A sprain results when the ligaments that connect bone to bone within the joint are stretched and perhaps torn. This can result when the wrist is bent forcefully backward, as can happen in a fall onto the palms of the hand.

Signs and symptoms of a wrist sprain may vary in intensity and location, depending on the degree of injury. Indications of a wrist sprain include:

• Swelling in the wrist
• Pain at the time of the injury
• Persistent pain when the wrist is moved
• Bruising or discoloration of the skin
• Tenderness at the injury site
• A feeling of popping or tearing inside the wrist
• A warm or feverish feeling to the skin

During the physical examination, the doctor will review how and when the injury happened. He or she will review all the symptoms, including asking about any numbness in the hand. Past medical history, especially any previous injuries to your hand or wrist, will also be reviewed.

The physician will examine the entire arm and hand, to ensure that there are no other injuries. Tenderness in certain areas may suggest a broken bone.

If a severe sprain is suspected, X-rays may be ordered. In some cases, a magnetic resonance image (MRI) or computed tomography (CT) scan also may be ordered. An arthrogram involves the injection of some liquid into the joint. This makes the joint show up more clearly on the X-ray. The liquid passes through an area where a ligament is torn, making it easier to identify injury.

Wrist sprains are graded, depending on the degree of injury to the tissues.

• Grade 1, or mild, sprains occur when the ligaments are stretched, but not torn.
• Grade 2, or moderate, sprains occur when some of the ligaments are torn. Grade 2 sprains may involve some loss of function.
• Grade 3, or severe, sprains occur when the ligament is completely torn. These are significant injuries that require medical or surgical care. As the ligament tears away from the bone, it may also take a small chip of bone with it, called an avulsion fracture.

Sometimes, a sprain can show only mild swelling, but it still may be serious enough to require surgery. To avoid problems later, proper diagnosis and treatment is important.

An unrecognized (occult) fracture may be mistakenly diagnosed as a sprained wrist.

Mild wrist sprains can usually be treated at home with the RICE protocol.

R	Rest the joint for at least 48 hours.
I	Ice the injury to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice or a package of frozen vegetables. Apply ice for about 20 minutes at a time.
C	Compress the swelling with an elastic bandage.
E	Elevate the injury above the level of the heart.

A pain reliever, such as aspirin or ibuprofen, may be helpful. If pain and swelling persist for more than 48 hours, however, see a doctor.

Moderate sprains may need to be immobilized with a wrist splint for 7 to 10 days.

Severe sprains may require surgery to repair the fully torn ligament. This would be followed by a period of rehabilitation and exercises to strengthen the wrist and restore motion. A wrist sprain can take anywhere from 2 to 10 weeks to heal completely, depending on the severity of the sprain.

Partial ligament tears are sometimes difficult to diagnose, but may cause re-occuring (chronic) disability if not treated surgically. Every effort should be made to properly diagnose the cause of a sprained wrist.

Because wrist sprains usually result from a fall, be careful when walking in wet or slippery conditions. Wrist sprains also occur during sports, such as skating, skateboarding, and skiing. Wrist guard splints or protective tape can be used to support the wrist and prevent it from bending too far backward. When skiing, drop the poles during a fall to prevent wrist sprains.