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Chronic wrist pain treatment Finding the cause, and the splints, therapy and guided injections that help
Chronic wrist pain treatment starts with finding the exact cause, because wrist pain that lasts more than a few months usually comes from a specific structure: arthritis at the base of the thumb, a tear of the TFCC cartilage on the pinky side, an irritated tendon, a nerve problem like carpal tunnel syndrome, or an old injury that never fully healed. A physician examines the wrist and may use ultrasound, X-rays or nerve testing. Treatment usually combines a splint and activity changes, hand therapy, and, for joint or tendon pain that persists, an ultrasound-guided injection placed precisely where the problem is.
A sore wrist after a busy week usually settles with rest. Wrist pain that keeps coming back for months is different: it often limits gripping, typing, lifting a pan or doing a push-up, and generic rest and braces stop helping. The good news is that most chronic wrist pain comes from a short list of causes, and once the cause is clear, chronic wrist pain treatment can be targeted. In the first video, Jake Stephen, DO uses ultrasound to look inside the wrist before treatment.
Common causes of chronic wrist pain
- Thumb base (CMC) arthritis: aching at the base of the thumb with pinching, opening jars or turning keys, common after 50
- TFCC tear: pain on the pinky side of the wrist with twisting, push-ups or carrying, after a fall or from repeated strain
- De Quervain tendinitis: pain on the thumb side of the wrist with lifting and gripping, common in new parents
- Carpal tunnel syndrome: numbness and tingling in the thumb and fingers, often at night; see carpal tunnel relief
- Wrist arthritis or an old fracture: stiffness and pain after a break or sprain that never fully recovered, see wrist fracture recovery
- Ganglion cysts: a lump that can press on nearby structures
Our elbow, wrist and hand pain page covers wrist and hand pain treatment for these and other conditions, and elbow pain treatment covers the elbow.
How the cause is found
A careful exam of where it hurts and which movements provoke it narrows the list quickly. X-rays show arthritis and old fractures. Diagnostic musculoskeletal ultrasound shows tendons, cartilage, fluid and nerves in real time, right in the exam room, as in the first video. When numbness or tingling is part of the picture, an EMG/NCV test checks whether a nerve is being pinched at the wrist, elbow or neck, which is covered in our EMG test guide.
Chronic wrist pain treatment options
- Splinting and activity changes: a thumb or wrist splint, especially at night, and changes to grip, keyboard and lifting habits
- Hand therapy: occupational and hand therapy for joint protection, tendon gliding, strengthening (see grip strength exercises) and custom splints; it is offered at our Brooklyn office only
- Ultrasound-guided injections: a steroid placed precisely into the thumb joint, around an inflamed tendon or into the TFCC area can calm pain so therapy can work, as in the second and third videos; see joint injections
- Carpal tunnel care: splints, therapy and, when needed, an injection, see carpal tunnel treatment
- Surgical opinion: for a large tear, an unstable joint or severe arthritis that does not respond to these steps
Using ultrasound guidance means the medicine reaches the small structure that hurts, which matters in a joint as crowded as the wrist. Injections are not repeated often, and your physician will explain how many are reasonable for you.
When wrist pain needs prompt care
See a doctor soon for wrist pain after a fall, especially with swelling or pain in the hollow at the base of the thumb, which can be a scaphoid fracture that does not show on the first X-ray. Get care quickly for a hot, red, swollen wrist or fever, and for numbness or weakness in the hand that is getting worse.
More videos on treating wrist pain
More clips from our YouTube channel @precisioncaremedical showing ultrasound-guided injections for thumb arthritis and TFCC pain.
Related care at Precision Care Medical & Sports Performance
Wrist pain treatment near you
Looking for a hand pain doctor near me? Precision Care Medical & Sports Performance treats chronic wrist pain at all three offices. In Brooklyn, Ashley Marcus, MD sees patients at our Brooklyn pain management office on Shell Rd, and Valerie Khodorkovskiy, OTR provides hand therapy at the same office, including carpal tunnel treatment in Brooklyn. It is convenient to Bensonhurst, Gravesend and Coney Island.
On Staten Island, Jake Stephen, DO sees patients with wrist and hand pain at Staten Island pain management on Richmond Rd, close to Great Kills, Eltingville and Todt Hill. In Manhattan, Yuri Gordin, MD sees patients at the Precision Care Spine & Pain Center in Midtown Manhattan, near Turtle Bay and the UN Plaza and an easy ride from Harlem and Spanish Harlem; hand therapy is not offered at the Manhattan office. Request an appointment or call the office closest to you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
What is the best treatment for chronic wrist pain?
It depends on the cause. Most people do best with a combination of a splint and activity changes, hand therapy and, for arthritis or tendon pain that persists, an ultrasound-guided injection. Finding the exact cause first is the key step.
Why does my wrist still hurt months after a sprain?
Lingering pain after a sprain can come from a missed scaphoid fracture, a TFCC tear, a ligament injury or stiffness and weakness that never fully recovered. A physician can examine the wrist and use X-rays or ultrasound to find out.
Do wrist injections work?
For thumb base arthritis, de Quervain tendinitis and some TFCC pain, a guided steroid injection often eases pain for weeks to months and makes therapy easier. It works best as part of a plan with splinting and exercise.
What causes pain on the pinky side of the wrist?
A common cause is irritation or a tear of the TFCC, the cartilage cushion on the pinky side of the wrist. Tendon irritation and arthritis of the small wrist joints can also cause it.
When should I see a doctor for wrist pain?
After a fall with swelling or thumb-side pain, for pain that lasts more than a few weeks, for numbness or weakness in the hand, or for a hot, red, swollen wrist.
Where can I get chronic wrist pain treatment near me?
Precision Care Medical & Sports Performance sees patients with chronic wrist pain at all three offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Occupational and hand therapy is offered at the Brooklyn office only.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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