Hand Therapy TFCC Wrist Wrist Pain

Advice From a Certified Hand Therapist: Wrist Pain

Have you been experiencing pain in your wrist during day-to-day activities? Wrist pain may be attributed to many things, as the wrist is a complex network of tendons, ligaments, bones, vessels, and cartilage in and around the joints.

A common location of wrist pain is on the small finger side of the wrist, as highlighted in the image above. Pain in this area is referred to as ulnar sided wrist pain because it is on the same side of the wrist as the ulna bone.  This area has a large collection of ligaments and cartilage that form a complex structure called the Triangular FibroCartilage Complex, TFCC for short. Pain here can greatly interfere with and limit day-to-day activities. So what should you look for?

What causes ulnar-sided wrist pain?

Acute injuries such as falling on your hand and/or a twisting injury while gripping can cause pain on this side of your wrist. Another culprit for such wrist pain can be repetitive stress from continued gripping and/or weight bearing. Sports such as tennis, baseball and gymnastics are examples of activities where these types of recurring injuries most often happen.

What are some symptoms of ulnar-sided wrist pain?

There are many signs that you may have a wrist injury. Some of the common symptoms you should look for are as follows:

  • Worrying or fearing that your wrist will “give out” if you do certain tasks with it
  • Painful popping or clicking of the wrist
  • Pain during gripping activities
  • Pain while moving wrist from side to side
  • Pain during twisting activities (e.g. opening jars, using a screwdriver)
  • Pain during weight-bearing on wrist (e.g. pushing yourself up out of a chair, push-ups, handstands)
  • Weakness in wrist
  • Decreased movement
  • Swelling on small finger side of wrist

What kind of treatment is there for ulnar-sided wrist pain?

There are typically two types of treatment approaches for small-finger-sided wrist pain:conservative (non-operable) and surgical methods.

Conservative treatment usually consists of the following:

  • Splinting or casting of the wrist (e.g. custom or prefabricated orthotic, cast, Wrist Widget™)
  • Anti-inflammatories to reduce pain secondary to underlying swelling
  • Activity modification
  • Therapeutic modalities such as electrical stimulation (e.g. TENS), ultrasound, heat and ice
  • Cortisone injections

Surgical intervention may be appropriate when either the acute injury is severe or after 6 months of continued symptoms despite conservative treatment. Surgery can involve repair, debridement, and/or shortening of one of the bones in your forearm.

If you experience small-finger-(ulnar)sided wrist pain, please visit your local hand surgeon to be evaluated. Early diagnosis and treatment is key! You can find more information about TFCC injuries here. You can click here to find a hand therapist near you.


Sara D. Tchobanoff, MOT, OTR/L, CHT is a Certified Hand Therapist and a member of the American Society of Hand Therapists (ASHT).

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