Inflammation in the wrist

introduction

On the wrist are several structures such as tendons, tendon sheaths and bursae, which can all be the starting point of inflammation.

When speaking of an inflammation of the wrist, it may mean tendinitis, tenosynovitis, or bursitis .

symptoms

The symptoms of a wrist inflammation are the classic signs, as they occur with other inflammations.

  • The wrist is swollen and often hurts severely.
  • In addition, a reddening is often seen and a significant overheating felt.
  • Due to pain and swelling, the mobility is usually very limited.

Depending on the cause of the wrist inflammation, more specific symptoms may also occur.
Occasionally, tendrils tend to crunch when they move, and rheumatoid arthritis, for example, causes increased pain at night and in the morning.
In addition, a morning stiffness of the wrist is often reported.

An inflammation of the wrist resulting from the bursa may cause fever, fatigue, and swelling of the lymph nodes.

Swelling on the wrist

A swelling on the wrist is a very common symptom, which can have many causes. For example, anyone who has fallen on the wrist can have a traumatic swelling on the wrist. This can be due to a slight bruise, but also structural injuries lead to swelling.

There are also superficial swellings that are caused by outside influences, such as a sting. Even with inflammation, the wrist can swell. The cause is often not immediately recognizable (as in a trauma or a sting). Frequently the swelling develops slowly, in addition there are movement-dependent pains.

Find out more here: Bump on the wrist

Pain in the wrist

Wrist pain, as well as swelling, can have a variety of causes. First and foremost, a traumatic event such as a fall that is intercepted with the hand causes pain. These suddenly set in and are usually rather short-lived. In contrast, pain in inflammation of the wrist is characterized by a creeping onset. Especially when an overload is the cause of the inflammation, the pain is initially low and make themselves felt under stress. However, with increasing inflammation, the pain becomes stronger. In addition, symptoms such as swelling, redness and overheating of the wrist can occur.

Figure wrist pain

Figure pain hand: right hand seen from the palm side (palmar)

A - Chronic causes
B - Acute causes

  1. Rheumatoid Arthritis (RA) -
    inflammatory disease
    of the joints
  2. Arthrosis -
    Osteoarthritis
  3. Carpal Tunnel Syndrome (KTS) -
    Confinement of the median nerve
  4. Ganglion (overbone) -
    benign tumor formation
  5. Torn ligament -
    Rupture of a ligament
  6. Finger luxation -
    finger sprain
  7. Finger fracture (finger fracture) -
    a - distal
    b - medial
    c - promaximal
  8. Carpal fractures
    (here barefoot fracture)
    I - I - Finger joint -
    Articulatio metacarpophalangea
    II - II - Carpal Metacarpal Joints -
    Articulationes carpometacarpales
    III - III - Lower wrist -
    (Distal)
    Articulatio mediocarpalis
    IV - IV - Upper wrist -
    (Proximal)
    Articulatio radiocarpalis

causes

The causes of inflammation of the wrist are numerous.

Frequently, the inflammation is the result of excessive or unfamiliar stress.
Even a monotonous activity with always the same movements can cause a wrist inflammation.
It can be affected equally tendon sheaths as well as the bursae.

Another possible cause is an infection with bacteria, fungi or viruses, which then spreads to the joints.
This can happen, for example, after a non-adequately treated injury or in injuries where germs could invade the wound.

Wear on the joint can also lead to an inflammatory reaction of the wrist.

Inflammatory rheumatic diseases such as rheumatoid arthritis often affect the wrist. Due to the incorporation of substances into the joints, so-called crystal arthropathies lead to inflammation of the respective joints.

The most well-known example in this case is the gout, which causes the deposition of uric acid crystals.

Tendonitis

In most cases, tendonitis is due to overwork or malpractice. Tendons are particularly common, leading from the forearm to the hand, which is why tendonitis on the wrist often occur. The tendon sheath forms a shell within which the tendon can move almost smoothly. This is made possible by a thin liquid film, which is formed by the so-called synovial fluid.

In case of bad posture or overload of the wrist, the tendon and tendon sheath may swell. This causes the fluid to be displaced and therefore the tendon and the tendon sheath to meet directly. This results in a lot of friction with every movement, in some cases the tendon can even get caught in the tendon sheath or stick to it. This increased resistance additionally amplifies the inflammation.

