help or delayed treatment can significantly change the time it takes to heal your wrist pain.

Symptoms of wrist pain

How bad is my wrist pain, really?

Size – The larger the area of your wrist pain, is better, because tendons in your hand stretch from your finger tip to your elbow. Pain tends to radiate along the tendons and affect large areas. Tendons heal easier & recover faster.

Colour – Bruising in & around your wrist are quite common after a crack, splinter or fracture, because of the high concentration of small blood vessels in your hands. These capillaries rupture & leak plasma that pools in your fingers. Clearly something is wrong. Blue discoloration closer to your knuckles is more concerning for it involves your possible injury to the small bones in your hand & wrist.

Swelling – Swelling is your body’s way of healing itself by sending cells to heal the tissue. More swelling could mean more tissue damage, however not all hand injuries swell. Injury to tissue that develops over a few weeks doesn’t swell, because the tissue trauma is continuous and repetitive, so your body stops the inflammatory reaction. A new injury on an old problem is also possible.

Area – Wrist pain on the palm’s side are more restrictive when you grip & hold things, while pain at the back of your wrist limits you from typing or texting. If your wrist pain renders you unable to make a fist you must be more concerned. Sharp pain over a small area makes it easier to pinpoint structures near your pain. Vague, dull & deep wrist pain can take longer to identify the root cause. Compensatory patterns develop, sometimes it takes a while to just get rid of those.

Motion & sore wrists

Stiff – Wrist stiffness followed by pain is regressing and getting worse. Seek help. However, pain followed by stiffness is a good sign of tissue healing, specifically scar tissue formation. Scar tissue is hardening wound tissue that tends to shorten and pull on structures surrounding the injured site. This is more pronounced in muscle strains & tears, where the normal slide of muscles is restricted during a contraction.

Range of movement – Difficult moving your wrist through its range is a big problem. A painful arch means the structure injured only takes tension over that specific range i.e Only painful when you straighten your wrist the last 10 degrees. Wrist pain over a smaller range of movement is not necessarily better. This may point to connecting joint surfaces being injured like cartilage. If you feel pain only at the end of your range its less severe and easy to fix. When your wrist pain stops movement completely and its too painful to move, you should definitely come see us as soon as possible.

Changes over time

Intensity – When you grade your pain from 0 – 10. You may think it’s not that bad because it’s not that painful. On the contrary, pain intensity is not a sign of how severe your tissue injury is for example, complete ruptures of ligaments are less painful than partial tears. When fibers are stressed while it’s anchors are completely loose, there’s not much pain, but fibers that are partially torn will produce severe wrist pain. People have different pain thresholds, so be careful not to ignore your wrist injury.

Frequency – Pain that’s fleeting or intermittent, short burst of pain must not become more frequent and constant. This shows that the tissue damage is not getting any better. Pain that only lasts for a few seconds tend to heal faster, so the longer your pain lasts the faster you should get to us.

Latency – If your pain lags to come on and builds up over the day you must be very cautious. This is a sign of a relapse of your tissue pathology. It’s difficult to judge what makes it worse, because the pain only comes on a few hours after your activity, and not during. Your pain tends to be worse in the afternoons rather than in the morning.

Loading – Pushing through your wrist pain while you work is not a good idea. Putting compromised tissue under strain is dangerous. Would you tow a car with a partially torn cable? No! Because it just needs that final pull or jerk that could cause catastrophic tissue damage. Loading soft tissue without knowing what it’s able to handle is dangerous & reckless.

100% Covered by Medical Aid

Hand therapy claims directly from your medical aid.

Hand therapy claims directly from your medical aid.

No co-payments or extras. Most certainly, no unexpected bills. Plain and simple payments. We charge medical aid rates, so if you have funds available the treatment will be covered in full. Pay with cash or your medical aid.

Diagnosis of wrist pain

Our experts know and understand the intricate anatomy of your wrist. There are many structures to test, and we even consider the complex biomechanics of your hand & forearm. We’ll accurately diagnose which structures are involved, and to what degree. This gives you a good idea what exactly is happening inside your wrist in order to establish the extent of the tissue damage.

During your evaluation, we’ll be stretching & stressing the soft tissue structures like muscles, ligaments, nerves and tendons. This way we can diagnose muscle tears, ligament sprains, tendinitis’s and nerve irritations. We’ll test different aspects like muscle strength, range of motion, flexibility and stability in order to confirm how severe your tissue damage is, which will lead us to tailor a treatment plan. Then we’ll customize the treatment to your specific needs. Therefore our specialists are the best at diagnosing wrist pain & wrist injuries.

The Process of Diagnosis

Diagnosis is a process of exclusion, not inclusion. Medical professionals are taught a process of elimination and deduction to identify the most possible diagnosises for your wrist pain. The better you can describe & elaborate on your pain, the better picture you’ll give us to understand what’s happened & what you’re feeling.

