Broken vs. Sprained Wrist - How to Tell the Difference

It’s not always easy to know a broken vs sprained wrist, with a total of 8 carpal wrist bones, two forearm bones, and countless nerves, muscles, ligaments, and blood vessels all packed into this small area of the body. This can make it feel ambiguous in diagnosing your wrist injury and knowing how to move forward with treatment. Keep reading to learn about the symptoms of a broken vs. sprained wrist and how to tell the difference.

Is My Wrist Broken or Sprained?

Ultimately, the only way to know for sure what type of injury you have sustained is with an imaging order from your doctor. Regardless of which type of injury you have sustained, the most important first steps are rest and swelling management. The bigger concern comes in when symptoms are more severe or if mild to moderate symptoms continue to linger. Both severe sprains and fractures will most likely require splinting for 6 weeks or more to allow proper healing and restoration of stability.

What to Look for

Unfortunately, it is nearly impossible to self-assess what type of wrist injury you have sustained on your own. If symptoms are mild you can start home treatment  and then reassess symptoms over time and decide if you need further recommendations or care. 

• Range of Motion

  With pain and swelling from any wrist injury, range of motion limitations are normal. Typically, wrist range of motion will be most limited by a grade III sprain or distal radial fracture. When fracture or break is suspected, range of motion should be limited with a splint or brace for up to 6 weeks to allow proper bone healing.

• Pain

  Pain is not a great way to differentiate wrist injuries. Both wrist fractures and sprains can range from mild to severe pain symptoms depending on the severity of the injury. A grade III sprain and radial distal fracture tend to be the most painful conditions.

• Straightness

  One telltale sign of a fracture is deformity of the affected bones. If the wrist or base of the thumb appears misshapen or there is a new bulge in the injury area there is a good chance that you sustained a fracture. However, fractures can also occur without displacement too.

• Bruising

  Symptoms of bruising are common with all wrist injuries. Again, it comes down to the severity of the injury. As with all other symptoms, more severe bruising is typically a sign of a full wrist ligament tear or a fracture.

Common Types of Broken & Sprained Wrist Injuries

There are many connective tissues in the wrist that can be affected when you sustain an injury from impact or moving incorrectly. Here is a quick review of the most common types of wrist injury. 

• Sprain

  A wrist sprain involves overstretching one of the ligaments in the wrist. There are 3 grades of injury to look out for.

  Grades of Sprain

• Grade I

  Stretching of the ligament without any tearing, resulting in mild symptoms of pain, swelling, and/or bruising.

• Grade II

  A partial tear of one or more ligaments is sustained, with possible issues with instability and moderate symptoms.

• Grade III

  A complete tear of one or more ligaments leading to significant instability and severe symptoms.

• Distal Radius Wrist Fracture

  The distal radius is the end of the forearm bone, on the thumb side, that articulates with the ulna and wrist bones. This common fracture site often occurs with a fall on an outstretched hand. Symptoms include severe pain, swelling, bruising, numbness, difficulty moving the fingers and thumb, tenderness below the wrist joint itself and a possible deformity in the wrist.

• Scaphoid Wrist Fracture

  The scaphoid is one of the small bones located in the wrist itself. It is located just below the thumb. This fracture site is also common with a fall or high impact to the palm. Symptoms include pain, swelling, and tenderness just below the thumb. This small bone does not have good blood supply and will need to be monitored closely to avoid future complications due to poor healing.

When to See a Doctor

If your symptoms are mild to moderate and manageable at home you may choose to forgo medical treatment. Initially, you might find relief from wrapping your wrist or with a splint.

If you see any of these signs, see a doctor as soon as possible:

• Moderate to severe pain
• Feelings of instability in the wrist (at rest or with movement)
• Significant swelling and bruising
• Loss of wrist and hand function (including range of motion and strength)
• Deformity of the wrist or hand
• Hearing a large crack or popping sound during the injury
• Numbness, tingling, or stabbing pain in the wrist and hand
• Ongoing symptoms that aren’t getting better with rest and treatment

If you’re not sure about your symptoms or injury it's always best to seek medical advice. From there, pay close attention to your symptoms and let them guide you in the recovery process.

Sources:

https://www.reboundmd.com/news/distal-radius-fractures-causes-symptoms-and-treatment

https://orthoinfo.aaos.org/en/diseases--conditions/scaphoid-fracture-of-the-wrist#:~:text=A%20scaphoid%20(navicular)%20fracture%20is,the%20base%20of%20the%20thumb.

https://www.sports-health.com/sports-injuries/hand-and-wrist-injuries/my-wrist-broken-or-sprained