Risk factors for such a genesis of tendonitis in the wrist are, for example, office jobs where much is written by hand or on the computer. But even those who work hard physically and have to do a lot with their hands, may have to struggle with tendonitis. Rare causes of tendonitis are infections with bacteria. In this case we speak of septic tenosynovitis.

Bursitis in the wrist

Bursae serve as a natural buffer in the wrist where sinews extend directly over the bone. In particular, monotonous, repetitive movements can ignite the bursa. Such overload is the most common cause of bursitis. But also falls on the wrist or damage due to wear can lead to inflammation of the bursa. Very rarely, the bursitis on the wrist is caused by infection with bacteria or viruses.

Inflammation of the discus in the wrist

The Discus is a cartilage disc that lies between the carpal bones and the ulna. Especially with falls on the wrist, this discus can be affected. For example, the discus may rupture or bleed into the cartilage disc. This can lead to inflammation, which causes pain and a restriction of movement in the wrist.

But also by an overload of the wrist, the discus can ignite. The pain is at such an inflammation on the outer area of ​​the wrist and are particularly noticeable when the hand is also spread outwards.

diagnosis

The diagnosis of inflammation of the wrist begins with a medical history, followed by a physical examination.

The doctor first asks for more detailed information about the character and strength of the symptoms, as well as the resulting limitations.
In addition, it is important for the physician to know how long the symptoms have persisted and whether there may have been a specific trigger, such as a previous infection or trauma.

During the physical examination, the examiner scans the joint and looks for swelling, pressure pain and overheating.
He will also test the mobility carefully.

Following this, an X-ray of the hand, including the joint, is often made to reveal signs of possible damage to the wrist.
Special blood tests can confirm joint inflammation.

Important values ​​are the so-called inflammatory parameters.
These include the white blood cells ( leukocytes ), the C-reactive protein (CRP) and the erythrocyte sedimentation rate (BSG).
In rheumatoid arthritis, so-called rheumatoid factors are frequently found, and in gout, elevated blood uric acid levels can be detected.

To get more accurate information about the current situation in the wrist, a computed tomography (CT) or a magnetic resonance imaging (MRI of the hand) may be indicated.
Overall, MRI hand-marking is considered to be the most valuable in diagnosing inflammation on the wrist.

If these examinations are not sufficient for a diagnosis, a joint puncture (a removal of fluid or tissue material from the joint) or an articulation ( arthroscopy ) may be necessary.

therapy

Since a wrist inflammation can be triggered by different stimuli, the treatment depends on the particular cause.

Basically, it is important to avoid the activities that trigger the inflammation of the wrist.
Generally, the wrist is first immobilized by bandages or bandages for some time to prevent further damaging stimuli and give the joint time to heal.

By cooling the pain can be alleviated. It should be noted that in inflammation of the wrist, which has already reached the chronic stage, heat often helps better than cold.

Furthermore, various medical, physical and surgical measures are used.
Painkillers and anti-inflammatory drugs, which are regularly applied in ointment form, often form the basis of drug therapy.

If inflammation of the joint is due to bacterial colonization, antibiotics are used.

In rheumatoid arthritis involving the wrist, special rheumatism medicines called basic therapeutics or DMARDs (= Disease Modifying Antirheumatic Drugs ) are used.

In terms of physical therapy, there are various possibilities.
The relief of the joint can be done by a joint puncture. This process removes too much fluid from the joint, alleviating tension, restricted mobility and pain.
Also with cold compresses as well as with movement exercises and physiotherapy the complaints can be improved.

If the conservative measures do not improve the symptoms, surgery for tendonitis may also be considered.
The surgeon cuts through the ligament that holds the tendons together, the so-called retinaculum, and in this way relieves the tendons.

Homeopathy for inflammation in the wrist

In the case of an inflammation in the wrist, various homeopathic remedies can be used depending on the main symptoms. Overuse of the wrist or acute injury causes Arnica and Ruta graveolens. If the pain occurs especially during exercise, Rus toxicodendron can relieve the symptoms. If the inflammation is particularly pronounced and makes itself felt by swelling and redness of the wrist, one can resort to Bryonia and Apis mellifica.

