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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  • Cpy
    November 26, 2019 at 5:18 AM

    I’ve been working as a food delivery personnel and I’ve pain innthe mentioned area on my wrist suddenly one day.

    I don’t know the trigger but I can’t turn my arm (below my elbow) sideways and I can’t lift my palm too high up (like for “hi” and wave)… carrying weight at some angle cause some aching pain.

  • Ankit
    May 28, 2019 at 10:19 AM

    I have twisted my wrist during tennis serve last November and I had a small pain on my ulnar side wrist. I stopped playing for couple of month and came back to tennis. I realized pain is still there. My GP gave me some ointment for pain relief for one month. It did not work at all. This is already February and till this moment, my wrist has all strength and I can do everything. I only felt the pain when I do excessive twist of the right wrist eg during shower when I try to reach back of my body . I went on to a holidays and during which I lifted some luggage or may be something else. Due to which my pain was increased. I start loosing gripping power. I had pain all around my wrist. When I touch my ulnar side, I feel a pain sensation. It was really worse. My fingers were all good. I cold not open a lid or cut an onion. Then I used splint and atleast some pain was gone. I met my fysio and he clearly mentioned that I have tfcc tear after some examination. It was already end of April. He gave me wrist widget splint to keep my ulnar and radius bones more stable. He also mentioned to meet a surgeon. I met surgeon who is specialist in arthroscopy surgery said its peripheral TFCC tear mostly. he recommended to have a surgery. He did a testing by pushing ulnar and radius bones and there was a click sound. he said these two bones are unstable and tfcc tear is there. According to him if natural healing was possible then it could have been done by now. But it did not happened. So 2nd July 2019 is my surgery date. But with splint most of the pain around the wrist is gone except the tfcc pain. With rotation or twist I feel the pain immediately.
    Any recommendation or solutions or experience like this?

  • Joan
    April 11, 2019 at 11:14 AM

    I have a TFCC injury with a partial tear in my scapholunate ligament and ECU strain and have been seeing a specialist and OT for it. There’s no significant improvement since I started therapy (I am already on my 2nd script doing Therapy, already did 16 sessions). On my 10th session my OT asked me to do the hammer exercises and I’ve tried doing it for a couple of days even it was painful and well, my pain got worse after that and well, I have not recovered ever since. I’ve had the injury for 14 weeks now and couldn’t work because my restriction is still under No Use of Right Hand and my dominant hand is my right. I am frustrated because my doctor says that the MRI results doesn’t seem to be that bad which doesn’t require for surgery however my OT is confused as to how slow my progress during treatment is. Is there something that my doctor is missing? I get wrist pain most of the time even with a splint and not doing anything. Icing and heating the injured area is only a temporary relief.

  • Ajatha Reddy
    February 20, 2019 at 1:49 PM

    I have experienced little finger side wrist pain while playing cricket and i consulted the hand surgeon, he gave some pain killers and stretch band. still iam feeling the pain after using those medicine and stretch for 4 weeks. Now what should i do

  • Catee
    December 23, 2018 at 8:25 AM

    As someone with a confirmed TFCC tear, why would you recommend a branded product such as Wrist Widget, which is not supported by clinical trials and does not prevent rotation of the wrist that is key for allowing a TFCC tear to heal?

  • June 12, 2018 at 8:11 AM

    Thanks for sharing your thoughts with all of us through your post. Good job, Keep posting and share your valuable tips with us.

    • Sara Tchobanoff
      July 10, 2018 at 7:19 PM

      Thank you so much for your comment!

  • Doris Tchobanoff
    May 10, 2018 at 10:37 AM

    As a nurse, I frequently hear of wrist complaints and this article is very helpful to refer to!

    • Sara Tchobanoff
      May 11, 2018 at 1:06 PM

      Thank you! I am glad this is helpful.

  • Diana Clark
    May 10, 2018 at 7:24 AM

    Very informative! Now I know where to start with conservative treatment when any baseball pain flares up in this area.

    • Sara Tchobanoff
      May 11, 2018 at 1:07 PM

      Thank you! Glad this helps.

  • Diana McClaran
    May 10, 2018 at 7:01 AM

    I have had this type of pain in my wrist for more than a year. I really don’t remember when it started. It shots pain up ito my my wrist and know travels up into my arm. I am afraid of my wrist going out as the pain is bad enough to do so. I believe it is one of two things that has caused it. I curl my wrist in when I am sleeping or when I am driving I extend my hand when holding on to the steering the wheel. I have been trying to change both. I even tryed a hand splint. No luck on any of the above. What should I do next.?

    • Sara Tchobanoff
      May 11, 2018 at 1:09 PM

      Thank you Diana for sharing your experience! I would advise you to visit your local hand surgeon for an evaluation as soon as possible.

      • mohamed saleiman muhumed
        January 24, 2019 at 1:44 AM

        i have experience some wrist pain

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