The practitioner uses their skills to eliminate diagnosis’s it’s not and zoom in on your problem. This elimination brings us to only a few possibilities to what could be causing your wrist pain. Then we test & assess all our possibilities to get to the root cause of your pain. We encourage you to be honest and open about what you’re feeling – to clarify, carry on or change our approach.


  • No ibuprofen or other forms of Anti-inflammatories in the first 48 hours after an injury

  • Do not use heat packs or soak your hands in warm water for the first 2 to 3 days after an injury

  • Don’t try to lift heavy objects or grip anything too tightly

  • Click, pull or your fingers

  • Try to stretch through the pain

  • Ignore swelling (clearly something is wrong)

  • Treat it without a proper diagnosis, you may end up causing more harm

  • Ignore the pain (it may be a sign of a deeper problem)

  • Leave it untreated & hope it’ll heal

Must Do

  • Protect it from further injury

  • Put an ice pack in a towel and place it on your wrist for up to 20 minutes every 2 to 3 hours

  • Take off any jewelry or watches if your wrist starts swelling

  • Stop, cut down or limit activities that brings on your pain

  • Wear a splint to support your wrist, especially at night – you can get these at our reception (if you’re strapped for cash)

  • We can diagnose your problem fast & treat it

  • If you’re unsure what it might be – rather get an expert’s opinion

  • Give us a Call to set up an appointment to determine the tissue damage & how severe your problem is.

Makes it worse

  • Typing

  • Writing

  • Painting

  • Carry bags

  • Texting

  • Driving

  • Unlocking a door

  • Pushing onto it

Wrist pain Treatment

We have seen many patients with wrist pain and provide the best possible treatment for a faster recovery. Pain and stiffness after a wrist injury prevent you to grip or hold things. You might feel afraid to move, or scared you’ll damage it even more. We know that you’re anxious about the unknown, so that is why we are here to guide you and give you all the answers.

Your wrist pain treatment will be tailored according to various factors, but just to give you a broad idea, our focus of our treatments are:

  1. Determine what structures are injured in your wrist
  2. How bad is it injured?
  3. Protect it from further injury
  4. Help accelerate healing
  5. Re-evaluate to monitor progress
  6. Change and adapt as you get better

Hand therapy expert

Our experts can diagnose, test and treat any kind of wrist pain. We guide you to get rid of your pain as fast as possible. Our world class techniques & machines make sure you get the best value for your money. We will test a lot of different possibilities why you’re feeling this wrist pain in order to explain what’s going on in your body. It all depends on the results of our tests to determine what needs to be done. All our experts are hand specialists that can determine the slightest problem coming from your finger, hand or wrist, so if you’re uncertain – we can help you.

Our experts determine multiple problems that can be involved, this means that we test everything to ensure we’re treating it the right way. This is our expertise & what we’re best at. We take on many roles to achieve your goals: Teacher, counselor, trainer, coach and engineer. As a teacher we explain the extent of tissue damage & the intricate details of your wrist pain & how it may affect other problems. As a counselor & pain expert, we’ll guide you every step of the way. As engineer we check the structural integrity of the tendons, ligaments & joints in your wrist.

Most common wrist injuries we treat
  • Scaphoid fractures

  • Extensor digitorum tendinitis

  • Flexor digitorum tendinitis

  • Carpal (wrist) bone fractures

Come see us if
  • Your wrist pain is severe or stopping you form doing your normal activities

  • Its getting worse or keeps coming back

  • Unable to work

  • you need an accurate diagnosis

  • The wrist pain has not improved after resting it for 7 days

  • You feel any tingling, pins and needles, numbness or any loss of sensation in your hand, wrist or fingers

  • You are Diabetic – hand problems can be more serious if you have diabetes

Urgent medical treatment is necessary if
  • you have severe pain

  • feel faint, dizzy or sick from the pain

  • heard a snap, grinding or popping noise at the time of the injury

  • you are not able to move your wrist

  • hold or grip objects

  • have a wrist that’s changed shape or colour, such as blue or white

  • swelling that gets worse

  • you’re unable to sleep from the wrist pain

  • your pain regresses to tingling, pins and needles or numbness – could indicate nerve damage

What our patients say:

“Please consider seeing Elmarie before you consider wrist surgery!”

C Legge

“Elmarie is a super qualified expert with skills identifying the problem and working towards fixing it. She is professional and puts your mind to rest. I can definitely recommend her for any wrist problem”

T Heard

“Fell off my bike, broke my scaphoid (a small bone in my wrist). She’s just brilliant, so glad I found her.”

O Swanepoel

Wrist treatment is a process of understanding

Wrist treatment is a process of understanding

We have a whole range of hand treatments, but first we must know what we’re dealing with. An accurate diagnosis gives us a better understanding of the causes of your in pain.

Our Partner

Well Health Pro is a medical group of professionals that treat a wide range of muscle, joint, tendon & nerve problems.