Sprains and strains are the two most common types of injuries affecting the hand and wrist. They occur as a result of excessive stress applied during a stretching, twisting, or thrusting action. A sprain occurs when a ligament holding bones together is damaged. Ligaments are made up of separate fibers, and some or all of the fibers can be damaged. A strain occurs when a muscle or the sheath covering it is damaged. A muscle is also made up of groups of fibers, and some or all of the fibers can be damaged.
The severity of the injury is determined by how many ligament or muscle fibers are torn or damaged. The extent of the injury also depends on whether these fibers are just pulled and stretched or actually torn. A mild sprain or strain may cause very little damage, while a severe stress to the ligament or muscle may result in a complete tear.
The symptoms and treatment will vary depending on the amount of damage the tissue has suffered. In a mild sprain or strain, there will be mild tenderness and slight swelling at the site of injury. A severe sprain or strain will be extremely painful, very swollen, and bruised, and the function of the hand and wrist will be limited. An avulsion fracture, in which the ligament pulls a bone fragment loose or pulls the bones out of their normal position, may also occur.
Radiographic examination of the affected structures may be required to determine the extent of damage and to see if there are any fractures in the bones. These tests may include x-ray films, a CT scan, or an MRI. Occasionally, surgery will be required to repair the damage, however most sprains and strains will repair themselves with the RICE treatment formula (rest, ice, compression, and elevation).
Once swelling, bruising, or pain is gone, it is important to begin gentle exercises to regain hand strength. View the rehabilitation section of this site to learn more about exercise for the hand and wrist. If any symptoms return, however, exercises should be stopped and further evaluation considered. It is also important to review the cause of the original injury to learn how to prevent a recurrence. For example, if the injury occurred from a fall in the home, home safety may need to be improved. If the injury is from sports, proper stretching and warm up exercises or a sports brace may be helpful.
For more information about hand and wrist sprains and strains, please call (918) 494-AOOK (2665).