Wrist Pain Without Swelling: Causes & Remedies

Wrist Pain: Something Very Common!

When questioning people randomly in the population, regardless of age, 10% of them have wrist pain! And when asking people how many have had wrist pain at least once in the past year, it’s almost 1 in 5 who say yes.

These pains are more common in people who play sports or have a very physical job. The most affected individuals are teenage girls involved in gymnastics.

Wrist pains are also one of the most common reasons for consultation with general practitioners, emergency rooms, or physiotherapists.

Source: Ferguson 2019

Personally, I find this information reassuring: since wrist pain (even without a fall) is very common, it’s likely that when I have wrist pain, it’s not something serious!

Source: Ferguson 2019

What are the symptoms of wrist pain without swelling?

One of the first reflexes when experiencing pain somewhere, especially in the wrist, is to question:

1. The location of the pain: where does it hurt?
2. Its mode of onset: for example, while weightlifting? What specific movement increases the pain?
3. The severity of the problem: could it be something serious? Will it last long?

You are absolutely right to ask yourself these questions, and it can already guide you on what is relevant to do or not: consult? Worry? Be reassured that it will probably pass on its own?

In this first part, I will go over the most common feelings of people with wrist pain. You will probably recognize yourself in one or another of these situations! This will give you some initial clues to better understand your pain and its origin.

Whether or not there is swelling associated with what you feel doesn’t really provide more clues about the precise cause of your wrist pain. It just tells us that it is probably really unnecessary to apply solutions aimed at reducing joint swelling.

External Wrist Pain (on the pinky side)

The external side of the wrist is where pain is most often felt, especially if it is not due to a fall. There are many structures that pass through this area, as shown in the diagram below: bones, ligaments, tendons, etc.

Even though the initial reflex of healthcare professionals is often to ask where you are precisely experiencing pain, the precise location of the pain does not allow for a diagnosis. It is a combination of factors, with location being just one component among others.

I discuss this further in the article!

Internal Wrist Pain (on the thumb side)

One can also experience pain localized on the internal side of the wrist, at the base of the thumb. It may radiate more or less into the hand or forearm.

Wrist Pain When Bending

When bending the wrist, it puts tension on numerous muscles, tendons, fascia, and other components of the joint. Therefore, pain when bending the wrist is not characteristic of a particular pathology.

Unless you are unable to bend or straighten the wrist at all, following a fall: in that case, it could be a sign of a wrist fracture or crack.

Wrist Pain When Rotating

The same reasoning applies to wrist rotation as for wrist flexion (when bending): rotating the wrist to either side puts tension on different structures, which can cause pain.

If you cannot rotate the wrist at all following a fall, it may be a sign of a fracture. But generally, you won’t be able to bend it either. Only an X-ray will confirm the diagnosis if the healthcare professional you consult deems there are enough symptoms to warrant this additional examination.

Wrist Pain When Pressing on It

Even without a specific pathology, it is very common to experience pain in the wrist when pressing on it. This is due to the fact that as we age (starting in our twenties or thirties!), we become less flexible and tolerate less extensive movements.

Pressing on the wrist requires flexing or extending it a lot, which can cause pain.

All other pathologies affecting the wrist (osteoarthritis, tendonitis, carpal tunnel syndrome, etc.) can also increase pain when pressing on it.

Protruding Wrist Bone and Pain

If you feel like you have a protruding wrist bone, the first thing to ask yourself is: is it following a very recent fall, or a blow to the wrist, which is also the cause of the wrist pain?

✅ If yes, and you have difficulty using the wrist, then consulting a healthcare professional to rule out a fracture seems appropriate.

❌ If you have not recently fallen or had a recent impact on it, it is unlikely to be a fracture. It could be many different things: osteoarthritis, birth deformity, cyst, arthritis, etc.

Pain in the Wrist Veins

When you have pain in the wrist veins, it doesn’t necessarily indicate a problem with the veins. Although there are pathologies that affect the veins, or they can be damaged, this is rather rare.

When you have wrist pain, even if it’s in the veins, it’s rare for it to be a venous problem.

In fact, next to, below, behind, and in front of the veins, there are many other anatomical structures: ligaments, tendons, components of the joint…

One of the most common pathologies affecting this area is carpal tunnel syndrome. But the location of the pain does not confirm the diagnosis, especially when one is not accustomed to seeing people with this type of symptom.

If you consult for pain in the wrist veins, your doctor will ask you questions to clarify. If the pain is tolerable and does not bother you, and there are no other associated signs, consultation may not be necessary.

Why Does a Wrist Hurt?

What is the mechanism behind wrist pain?

As with any part of the body, pain is a warning signal from your body to draw attention to something.

