Persistent Left Wrist Pain: Causes and Solutions

left wrist

During class at a tutoring center, I was sitting in the back where the chairs are higher, and I had to use my hands to support myself in order to jump up and sit down.
One time, I pressed down hard with my palm, and there was a loud "pop." The right side of my left wrist (the area just below the joint) swelled up to the size of a ten-dollar coin.
Later, I went to see a doctor, who asked me to move my wrist up and down.
The doctor said that since I could still move it, it was likely not a ligament tear.
After taking medication, the swelling did not go down, and due to my busy schedule, I did not return for further evaluation.
It has now been over five years, and the swelling has not subsided.
My wrist is not flexible, and when the weather gets cold, the swollen area becomes hard (but softens when I apply hot water).
It is painful, and even turning a doorknob can cause discomfort.
Could you please explain the possible reasons for this? Thank you! P.S.
The area above the swollen part is also painful to the touch! The swelling is on the right side of my left wrist joint, but the area about one centimeter above it also hurts when pressed! It's really strange.

taiwan, 30~39 year old female. Ask Date: 2009/02/20

Dr. Wang Shouji reply Orthopedics

The wrist joint has a very complex structure, including cartilage, ligaments, and tendons.
After five years with no improvement, it is recommended to visit an orthopedic clinic for further examination.
Wishing you a speedy recovery.

Reply Date: 2009/02/20

More Info

Understanding persistent left wrist pain, especially after an injury, can be complex and multifactorial. Based on your description, it seems that you experienced a significant trauma to your left wrist, which resulted in swelling and ongoing discomfort. Here are some potential causes and considerations regarding your symptoms:
1. Soft Tissue Injury: The initial "pop" sound you heard when you pressed down on your wrist could indicate a soft tissue injury, such as a sprain or strain. This could involve the ligaments, tendons, or muscles surrounding the wrist joint. Even if the doctor assessed that there was no complete ligament tear, partial tears or inflammation could still lead to persistent pain and swelling.

2. Ganglion Cyst: The swelling you described, which has persisted for over five years, could potentially be a ganglion cyst. These are fluid-filled sacs that commonly develop around joints or tendons, particularly in the wrist. They can fluctuate in size and may cause discomfort, especially with movement or pressure.

3. Tendonitis: Chronic pain and swelling in the wrist can also be attributed to tendonitis, which is inflammation of the tendons. This condition can arise from repetitive strain or overuse, particularly if you have been using your wrist in a way that puts stress on the tendons.

4. Arthritis: Given the duration of your symptoms, it’s also worth considering the possibility of arthritis, particularly if you experience stiffness and pain that worsens with cold weather. Osteoarthritis or post-traumatic arthritis can develop after an injury and lead to chronic pain and swelling.

5. Carpal Tunnel Syndrome: If you are experiencing numbness or tingling in your fingers, it could indicate carpal tunnel syndrome, where the median nerve is compressed at the wrist. This condition can be exacerbated by repetitive wrist movements or swelling in the area.

6. Chronic Inflammation: The fact that the swelling becomes harder in cold weather and softens with heat suggests that there may be ongoing inflammation in the joint or surrounding tissues. This could be a sign of chronic synovitis, where the synovial membrane becomes inflamed.

Recommendations for Management:
- Medical Evaluation: It is crucial to seek a thorough evaluation from a healthcare professional, ideally an orthopedic specialist. They may recommend imaging studies such as an MRI or ultrasound to assess the soft tissues and determine the exact cause of your symptoms.

- Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the wrist, improve flexibility, and reduce pain. A therapist can provide tailored exercises and modalities to address your specific issues.

- Pain Management: Over-the-counter anti-inflammatory medications (like ibuprofen) can help manage pain and swelling. However, consult with a healthcare provider before starting any medication.

- Activity Modification: Avoid activities that exacerbate your pain. If certain movements or positions cause discomfort, it may be beneficial to modify how you use your wrist.

- Heat and Cold Therapy: Applying heat can help relax and soothe stiff muscles, while cold therapy can reduce swelling and numb sharp pain. Alternating between the two may provide relief.

- Surgical Options: If conservative treatments fail and the pain significantly impacts your quality of life, surgical options may be considered, especially if a ganglion cyst or other structural issue is identified.

In conclusion, persistent wrist pain following an injury warrants a comprehensive evaluation to identify the underlying cause. Early intervention can lead to better outcomes and help restore function to your wrist. Don't hesitate to seek medical advice to explore your options for relief and recovery.

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