Wrist bursitis (retinaculum) is different from carpal tunnel syndrome. Symptoms Causes Treatment Preventions & More All you need to know
Wrist bursitis is the inflammation of the bursa present in the wrist joint. Two bursas are involved in the wrist joint; the radial and the ulnar bursa. The condition causes pain with the movements applying the wrist joint.
Anatomy of the wrist joint
The wrist joint is made of many small bones and connects the forearm with the hand. The joint also includes the distal ends of the forearm bones, radius, and ulna.
The wrist comprises eight small bones; the carpal bones or the carpus. The carpus joins your hand to the bones of the forearm, the radius, and the ulna.
The wrist is not a single joint. Instead, it has three main joints.
- Radiocarpal joint
- Ulnocarpal joint
- Distal radioulnar joint
The design of the wrist joint makes it more stable and increases the joint's flexibility. Up and down, forward and backward, side to side, rotation; all movements are made possible in the wrist joint owing to its structural design.
Radial and ulnar bursas complement the wrist movements by providing a cushioning effect.
The ulnar bursa is a synovial sheath bursa that surrounds the muscle tendons of the flexor digitorum superficialis and profundus muscles, more towards the center in the palmer side of the wrist.
The radial bursa is present in the palmar surface of the hand. It is small in size, and like the ulnar bursa, it surrounds one of the muscles of the wrist joint, the flexor pollicis longus tendon on the thumb and palm sides of the wrist. The radial bursa extends for a centimeter or two across the carpal tunnel.
The radial and the ulnar bursa may communicate with each other proximal to the transverse carpal ligament.
Causes of wrist bursitis
Inflammation of the bursa involved in the wrist joint can follow;
- A direct injury or sudden impact on the wrist joint
- Repetitive friction due to an overuse of the joint
People who play sports that require frequent throwing or twisting movements involving the wrist often succumb to this condition. Such sports include baseball, badminton and tennis, rowing, weight lifting, and so on.
Symptoms of the wrist bursitis
Symptoms of wrist bursitis can be debilitating because the joint is involved in most everyday activities. These include;
- Apparent swelling in the wrist
- Tenderness over the tendons
- Pain in case of pressure applied on the bursa, for example, moving the wrist in the backward direction.
Wrist pain is a common complaint and can originate even from overstretching of the ligament. This is because the wrist is not a simple joint. Instead, it is a complex joint containing many bones. In addition, several muscles and ligaments hold the bony structures involved in the joint together.
One such condition, which should be differentiated from wrist bursitis, is carpel tunnel syndrome.
Carpal tunnel syndrome develops when a ligament taking part in the wrist joint thickens due to overuse. The thickened ligament presses on the underlying nerve. The squeezed nerve presents with signs and symptoms like pain, numbness, and weakness in the hand.
Obesity and diseases like diabetes and arthritis are some high-risk factors for carpal tunnel syndrome. In addition, people who perform repetitive work movements regularly like lifting, typing, or using a vibrating tool are also more prone to developing the CT syndrome.
Treatment of wrist bursitis
Wrist bursitis is treated conservatively. Very rarely, surgical intervention is required.
- Immediately after the injury to few days
TENS should be employed after the swelling is gone. It is important to use smaller electrodes when using TENS on the wrist. Alternatively, a TENS conductive electrode cuff can also be placed for effective pain management.
Place the electrodes on either side of the wrist but not over the bones. Electrodes placed on the palmer side can also effectively address the bursitis pain.
- After the first few weeks
After the initial injury has resolved, massaging the lower arm area helps to relax the muscles involved in the wrist joint. It also eases pressure accumulated in the bursas of the wrist.
- Therapeutic ultrasound
Therapeutic ultrasound helps wrist bursitis by treating chronic and lingering pain associated with the condition.
Since the condition is linked to repeated movements at the wrist joint usually encountered in daily life and these activities must go on, therapeutic ultrasound can help prevent a recurrence every few weeks.
- Active rehabilitation
Some exercises for wrist bursitis include;
During the initial days, move your wrist in all directions without putting any strain or pressure. These include movements like
- Wrist forwards and backward
- Side to side
- Forearm rotation
- Making a fist
- Making knuckle bends followed by finger straightening
After the injury has healed, adopt the following;
Wrist stretch backward
- Keep your elbows resting on a table.
- Keep your palms together.
- Extend your forearms and lower your wrists on the table until you feel a stretch.
- Hold the stretch for 5 seconds.
- The palms must be kept together.
Wrist stretch forwards
- Keep your elbow straight
- Bend your wrist in a downward direction until you feel a stretch.
- Hold the stretch.
- You can add some pressure with your other hand.
Wrist stretch with elbows straight
- Place your arms on a table.
- Move your body over your hands in such a manner that you feel a comfortable stretch in your forearms.
- Hold for about 5 seconds.
Prevention of wrist bursitis
- Using proper posture and playing technique.
- Keep your wrists relaxed while performing a job.
- Use a wrist-friendly keyboard if spending extended hours working the keyboard.
- Learn to use hand tools and game gadgets properly.
- Taking regular breaks from repetitive movements.
- Using wrist guards to prevent injuries when practicing or playing sports like skateboarding, snowboarding, and rollerblading.