Wrist

How to Manage Ulnar-Sided Wrist Pain with a Brace

By November 11, 2019 No Comments

Wrist pain is a common ailment, as wrists are used in many activities. Everyone from professional athletes to office workers may be susceptible to wrist pain or injury. The pain can come on quickly or develop slowly over time. One of the most common treatments, wearing a brace, offers a simple solution to wrist pain. In many cases, more than one treatment plan are used to alleviate symptoms. Read on to learn more about what may be causing ulnar-sided wrist pain, how to treat it, the benefits of wearing a brace, and how regenerative medicine could help.

Anatomy of the Wrist
The wrist is made up of the radius and ulna, which connect to the carpal bones at the base of the hand. These bones are also used to distinguish parts of the wrist and the hand – there is a radial side of the wrist and an ulnar side. When hands are placed on a table with the palms facing downward, the internal side of the wrist is the radial side and the exterior is the ulnar side.

Bones often have a piece of articular cartilage where it will need to make contact with another bone. This type of cartilage occurs most often in joints and acts as a cushion between bones. The wrist and hand also contain tendons, ligaments, and cartilage that provide support for joint movement.

Each of these structures can encounter their own unique sets of issues. This means that the exact cause of ulnar-sided wrist pain may be difficult to diagnose at first, as it is necessary to rule out all of the possibilities.

Causes of Ulnar-Sided Wrist Pain
There are many potential causes of wrist pain. Some of the most common reasons an individual may develop this condition are:

  • Overuse: repetitive motion of the wrist, such as with a tennis player, can cause the joint to deteriorate more rapidly over time.
  • Injury: Injury can lead to torn ligaments, broken bones, a sprain (torn ligament), or a strain (torn muscle or tendon). Injuries can occur from activity or an accident such as a fall or car accident. In some cases, injury can lead to structural differences over time if it does not heal correctly.
  • Arthritis: soft tissue in the body deteriorate naturally over time. This condition can become problematic when soft tissue such as articular cartilage deteriorates to the point where bones are rubbing against one another. This condition can cause pain, tenderness, and swelling.
  • Structural Abnormalities: some individuals are born with improper alignment of bones. This does not often lead to pain until the soft tissue surrounding them begins to deteriorate. This may also be referred to as ulnar impaction syndrome and can lead to pain and discomfort.
  • Tendonitis: the condition of tendon damage or injury. This condition may occur due to overuse, injury, arthritic structural changes, and many more.

Due to the many structures and systems that are interacting throughout the wrist, there may be other conditions that are causing pain as well. A proper diagnosis of what is causing pain will lead to the most effective treatment.

Diagnosis
The process of diagnosing ulnar-sided wrist pain begins with a consultation with a doctor. In many cases, doctors are able to perform a simple series of tests to locate the cause of pain, which can lead to a diagnosis. These tests consist mainly of hand and wrist movements. Pain during certain motions can indicate what is causing it. Doctors may also check for tenderness or swelling in the wrist. If these minimally invasive tests do not result in a diagnosis, doctors may turn to imaging techniques to provide a more accurate picture of what is happening. These imaging tests may include:

  • MRI: Magnetic Resonance Imaging is able to produce an image of a patient’s soft tissue. It may reveal the source of discomfort if the cause of wrist pain is in a ligament, muscle, tendon, or cartilage.
  • X-Ray: this imaging technique is used to determine the bone structure. If the cause of wrist pain is a fracture of the bone or an abnormality in the bone’s alignment, an X-Ray will be able to determine this.
  • CT Scan: this form of imaging is able to produce a more 3D image of what is occurring, and can be used to diagnose most conditions.

Once a diagnosis is reached, doctors will begin to devise a treatment plan that is unique to each patient.

Signs and Symptoms
There are several symptoms associated with this ulnar-sided wrist pain. These may include:

  • Pain – can be anywhere from a short, stabbing pain to a persistent dull ache. Pain can occur chronically or only during certain activities.
  • Tenderness or Soreness: the skin may feel tender to the touch or ache.
  • Weakness: an individual with wrist pain may have trouble using their hand and wrist for normal activities such as gripping or lifting items.
  • Limited Range of Motion: an individual experiencing wrist pain may no longer to move their hand in certain ways.
  • Popping Sensation or Sound: the wrist may “pop” when bent in a certain way. This could be indicative of several conditions associated with wrist pain.

