Do I have a broken wrist, or is it just a sprained wrist? How can I tell?
The wrist is a group of bones held together by strong ligaments. Damage to either part of the wrist can be a serious injury.
An injured wrist could mean anything from a mild sprain that only limits function for a few days, or a severely fractured bone that may take months to heal and recover from. You may not always be able to tell if you have a break or a sprain without an x-ray, but there are some general guidelines to keep in mind.
The most important thing to realize about wrist injuries is that some fractures are easy to recover from, and easy to treat. Some sprains are devastating injuries to the wrist and may lead to painful arthritis if not treated correctly.
So, just because it’s “only sprained” doesn’t mean it’s a minor injury. A sprain is a tearing or injury to ligaments in the wrist which hold the bones together.
Mechanism of injury – how it happened
Both injuries are painful when they first happen. A higher energy injury, like falling from a 10 foot roof or being in a car wreck, will result in more severe injury to the wrist. So, you should be suspicious of a bad injury if you’re in one of these situations.
What to look for
In general, fractures (breaks) usually result in more bleeding, swelling, and bruising than a sprain. If the pieces of the broken bone move against each other, you’ll feel or hear a crunching or grinding sound that goes along with excruciating pain when you try to move the wrist.
Lots of patients have told me that when they sprained their wrists, there was some swelling and some pain, but it went away pretty quickly. The pain from a broken wrist usually doesn’t go away very quickly.
The next step
Immediately after you injure your wrist, stop the activity that caused the injury – this advice mostly applies to athletes, obviously. If you’re in a collision in a football game and you injure your wrist, you may make things worse by staying in the game and re-injuring it or moving the damaged wrist.
Treat an injured wrist with cold (ice packs), elevation, and rest. Getting a wrist splint to keep the wrist from moving too much may be helpful.
Exceptions to the Rules
There are major exceptions to these rules. For example, a fractured scaphoid bone (a small bone in the wrist) may hurt for a few days and then stop hurting completely – it’s the best imitator of wrist sprains out there. Many scaphoid fractures have been mis-diagnosed as wrist sprains over the years, leading to early arthritis and wrist pain.
In a similar way, if the wrong ligaments are torn (sprained) in the wrist, it will lead to arthritis as the bones that used to be held together now move abnormally against one another.
How do I find out if I have a broken or sprained wrist?
Unfortunately, if you have pain in the wrist after an injury that isn’t going away or getting dramatically better after 3-5 days, go see a doctor you trust and get it checked out. They are usually able to tell if you need to see a hand and wrist specialist or not. X-rays are usually required to diagnose a wrist fracture or severe sprain.