Should one cool or warm the wrist?

An inflammation in the wrist should, if it enters acute, be cooled first. This counteracts the first inflammatory thrust and relieves the pain in the wrist.

But especially when inflammation lasts longer or even becomes chronic, heat is usually more helpful. The heat relaxes the muscles surrounding the wrist and forearm, and can relieve pressure on inflamed tendons or bursa. Whether it helps to cool or warm in a specific situation, the wrist usually "knows" itself best. That means: try and maintain cold and warmth, which feels better.

Taping the wrist

The taping of the wrist can provide relief in an inflammation. One should differentiate between two types of tapestry: With rigid (mostly white) tape, especially a stabilization of the wrist can be achieved. This is useful if the inflammation is currently very acute and the hand should be immobilized.

A rail usually fulfills the same purpose, but is often undhandlicher and therefore more disturbing. If the wrist is already operational again, the Kinesiotape can be used. These mostly colorful strips of tape are stuck along muscles and so relieve the tendons when the muscle becomes tense.

wrist Support

A wrist bandage is used when the wrist is to be spared due to inflammation. Such a bandage is usually elastic and thus allows some movement in the wrist. It differs from the wrist splint used at the beginning of the inflammation, which is supposed to completely immobilize the wrist. The bandage on the other hand supports the wrist when the hand can be loaded again and relieves muscles, tendons and bursa. In addition, the bandage exerts a certain amount of compression on the joint, thereby preventing the wrist from swelling.

When does inflammation on the wrist become chronic?

Acute is a disease that has just started and continues for a limited time. A chronic illness persists permanently or over a longer period of time. Inflammation of the wrist is usually referred to as chronic inflammation if the symptoms persist for a few months or more.

However, one must also think of a chronification of the disease, if over months and years repeatedly complaints, even if in between a symptom-free interval. The chronic inflammation on the wrist is often accompanied by structural changes of the bursa, tendons and / or tendon sheaths and is then usually not completely heal.

Which doctor treats inflammation in the wrist?

In a simple tendonitis due to an overload of the wrist is usually the orthopedist in charge. This can prescribe bandages and splints as well as physiotherapy. Those who are more likely to suffer from inflammation in the wrist, should visit a plastic surgeon specializing in hand surgery. These can rule out other causes of inflammation and offer more intensive treatment options. In addition, the hand surgeons can estimate if the inflammation has become chronic and / or wrist surgery is necessary.

duration

An inflammation in the wrist can be very tedious. Especially if it was triggered by an overload of the wrist. With immobilization and subsequent careful habituation to the burden one should expect a duration of several weeks to months. However, care is also needed after that, as such inflammation often recurs. In particular, people who are prone to such inflammation in the wrist and write a lot by hand or work on the computer, are often plagued by inflammation in their wrist throughout their professional lives.

forecast

The prognosis depends on the cause of the inflammation.

With early and appropriate therapy, the chances of cure of tendonitis, bursitis and tendinitis are quite high.
Afterwards, one should take care to avoid the factors that triggered the inflammation of the wrist as much as possible.

Conversely, inadequate treatment of tendonitis can also develop a chronic inflammation, which can then last for several months. A doctor should therefore be consulted early. An acute infectious arthritis also usually heals without consequences.

However, it may also come in the course of the inflammatory process to a destruction of the joint and, consequently, to a permanent malposition.

If the inflammation of the wrist, for example, in the context of an existing underlying disease such as rheumatoid arthritis already in the chronic stage, healing and complete regeneration are usually no longer possible.

In this case, the goal is to prevent further progression of inflammation and joint destruction as well as to relieve pain and inflammation.

prophylaxis

In order to prevent the development of an inflammation of the wrist, the avoidance or the rarest possible executing triggering activities and movements is recommended.

In the event of injury near the wrist, early and appropriate treatment should be provided to prevent infection and prevent consequential damage resulting in joint inflammation.

In the case of existing underlying diseases, which can lead to inflammation of the joint, treatment with this underlying disease should be started in good time.

Regular checks on the success of the therapy and any signs of incipient inflammation in the wrist are recommended.


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