Anatomy & Background


The wrist joint contains the ends of the radius, ulna and eight carpal bones. This joint was designed to help the hand be capable of moving with a wide range of motion and flexibility. The wrist joint is surrounded by two individual bursa. A bursa is a fluid filled sack that serves to reduce friction in the joint. The two major bursae of the wrist are the radial bursa and the ulnar bursa.

  • Radial bursa: reduces friction on the tendons that run from the forearm through the wrist and into the hand, and serves the thumb. This bursa extends to where the wrist creases.
  • Ulnar bursa: reduces friction on the tendons that run from the forearm through the wrist and into the hand, and serves the index, middle, and ring fingers.

Causes


  • A direct blow to the bursa can produce inflammation and irritation.
  • A fall on to the wrist.
  • Constant pressure on the bursa from overusing the wrist.
  • Repeated stress injuries to the bursa and tendon from using the hand.
  • Complications from rheumatoid arthritis, osteoarthritis or gout.
  • Infection of the bursa or wrist.
  • Bursa can become swollen as a response to other injuries in the wrist.

Symptoms of Wrist Bursitis


  • Pain and tenderness over the location of the bursa
  • Swelling
  • Loss of motion of the wrist
  • Pain with activities that stress the bursa like typing and writing

Treating Wrist Bursitis


  • Initial treatment of bursitis includes avoiding activities that produce pain or stress of the bursa and the associated tendons.
  • Splinting of the involved area.
  • The use of ice to reduce inflammation and pain.
  • NSAIDS (non-steroidal anti-inflammatory drugs)
  • Hand Therapy
  • Drainage of the fluid in the bursa for severe cases.
  • Antibiotics in the case of infections of the bursa
  • Surgery may be indicated in extreme cases if the problem becomes chronic.

Medicine Intervenes


First avoid the activities that produce the pain or stress. Then try:

  • RICE: (Rest, Ice, Compression, Elevation)
  • Splinting of involved area as appropriate.
  • NSAIDS (non-steroidal anti-inflammatory drugs)
  • Needle drainage to remove excessive fluid from the bursa
  • Injection of steroids to reduce inflammation in bursa
  • In the case of infection antibiotics may be prescribed
  • In severe recurrent conditions, surgery to remove the bursa may be needed.

Prognosis


It is important that once the pain and inflammation is reduced, and motion and strength are restored, the patient should gradually return to their daily activities. Instruction on daily activities is helpful to reduce the chance of a re-occurrence of wrist bursitis. In most cases, full return to activity will take from 2-6 weeks depending on the severity of the condition. As a preventive measure individuals should:

  • Make modifications in work or daily activities
  • Maintain strength and flexibility to reduce stress on the bursa and tendons of the wrist
  • Avoid highly repetitive activities whenever possible.