QUESTION: A 42 year old lady fell on her outstretched hand and is now complaining of pain over the ulnar side of her wrist particularly on twisting motions. She is unable to play tennis. What should she do?
What is it?
Ulnar sided wrist pain can be caused by a number of different factors. The most common being an injury to the Triangular Fibro Cartilage Complex (TFCC). The TFCC is the main ligament that stabilises the distal radio-ulnar joint, supporting the wrist under load and on rotation of the forearm. An injury to this structure will elicit pain on the ulnar side of the wrist and cause difficulty with activities that require gripping and twisting of the wrist.
A X-Ray, Ultrasound or MRI may be appropriate. Your hand therapist will let you know if this is required.
Splinting and exercises can help to improve stability and reduce pain. There are different types of splints available depending on the needs of the patient and how much support is required. You will also be provided with:
- Pain management techniques and activity modification
- Provision of a splint, if appropriate
- Graded strengthening and proprioception exercises to help improve stability, coordination and strength in the hand and wrist
Surgical review may be required if there is substantial laxity in the wrist and if pain and symptoms are not resolving. Your therapist will be happy to discuss with you and your GP whether referral to a hand surgeon is appropriate.