Wrist pain usually comes from one of four things: irritated tendons, the small joints of the wrist, the cartilage and ligament cushion on the little finger side, or a nerve being squeezed. Which side of the wrist hurts narrows the list down quickly.

Each side has its own short list. Here is how to sort yours.

Which side of your wrist hurts?

• Thumb side. Irritated tendons running to the thumb, or arthritis at the base of the thumb.
• Little finger side. The cartilage and ligament cushion there, forearm bones sitting at uneven lengths, or an irritated tendon behind the wrist.
• Palm side. A squeezed nerve in the carpal tunnel, or gripping tendons.
• Back of the wrist. Irritated straightening tendons, or a ganglion cyst.
• The whole wrist. Osteoarthritis, an old fracture, or inflammatory arthritis.

Pain that started with a fall is covered further down.

Pain on the thumb side of the wrist

The common cause is De Quervain’s tenosynovitis, irritation of the sheath around the two tendons running from the wrist into the thumb.

It is classically painful lifting a baby or a full kettle. Anything that moves the thumb while the wrist tilts sideways tends to hurt, and the ache sits over the bony bump on the thumb side, sometimes with swelling or a creaking feeling. It often follows a change in load: a new baby, a new job, heavy phone use.

The other cause there is arthritis at the base of the thumb: a deep ache with pinching and gripping, such as jar lids and keys. A separate post covers it in full.

Ulnar wrist pain, on the little finger side

The structure most often involved is the TFCC, short for triangular fibrocartilage complex: a small pad of cartilage and ligament that cushions that side and holds the two forearm bones together while you rotate your hand.

It is injured in two ways: a fall onto an outstretched hand, or repeated rotation under load, such as using a screwdriver or lifting with a twist.

Pain is worse turning a doorknob or a key, pushing up out of a chair, wringing out a cloth, or opening a jar. Some notice a click or clunk with rotation, or a sense the wrist gives way.

Two other causes sit on that side. In ulnar impaction, the forearm bones sit at uneven lengths, so the one on the little finger side presses into the small wrist bones beneath it, giving a load-related ache with the same twisting. The ECU tendon, which runs in a shallow groove behind the wrist there, can also be irritated or snap across the bone when you rotate.

Pain on the palm side of the wrist

Carpal tunnel syndrome is the well-known one. The median nerve is compressed at the front of the wrist, causing tingling, numbness and night waking more than pure pain. Which fingers are affected is the clue, and our post on numbness in the fingers maps that out.

The other cause is flexor tendinopathy, irritation of the tendons that bend the wrist and fingers, from repeated hard gripping. It aches at the front and is worse making a tight fist.

Pain at the back of the wrist

Extensor tendinopathy is irritation of the tendons that straighten the wrist and fingers. It follows repeated lifting palm down, or long stretches of keyboard work, and aches across the back.

A ganglion cyst is the other common finding: a fluid-filled lump that often changes size week to week and sometimes disappears and returns. It is usually harmless, though a larger one can ache or limit bending.

When the whole wrist hurts

Three causes spread across the joint rather than one side.

Osteoarthritis, meaning wear of the joint surfaces, causes stiffness and a deep ache that is worse with use. A previous fracture matters too: if a wrist bone healed in a changed position, load passes through the joint differently and can hurt years later.

Inflammatory arthritis looks different. It usually involves both wrists, morning stiffness lasts well beyond half an hour, other joints are often affected, and there may be swelling. That pattern is worth raising with your doctor.

Wrist pain from typing and desk work

This is rarely one thing. It is the position held for hours, plus sustained light gripping, plus no breaks. Practical changes:

• Set keyboard and mouse low enough that your wrists are not tipped back, with forearms roughly level.
• Keep the mouse close to the keyboard rather than out to the side.
• Support your forearms on the desk or armrests instead of holding them up.
• Break sustained gripping every 30 to 45 minutes. Let go and shake the hands out.
• Type and click with a lighter touch, and cut back on phone scrolling.

When a wrist injury needs imaging

If you fell onto an outstretched hand and you are tender in the small hollow at the base of the thumb, that can indicate a scaphoid fracture, a break in one of the small wrist bones.

The scaphoid has a fragile blood supply, and a fracture there often looks normal on an X-ray taken in the first days. Treated as a sprain and missed, the bone may fail to heal, causing long term pain and arthritis in that wrist.

So a fall with tenderness there needs proper assessment even when the first X-ray is clear, and repeat imaging may be needed.

How wrist pain is treated

Treatment moves in steps, starting with the least invasive.

Activity and ergonomic changes. Reduce the movement that reproduces the pain for several weeks. For tendon problems this alone settles many cases.

Splinting. A wrist or thumb splint rests the irritated structure, often worn at night or during aggravating tasks.

Physiotherapy. Graded loading, grip and forearm strengthening, and changes to how you lift.

What a pain clinic adds. When that is not enough, our physicians can place an ultrasound-guided injection precisely into the tendon sheath or joint generating the pain. We assess and treat nerve entrapment, and use nerve blocks for persistent nerve pain in the hand and wrist. Platelet-rich plasma is considered for some stubborn tendon problems. Suitability is decided case by case after assessment.

Warning signs that need urgent care

Seek same-day medical care if you have:

• a visibly deformed wrist after a fall
• no ability to move the wrist or grip at all
• a hot, swollen, red wrist with fever
• numbness with weakness that is getting worse, or thinning of the muscle at the base of the thumb
• severe pain and swelling after an injury that keeps worsening

Frequently asked questions

Why does my wrist hurt when I bend it?

Bending loads the tendons crossing the wrist and compresses the joint surfaces. Pain on bending forward often points to the flexor tendons at the front, while pain on bending back points to the extensor tendons or the joint itself. Sharp pain on the little finger side suggests the cartilage cushion.

How is ulnar wrist pain treated?

Ulnar wrist pain treatment usually starts with resting the twisting movements that provoke it, then physiotherapy to rebuild forearm and grip strength. If it persists, an ultrasound-guided injection into the specific joint or tendon sheath may be considered, and imaging can show whether the cartilage complex is torn.

Can wrist pain go away on its own?

Often, yes. Tendon irritation that follows a change in activity frequently settles over a few weeks once that load is reduced. What does not settle by itself is pain after a significant fall, pain with numbness and weakness, or pain that has lasted months without improving.

Should I wear a wrist brace?

A brace helps when the goal is resting an irritated tendon or joint for a set stretch, such as at night or during aggravating tasks. Wearing one all day for months is less useful, because the forearm muscles weaken. Many people find a few weeks of targeted use with physiotherapy works better.

This article is general information, not medical advice. It cannot diagnose your pain. If your symptoms are new, worsening, or worrying you, speak with your family doctor or contact us for an assessment.

Talk to us about ongoing wrist pain

If the pain has lasted beyond a few weeks despite rest, a splint and physiotherapy, an assessment can identify which structure is involved. Our physicians in North Toronto use ultrasound and fluoroscopy guidance to treat the specific tendon, joint or nerve.

Most services are covered by OHIP with a physician referral, and you do not need to wait for one: you can refer yourself directly, or ask your family doctor to send a physician referral.