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Wrist Pain

Wrist pain that hasn’t been identified yet? The wrist packs a lot of structures into a small space — but where it hurts, and what provokes it, narrows things down considerably.

Overview

What’s Causing Your Wrist Pain?

The wrist contains eight small bones, two forearm bones, numerous tendons and several nerves in a compact area, so precise localisation matters more here than almost anywhere else. Pain on the thumb side, the little finger side, the back, or the palm each points towards different structures. The single most important thing to exclude early is a scaphoid fracture after a fall, because these are easily missed and heal badly if not treated.

Radius Ulna

Tap an area, or use the buttons, to see what typically causes pain there.

Common

Radial Wrist Pain

Pain on the thumb side of the wrist, worse gripping and lifting with the thumb. Usually de Quervain’s tenosynovitis — irritation of the thumb tendons — or thumb base arthritis. After a fall, a scaphoid fracture must be excluded.

Symptoms

What Your Physio Will Want to Know

Precise location and mechanism matter more in the wrist than almost anywhere else:

Exactly Where

Thumb side, little finger side, back or palm — each points to a different group of structures.

Any Fall Involved

A fall onto an outstretched hand always raises the question of a fracture, particularly the scaphoid.

Numbness or Tingling

Which fingers are affected points to a specific nerve and a specific location.

Weight-Bearing Through the Hand

Pain pushing up from a chair, or during press-ups and yoga, suggests joint or dorsal loading.

Rotation

Pain turning a key, a door handle or a screwdriver often points to the little finger side of the wrist.

Swelling or Lumps

A visible lump on the back of the wrist is commonly a ganglion, which is benign.

Causes & Risk Factors

The Usual Suspects

Most undiagnosed wrist pain falls into a handful of categories:

01

Tendon Problems

De Quervain’s tenosynovitis on the thumb side is the most common, often after a change in gripping or lifting.

02

Carpal Tunnel Syndrome

The most common nerve problem, producing numbness rather than pain as the dominant feature.

03

Thumb Base Osteoarthritis

Very common from middle age, particularly in women, and often mistaken for a wrist problem.

04

Fractures

Scaphoid and distal radius fractures after a fall. Scaphoid fractures are notorious for being missed on initial X-rays.

05

Ganglion Cysts

Benign fluid-filled swellings, most commonly on the back of the wrist, often painless.

How We Can Help You

Treatment & Management

Precise diagnosis is disproportionately important here, because the wrist packs so many structures into a small space and the treatments differ substantially.

Thorough Assessment: Systematic examination of each region of the wrist, specific tendon and nerve testing, and screening for fracture where there’s been a fall.
Fracture Screening: Careful assessment of the scaphoid after any fall onto the hand, with prompt referral if there’s any doubt.
Load Management: Modifying gripping, weight-bearing and rotational tasks according to the diagnosis.
Splinting: Targeted splinting where it helps — thumb spica for de Quervain’s, neutral wrist splint for carpal tunnel.
Progressive Strengthening: Building grip and wrist capacity, which is consistently the part that produces durable improvement.
Onward Referral: For suspected fracture, persistent ulnar-sided pain, or nerve symptoms not responding, referral for imaging or a hand specialist opinion.

What the evidence says

Scaphoid fractures are missed on initial X-rays in a meaningful proportion of cases, and untreated they carry a high rate of non-union and subsequent arthritis. Anyone with tenderness in the anatomical snuffbox after a fall should be treated as having a fracture until proven otherwise, with repeat imaging or further investigation.

For most soft-tissue wrist conditions, splinting combined with progressive loading has better outcomes than either alone, mirroring the pattern seen across musculoskeletal care.

When to Seek Help

Red Flags — Don’t Ignore These

Wrist pain after a fall deserves particular caution:

⚠ Seek prompt medical assessment if you notice:

  • Tenderness in the hollow at the base of the thumb after a fall (possible scaphoid fracture — needs assessment even if an X-ray was normal)
  • An obvious deformity, or inability to move the wrist after injury (possible fracture — attend A&E)
  • A hot, red, swollen wrist with fever or feeling generally unwell (possible infection — seek emergency care)
  • Progressive weakness or visible muscle wasting in the hand
  • Constant numbness in the hand that no longer comes and goes

Scaphoid fractures are frequently invisible on the first X-ray. If you have snuffbox tenderness after a fall, please seek medical assessment even if you have already been told your X-ray was clear.

Common Questions

Frequently Asked Questions

I fell and my X-ray was clear, but it still hurts — is that normal?

It’s worth taking seriously. Scaphoid fractures are frequently not visible on the initial X-ray and only become apparent on repeat imaging days later. Persistent tenderness at the base of the thumb after a fall should be reassessed rather than assumed to be a sprain.

Is the lump on my wrist serious?

Almost certainly not. Ganglion cysts are benign fluid-filled swellings, most often on the back of the wrist, and many resolve spontaneously. They only need treatment if they’re painful or interfering with function — and the old advice about hitting them with a book is best ignored.

Why does my wrist hurt doing press-ups?

Weight-bearing through an extended wrist loads the joint at its end range, which many wrists tolerate poorly if they haven’t been prepared for it. Modifying the position, using parallel handles, and building wrist capacity progressively usually resolves it.

Do I need a scan?

Often not. The exception is where a fracture is suspected or where ulnar-sided pain persists, since that region is genuinely harder to assess clinically and MRI can be informative.

Get the Right Structure Identified

A systematic assessment of a complex joint, with particular care around the injuries that are easy to miss.

Book Your Initial Assessment

This page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.