Wrist Sprain vs Strain: What's the Difference?

What is the Difference between a Wrist Sprain vs. Strain

An injury occurring to any of the ligaments of the wrist is known as a wrist sprain.  While an injury to the tendon(s) is referred to as a wrist strain. 

Image of a human hand with wrist pain from a wrist sprain vs. strain. JOI RehabWrist Sprain vs Strain. What is the difference?

Anatomy of the Wrist

The wrist is comprised of 8 carpal bones consisting of a proximal and distal row including tendons, ligaments, and nerves. These tendons and the median nerve travel through the carpal tunnel. They are responsible for movement, stabilization, and sensation to the wrist, hand, and fingers. It is often not easy to tell a wrist sprain vs strain.  A physician will do a thorough exam to determine which diagnosis is correct. 

What causes a Strained or Sprained Wrist?

These injuries can occur from a number of different ways but most commonly include falling onto an outstretched hand (FOOSH injury) or impact to the wrist from an object such as a ball in sports. 

How do You Tell if Your Wrist is Sprained?

The ligaments either are overstretched or torn. Symptoms of a wrist sprain include:

  • Increased pain
  • Swelling
  • Bruising
  • Instability
  • Loss of motion and strength.

 Sprains are usually categorized by levels as follows:

Level 1: Ligament is overstretched or minimally torn without instability of the joint

Level 2: More significant tear but not complete with some instability

Level 3: Ligament is completely torn resulting in instability of the joint

How do I know if my Wrist is Strained?

Strains refer to injuries of tendons, the elastic tissue that attaches muscles to bones. This results in the muscles surrounding the wrist being stretched past their normal limits and becoming injured. 

Symptoms of a wrist strain include: 

  • Pain at rest or during motion
  • Swelling
  • Bruising
  • Decreased strength

Treatment for wrist strains include increasing range of motion, promoting muscle healing, introducing specific resistive and strengthening exercises, and integrating functional tasks to promote independence in all daily activities. Both sprains and strains are relatively common injuries that affect everyone from professional athletes to weekend warriors.

illustration of a cross section of the human wrist anatomy highlighting tendons prone to a wrist sprain. JOI RehabWrist Cross Section

Treatment of Wrist Sprains and Strains

Conservative treatment usually can help manage the sprain or strain without having to see a doctor. Immediately following the injury this method can be utilized to manage swelling and pain.

  1. Rest the wrist
  2. Ice the wrist
  3. Compression of the inflamed area on the wrist
  4. Elevation of the wrist during rest.  

This is know as the RICE Protocol

Regardless of whether it is a wrist sprain vs. strain your physician may suggest a brace to aid in activity modification of the wrist. A wrist brace can help to immobilize the wrist to limit movement and aggravation of the ligament or tendon. Medications such as anti-inflammatories can also help to decrease swelling and pain.

Illustration of wrist muscles and tendons labeled. JOI RehabTendons of the Wrist

Surgery for a Wrist Sprain or Wrist Strain

In severe cases, an MRI may be obtained to determine the extent of the injury.  Depending on the results, this may warrant surgical intervention.  Some severe wrist sprains and wrist strains may be treated with surgery.  It is important to be evaluated by an orthopedic physician so that the best course of action can be determined. 

Related Articles: 

It is often hard to tell if you have a wrist sprain vs strain.  If your pain does not go away, you should seek out an appointment to get it evaluated.  To learn more about the wrist, go to this Wrist Sprain Video

By: Julia Guthart, CHT, OT

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