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Severe Wrist Pain

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Understand severe wrist pain symptoms, including 8 causes & common questions.

7 most common cause(s)

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De Quervain's Tenosynovitis
Rheumatoid Arthritis
Psoriatic Arthritis
Carpal Tunnel Syndrome
Wrist Sprain
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Kienbock disease
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Buckle fracture of distal radius

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Severe wrist pain symptoms

The wrists are prone to injury, such as trying to catch yourself when falling. Many other types of medical conditions and injuries can affect the wrist, and some can cause severe wrist pain. Multiple structures including bones, tendons, and nerves can be implicated in severe wrist pain.

Common accompanying symptoms of severe wrist pain

If you're experiencing severe wrist pain, you may also experience:

Severe wrist pain causes

The following details may help you better understand your symptoms. However, any severe pain should be evaluated by a physician for a proper diagnosis and treatment.

Acute injuries

An injury to the wrist can result in severe pain. This most commonly occurs when a large force is applied to the wrist with the arm outstretched, such as during a fall or car accident. One or more of the bones that make up the wrist can be fractured or dislocated, causing severe pain and swelling.

Chronic injuries

An injury is chronic if it is acquired over time, such as the following.

  • Tendon injury: Repetitive motion can cause an overuse injury to major tendons, resulting in severe pain on the thumb side of the wrist.
  • Nerve compression: Occupational activities or swelling due to underlying medical conditions can cause nerve compression and severe pain. You may also experience tingling in the hands and fingers.
  • Bone damage: Rarely, wrist pain can be due to progressive damage and destruction of one of the wrist bones. This is thought to occur due to decreased blood supply associated with repetitive manual labor.

Arthritis-related causes

Arthritis is characterized by inflammation and/or damage to joints caused by repetitive motions. Any type of arthritis can cause severe wrist pain.

  • Crystal arthritis: The wrist can be affected by forms of arthritis caused by the buildup of abnormal crystals in the joint, such as gout. An attack of gout will cause the wrist to be swollen, warm, and extremely painful.
  • Other types of arthritis: Arthritis may be inflammatory or result from joint damage over time (degenerative) in older people. Stiffness and swelling may also be present.

Infectious causes

A bacterial infection of the wrist joint is a serious condition and will cause severe pain that is worse with movement, swelling, and warmth. Risk factors for the development of a wrist infection include pre-existing joint abnormalities, such as arthritis, or a skin infection in the area of the wrist.

This list does not constitute medical advice and may not accurately represent what you have.

Wrist sprain

A wrist sprain is an injury to the ligaments in the wrist. A mild sprain involves just stretching of the ligaments while more severe sprains can tear the ligaments.

You should see your primary care doctor tomorrow. He or she may request imaging to make sure that there is no further damage to the bones of the wrist.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Psoriatic arthritis

Psoriatic arthritis is a complication of psoriasis, which causes the skin to become thickened, red, and scaly. Arthritis may appear before or after the psoriasis appears.

Both conditions are autoimmune diseases, where the body attacks itself, and are thought to be caused by genetic and environmental factors.

Most susceptible are people from 30 to 50 years of age with a family history of the disease and who already have psoriasis.

Symptoms include the joints on one or both sides of the body becoming painful, swollen, and hot; swelling and deformity of the fingers and toes; pitted, flaking fingernails; foot pain in the heels and soles; and joint pain in the low back pain.

It is important to seek treatment, as psoriatic arthritis can permanently damage the joints, eyes, and heart.

Diagnosis is made through physical examination, x-rays, and MRI. Blood tests and joint fluid tests can confirm psoriatic arthritis.

Treatment includes over-the-counter, nonsteroidal anti-inflammatory drugs; anti-rheumatic medication; immunosuppressants; and steroid injections for the joints. Surgery to replace damaged joints may also be tried.

Kienbock disease

Kienbock disease is a condition where the blood going to one of the small bones in the wrist is disrupted, causing the bone to die and the wrist to become stiff and painful. The cause is not known but may be related to trauma to the wrist.

You should visit your primary care physician because most people wait too long to be seen for a chronically painful wrist. It's hard to distinguish with a sprained wrist, but x-rays and MRIs will identify the problem. Treatment depends on severity, ranging from pain meds and splinting to surgery.

Rarity: Rare

Top Symptoms: hand weakness, pain in the back of the wrist, wrist pain from an injury, wrist pain that gets worse when gripping something, difficulty moving the wrist

Symptoms that always occur with kienbock disease: wrist pain from an injury, pain in the back of the wrist

Urgency: Primary care doctor

De quervain's tenosynovitis

De Quervain's tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. If you have de Quervain's tenosynovitis, you will feel pain upon turning your wrist, grasping anything, or making a fist.

You should visit your primary care physician to confirm the diagnosis and discuss treatment options. You can also reduce pain and swelling with over-the-counter pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve).

Rarity: Uncommon

Top Symptoms: hand numbness, thumb pain, hand weakness, weakness in one hand, numbness in one hand

Symptoms that always occur with de quervain's tenosynovitis:thumb pain

Urgency: Primary care doctor

Contusion of the wrist

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the wrist are common, often due to minor injuries.

You can treat this at home with R.I.C.E - rest (exercise as tolerated), ice (10-20 minutes at a time), compression (this is optional, with bandage or tape), and elevation.

Rarity: Rare

Top Symptoms: wrist injury, pain in one wrist, wrist pain from an injury, swelling of one wrist, wrist bruise

Symptoms that always occur with contusion of the wrist: wrist injury

Urgency: Self-treatment

Carpal tunnel syndrome

Carpal tunnel syndrome causes numbness and pain in the underside of the wrist and hand. It is caused by narrowing of the carpal tunnel passageway, which puts pressure on the nerve running through it.

