Your wrist likely hurts with ulnar deviation (bending your wrist towards your pinky finger) due to a variety of potential reasons, generally involving either soft tissue or bone structures being compressed, stretched, or inflamed. Common causes include tendinopathy, tenosynovitis, and issues related to the carpal bones or the ulnar side of the wrist.
Here's a breakdown of possible causes:
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Extensor Carpi Ulnaris (ECU) Tendinopathy/Tenosynovitis: This is a common cause. The ECU tendon runs along the ulnar side of your wrist and is responsible for extending and ulnarly deviating your wrist. Overuse or repetitive motions can lead to inflammation (tenosynovitis) or degeneration (tendinopathy) of the tendon. Pain is often felt directly over the ECU tendon and is exacerbated by resisted wrist extension and ulnar deviation.
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Ulnar Collateral Ligament (UCL) Sprain/Injury: The UCL provides stability to the ulnar side of the wrist. A sprain or tear can occur due to a traumatic event or repetitive stress, causing pain with ulnar deviation as the ligament is stretched.
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Triangular Fibrocartilage Complex (TFCC) Tear: The TFCC is a cartilage structure located on the ulnar side of the wrist that cushions and stabilizes the wrist joint. Tears can occur from falls onto an outstretched hand or from chronic wear and tear. Pain is typically felt on the ulnar side of the wrist, and it's often aggravated by ulnar deviation and rotation of the forearm.
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Ulnar Impaction Syndrome: This occurs when the ulna bone is longer than the radius, leading to increased stress and compression between the ulna and the carpal bones during ulnar deviation. This can cause pain and cartilage damage.
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Carpal Bone Instability: Abnormal movement or instability of the carpal bones (the small bones in your wrist) can cause pain, especially with specific movements like ulnar deviation.
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Arthritis: While less common in younger individuals, arthritis in the wrist joint can also cause pain with any wrist movement, including ulnar deviation.
What to do if you experience wrist pain with ulnar deviation:
- Rest: Avoid activities that aggravate the pain.
- Ice: Apply ice packs to the affected area for 15-20 minutes several times a day.
- Over-the-counter pain relievers: NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen or naproxen can help reduce pain and inflammation.
- See a doctor: If your pain is severe or doesn't improve with home treatment, it's essential to see a doctor or physical therapist for a diagnosis and treatment plan. They may recommend imaging tests (like an X-ray or MRI) to determine the underlying cause of your pain.
A healthcare professional can properly assess your wrist, determine the underlying cause of your pain, and recommend the appropriate treatment, which may include:
- Splinting or bracing: To immobilize the wrist and reduce stress on the injured tissues.
- Physical therapy: To improve strength, flexibility, and range of motion.
- Corticosteroid injections: To reduce inflammation.
- Surgery: In severe cases, surgery may be necessary to repair a TFCC tear, UCL tear, or correct carpal bone instability.