• When there is an injury, inflammation, or something unusual in your wrist, special cells called nociceptors detect changes in the tissues.
• They send this information in the form of electrical signals to your spinal cord (along the back) through nerve fibers known as nociceptive fibers.
• From there, the pain signals are transmitted from the spinal cord to the brain.
• Once the signals reach the brain, it interprets them as a sensation of pain. This triggers an emotional and behavioral response associated with pain, such as withdrawing from the source of pain (e.g., in the case of a splinter or burn) or expressing discomfort (e.g., by searching for information on the internet about your pain 🙂).
• The intensity of pain can be influenced by your emotional state and environment.

This is why, for the same anatomical problem (such as wrist osteoarthritis, a fracture, or carpal tunnel syndrome), you may not necessarily feel the same as another person. Or you may not feel the same at two different times, even though you have the same “structural” problem.

What are the common causes and meanings of painful but not swollen wrists?

Here are the main causes of wrist pain:

Following a fall or blow to the wrist:

• Simple bruise: you had a blow or impact, but nothing is broken (bones) or damaged (tendons, ligaments, nerves, blood vessels). This is by far the most common situation.
• Sprain of one of the wrist ligaments: a ligament is more stretched than usual or torn in part.
• Fracture of one of the wrist bones: Colles’ fracture, scaphoid fracture, radius fracture or ulna fracture, etc. The main sign of a fracture is the deformation of the wrist (even if it is not always present) and the inability to move the wrist, which is stuck in a position. An X-ray usually determines whether there is a fracture or not. However, an X-ray is not always done after every fall, as it is not a trivial examination.
• Wrist dislocation.
• Injury to a nerve or blood vessels: one generally does not overlook this. It is difficult to move the fingers, and there is a loss of sensitivity. There is often also a associated fracture or dislocation.

Without a traumatic event:

• “Simple” overuse of the wrist compared to the pace it is accustomed to or can tolerate: for example, using the computer too much, engaging in highly repetitive manual activities, etc.
• Tendonitis of one of the wrist tendons, De Quervain’s tenosynovitis, etc.
• Carpal tunnel syndrome: the nerve passing at the wrist is too compressed compared to what it can endure.
• Wrist osteoarthritis (1 in 7 people worldwide has wrist osteoarthritis! However, this is not always a source of pain).
• Inflammatory flare-up in the case of rheumatoid arthritis or another rheumatic disease.
• Ganglion cyst: a kind of cyst filled with synovial fluid (the fluid that lubricates the joints).
• Instability/hypermobility.
• Gout attack.
• Cervical radiculitis
• Wrist CRPS.
• Etc.

Source: InformedHealth 2020; Akhondi 2023

Painful Wrist but Not Swollen After a Fall

It is very common for a wrist to hurt after a fall. If it is not swollen, is that reassuring?

Yes, it is somewhat reassuring because it indicates that there is not a significant inflammation. However, even without swelling, a wrist can be broken. For example, scaphoid fractures sometimes go unnoticed as they do not always cause swelling.

This does not mean that you should automatically consult every time you fall on your wrists, with or without swelling. We will see later precisely when to seek medical attention.

Is a Wrist Sprain Possible Without Swelling?

Indeed, it is possible to have a wrist sprain (and even a fracture) without it being swollen. Conversely, you can have a very large swelling without a sprain or fracture.

As a reminder, a sprain is when a ligament is stretched beyond normal. It may even be torn or partially ruptured.

While wrist swelling is a very visible sign, it is not a very reliable indicator for making a diagnosis.

Wrist Tendinitis Without Swelling?

Yes, it is entirely possible to have a tendon problem (tendinitis, tendinopathy) without swelling.

As a reminder, tendinitis is a problem with a tendon: the tendon is damaged or inflamed.

How to Determine the Cause of Your Wrist Pain?

What matters most is not to overlook something “serious” that would require specific treatment for a problem other than just pain and discomfort.

However, in such cases, there are often other associated signs, known as red flags: fever, weight loss, etc.

Here is a list of questions to help you better determine the possible origin of this wrist pain.

Of course, seeking the advice of a healthcare professional accustomed to seeing this type of problem every day can provide more certainty about the diagnosis.

• When did the pain (and other symptoms) first appear?
• Is it related to something specific? A fall, impact, sports activities like weightlifting, more intense desk work schedule, change of computer or mobile phone, increased training load, etc.
• Does the pain occur mainly when doing something or when at rest? Is it more intense at night?
• What are the other symptoms you are experiencing?
• Have you ever had this problem or a similar problem, and in what context?
• Do you feel that your wrist is becoming increasingly painful, stable, or decreasing?
• Do you have any diseases (osteoarthritis, rheumatic disease, etc.) or a physical condition (overweight, muscle weakness) that could partly explain this pain?

After answering these questions, revisit the section I dedicate to common causes of wrist pain without swelling. This may provide you with some insights.