Narrowing and deformity of the tunnel is most often from overuse, especially highly repetitive activities such as typing or working on an assembly line. Wrist fracture or arthritis can damage the carpal tunnel, and so can diabetes and obesity.

Symptoms include numbness and shocklike pain in the wrist, palm, and fingers. There may be weakness in the hand when trying to hold an object.

Carpal tunnel syndrome virtually always gets worse over time. Permanent damage may result, so it is important to be seen by a medical provider.

Diagnosis is made through patient history and physical examination. X-rays or electromyography testing may be used.

Rest and cold packs to the wrist will reduce swelling. Wrist splints and ergonomically correct keyboards and other devices during work are often helpful.

Corticosteroid injections and surgery may also be tried.

Buckle fracture of distal radius

A buckle fracture of the wrist, also known as a torus fracture, is a condition that are most common in children aged 5-10 years due to the elasticity of their bones. This fracture occurs when force is applied to the radius (one of the two bones of the forearm), causing the bone to split along the growth plate.

You should visit your primary care physician within the next 24 hours. The treatment for this kind of fracture is immobilization in a cast.

Rarity: Common

Top Symptoms: constant forearm pain, forearm pain from an injury, pain in one forearm, swollen forearm, wrist injury

Symptoms that always occur with buckle fracture of distal radius:forearm pain from an injury, constant forearm pain

Urgency: Primary care doctor

Severe wrist pain treatments and relief

When it is an emergency

Seek emergency severe wrist pain treatment if:

  • You have any of the following symptoms after an acute injury: significant swelling; tenderness to pressure at one specific spot; tingling or weakness in your fingers; or an abnormal angle of the wrist.
  • You have the following symptoms and a fever: You have rapid-onset severe wrist pain, swelling, and warmth, and/or had a recent injury that broke the skin over the wrist.

In some cases, even though emergency care isn't necessary, you may need evaluation and treatment.

When to see a doctor

Make an appointment with your medical provider if:

  • Your wrist pain is preventing you from carrying out your usual daily activities
  • Your sleep is affected: You are waking up at night due to pain.
  • Your wrist pain does not resolve over time or gets progressively worse
  • You have additional symptoms: Such as swelling and stiffness
  • You have tingling pain in your fingers

Medical treatments

Your medical provider may prescribe one or more of the following treatments, depending on the cause of your severe wrist pain:

  • Steroid injections: To help with pain and inflammation
  • Medication for arthritis: To slow the progression of inflammatory forms of arthritis
  • Medications to treat a current attack of gout: And prevent future attacks
  • Application of a splint to immobilize the wrist
  • Referral for surgical management: If other treatments are not effective

At-home treatments

Some home treatments may help with severe wrist pain.

  • Ice packs: Applying an ice pack for up to 15 minutes a few times a day can help ease pain and swelling due to arthritis or an injury.
  • Pain medication: NSAIDs such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help with the pain.
  • Move the wrist: Gently move the wrist from time to time in all directions to maintain range of motion.
  • Avoiding shellfish, red meat, and alcohol: This can help prevent attacks of gout in those predisposed to this illness.

FAQs about severe wrist pain

Here are some frequently asked questions about severe wrist pain.

Why is my wrist swollen and painful?

A variety of conditions can cause wrist swelling and severe pain, such as if you recently fell onto your hand. If the swelling and pain are more chronic, arthritis or an overuse injury could be the cause. Sudden pain and swelling without a preceding injury could be caused by gout or an infection in the joint.

Why do I have tingling pain in my wrist and fingers?

A tingling, painful sensation in the wrist and fingers is likely due to compression of a nerve. In carpal tunnel syndrome, the median nerve is compressed as it passes through the wrist. Carpal tunnel syndrome typically causes pain and tingling in the wrist, thumb, first two fingers, and the half of the ring finger closest to the thumb. The pain is often particularly noticeable at night.

Can severe wrist pain be due to arthritis?

Yes, arthritis can occur in the wrist and can cause severe pain along with stiffness and swelling. The wrist can be affected by rheumatoid arthritis (RA) or osteoarthritis, common in older people caused by wear-and-tear. An injury to the wrist earlier in life causes a predisposition to the development of osteoarthritis. In addition, wrist pain can result from arthritis caused by abnormal crystals in the joint, such as gout or pseudogout.

Can falling on the hand result in a wrist injury?

Falling on the hand with the arm stretched out is a common cause of injuries in the wrist. Severe wrist pain can result from a fracture of one or more of the arm and hand bones that meet to create the wrist joint. A fall onto the hand can also result in a dislocation of the wrist, where the bones are displaced from their normal positions. A fracture or dislocation will cause pain, swelling, and difficulty moving the wrist.

Why do I have severe pain in only one wrist?

Many causes of severe wrist pain will be present on only one side. Arthritis may affect just one wrist. This is particularly likely for gout or pseudogout, in which attacks typically occur in one joint at a time. An injury or infection may occur in only one of the wrists. Depending on how you use your wrists, one is likely more vulnerable to overuse injuries than the other.

Questions your doctor may ask about severe wrist pain

  • Push the backs of your hands together like in this picture, and hold for 1 minute. Do you notice any numbness, tingling, or pain in either of your fingers/hands? (This is called the Phalen's maneuver.)
  • Have you ever been diagnosed with diabetes?
  • Lightly tap on your inner wrist. Does this cause your symptoms to reappear?
  • Is your wrist pain worse when holding something?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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