Treating Ulnar-Sided Wrist Pain
Injuries in the wrist are not often serious. Treatment for wrist pain typically begins with minimally invasive procedures that increase in intensity over time if they do not relieve pain. The treatment timeline is typically as follows:

  • Rest: the first step to recovery is simply resting the joint. The human body is fairly capable of repairing damage on its own, so allowing it to heal can sometimes be enough to reduce pain.
  • Anti-Inflammatory Drugs: over-the-counter drugs such as Ibuprofen or Naproxen can help to alleviate pain while the wrist heals.
  • Physical Therapy: if rest and pain management are not enough to reduce symptoms, doctors may recommend physical therapy. The main goals of physical therapy are to restrengthen muscles that may have grown weaker throughout the course of the injury, and to provide support for the injury while it heals. Physical therapy exercises can also increase blood flow, helping it to heal.
  • Corticosteroid Injections: these types of injection deliver a densely concentrated anti-inflammatory hormone into the pain site. These injections can be effective for treating pain in the short-term, but may not be recommended for patients of a certain age and activity level as they have been proven to damage soft tissue over time.
  • Surgery: there are several forms of surgery which may be considered to treat wrist pain. These surgeries all come with their own list of risks and complications and should therefore be discussed thoroughly with a doctor or surgeon before a patient makes the decision to undergo surgery.

There are many other treatment options available on the market, these are simply the most common. Another common treatment is wearing a brace.

Wearing a Wrist Brace
Wrist braces are a common form of treatment for managing pain. They can be purchased at most pharmacies and big box stores, even some grocery stores. They are often simple to put on and take off and are fairly inexpensive.

Doctors will often recommend that patients experiencing wrist pain wear a brace, as it allows the joint to remain stabilized. Stabilization of the joint can allow it to heal more quickly. When an individual continues activity in the same way that they did before the injury occurred, they could be allowing further injury to occur. For example, if the wrist pain is caused by a torn ligament, activity could tear the ligament further. It is generally recommended that an injury be stabilized in order to help it heal – this is why bone fractures require casts.

Doctors will suggest that a patient wear a brace based on the patient’s specific needs. It is often recommended that patients wear their brace during sleep, as the wrist is more likely to get bent during this time. Some patients may wear their brace during certain activities as well, especially activities that cause pain or contribute to the injury.

Wearing a brace on the wrist can be beneficial for the treatment process. It is often coupled with other treatments such as physical therapy and anti-inflammatory medication.

Alternative treatments may offer a solution to wrist pain as well. The up-and-coming field of regenerative medicine offers yet another solution to chronic wrist pain.

How Regenerative Medicine Can Help Ulnar-Sided Wrist Pain
When seeking treatment for wrist pain, it is important to consider all of the options available on the market. The field of regenerative medicine offers pain relief for those who are experiencing certain forms of chronic pain. These types of therapy have yielded positive results for conditions such as arthritis, joint complications, tendonitis, and many more. There are two types of regenerative medicine offered at CELLAXYS:

  • Stem Cell Therapy: this form of therapy takes a patient’s own stem cells, most often taken from fat cells, blood cells, or bone marrow. Once the cells have been processed to be more concentrated, they are then injected into the source of pain. These cells are believed to be able to help healing processes that are already naturally occurring.
  • Platelet-Rich Plasma (PRP) Therapy: this form of therapy begins with a blood draw. The blood is then placed in a centrifuge to separate the platelets from the rest of the blood. These concentrated platelets are then injected into the pain site, similar to stem cell therapy. Platelets contain healing factors and proteins that occur naturally in the blood. Injecting them into an injury or site of damage could help with the body’s natural regenerative processes.

Both forms of therapy use an imaging technique such as MRI or ultrasound to guide the needle to the exact location where it is needed most. These are outpatient procedures that take one to two hours. Some patients report feeling a pain at the injection site immediately after the therapy is received, but this typically goes away in a matter of days. Patients often report reduced pain within a couple of days.

Regenerative therapies are often coupled with other treatments – in the case of wrist pain, they might be coupled with physical therapy, medication, or wearing a brace. Though wearing a wrist brace may be somewhat effective in relieving symptoms of wrist pain, it can become even more effective when coupled with other treatments.

Conclusion
Wrist pain can be anywhere from irritating to debilitating. Once it begins to impact daily life, it should be examined by a doctor. There are many potential causes of wrist pain due to the complex nature of the joint. Doctors are able to use advanced techniques to reach an accurate diagnosis. Once a diagnosis has been made, treatment can begin. There are many options for treatment of wrist pain, so it is important to consider all of the options on the market. It is sometimes possible, even recommended, to employ more than one treatment at a time. In the case of the wrist brace, it is almost always coupled with other treatments. Treatment should be as painless and comfortable as possible, and regenerative therapies could allow for more comfort during the healing process and for years after.

Dr. Matthew HC Otten

Dr. Matthew HC Otten

Director of Orthopedic & Orthobiologics
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan Stage University Alumni