A sprain is an injury to the ligaments around a joint. Ligaments are strong, flexible fibers that hold bones together.

When you sprain your wrist, you have strained or torn one or more of the ligaments in your wrist joint. This can happen from landing on your hand wrong when you fall.

See your health care provider as soon as possible after your injury.

Scapholunate ligament sprain - aftercare

Wrist sprains can be mild to severe. They are ranked by how severely the ligament is pulled or torn away from the bone.

• Grade 1 -- Ligaments are stretched, but not torn. This is a mild injury.
• Grade 2 -- Ligaments are partially torn. This is a moderate injury and may require splinting or casting to stabilize the joint.
• Grade 3 -- Ligaments are completely torn. This is a severe injury and usually requires medical or surgical care.

Some wrist sprains may be associated with a fracture of a wrist bone such as the navicular bone. Chronic wrist sprains from poorly treated ligament injuries in the past can lead to weakening of the bones and ligaments in the wrist. If not treated, this can lead to arthritis.

Symptoms such as pain, swelling, bruising and loss of strength or stability are common with mild (grade 1) to moderate (grade 2) wrist sprains.

With mild injuries, stiffness is normal once the ligament begins to heal. This can improve with light stretching.

Severe (grade 3) wrist sprains may need to be checked by a hand surgeon. X-rays or an MRI of the wrist may need to be done. More severe injuries may require surgery.

Chronic sprains should be treated with splinting, pain medicine, and anti-inflammatory medicine. Chronic sprains may need steroid injections and possibly surgery by a hand surgeon.

Follow any specific instructions for symptom relief. You may be advised that for the first few days or weeks after your injury:

• Rest. Stop any activity that causes pain. You may need a splint. You can find wrist splints at your local drugstore that may be appropriate for your injury.
• Ice your wrist for about 20 minutes, 2 to 3 times a day. To prevent skin injury, wrap the ice pack in a clean cloth before applying.

Make sure to rest your wrist as much as you can. Use a compression wrap or splint to keep the wrist from moving and to keep the swelling down.

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.

• Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
• Do not take more than the amount recommended on the bottle or by your provider.
• Do not give aspirin to children.

To build strength once your wrist starts to feel better, try the ball drill.

• With your palm up, place a rubber ball in your hand and grab it with your fingers.
• Keep your hand and wrist still while you gently squeeze the ball.
• Squeeze for about 30 seconds, then release.
• Repeat this 20 times, twice a day.

To increase flexibility and movement:

• Warm up your wrist by using a heating pad or warm washcloth for about 10 minutes.
• Once your wrist is warm, hold your hand out flat and grab your fingers with the uninjured hand. Gently bring the fingers back to bend the wrist. Stop just before it begins to feel uncomfortable. Hold the stretch for 30 seconds.
• Take a minute to let your wrist relax. Repeat the stretch 5 times.
• Bend your wrist in the opposite direction, stretching downward and holding for 30 seconds. Relax your wrist for a minute, and repeat this stretch 5 times, as well.

If you feel increased discomfort in your wrist after these exercises, ice the wrist for 20 minutes.

Do the exercises twice a day.

Follow up with your provider 1 to 2 weeks after your injury. Based on the severity of your injury, your provider may want to see you more than once.

For chronic wrist sprains, talk to your provider about what activity may be causing you to re-injure your wrist and what you can do to prevent further injury.

Contact your provider if you have:

• Sudden numbness or tingling
• A sudden increase in pain or swelling
• Sudden bruising or locking in the wrist
• An injury that does not seem to be healing as expected

Franco VS, Kim HT. Wrist and forearm injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 43.

Marinello PG, Gaston RG, Robinson EP, Lourie GM. Hand and wrist diagnosis and decision making. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 67.