Ulnar sided wrist pain

Ulnar sided wrist pain

What is it?
This term describes discomfort that occurs on the little finger side of the wrist. It is a very common site of pain which can occur following an injury, overuse or from a more longstanding or chronic underlying condition.

What is the cause?

The anatomy of this side of the wrist is very complex and the symptoms can relate to injury to several structures. Commonly, ulnar sided wrist pain can occur following a fall on to the outstretched hand. This can cause an acute injury to the structures of the wrist.

Commonly injured structures include the TFCC (Triangular Fibro-Cartilage Complex), the tendons (including the ECU and FCU tendons), or the joint between the ulnar bone and the radius at the wrist (Distal Radio-Ulnar Joint or DRUJ).

Ulnar-sided wrist pain that comes on more gradually can result from inflammation or irritation of the above structures, but can also be caused by arthritis of the wrist bones or sometimes by a condition called ulno-carpal impaction syndrome. This condition relates to the shape of your bones at your wrist.


Diagnosis can often be made from the clinical history (the account of events and symptoms from the patient) and the clinical examination. Patients will usually need further investigations in terms of X-rays and some will require special scans – ultrasound, CT or most likely an MRI. Sometimes keyhole surgery (wrist arthroscopy) is undertaken to confirm the diagnosis.

Treatment options

Here are the treatment options for Ulnar sided wrist pain:

Treatment for ulnar-sided wrist pain will depend on the cause. Initially it is likely that you will be advised on measures that will aim to relieve the discomfort. These may include:

  • Taking anti-inflammatory medication (if appropriate), such as naproxen or ibuprofen or newer non-steroidal anti-inflammatory drugs (NSAIDS), or steroid injections to ease pain
  • Casting or splinting to rest the wrist
  • Hand Therapy (exercises to mobilise, strengthen tendons and ligaments in the wrist)
  • Changing your hand’s position during activities/sport/work (ergonomic adjustment)
In some scenarios surgery may be required to improve the symptoms in your wrist. This will be tailored to your specific needs and will be discussed with you in detail at your consultation.

This surgery may involve wrist arthroscopy (keyhole surgery) and/ or open surgery. Please don’t feel daunted by the complexity of this area of the wrist, we are very used to managing these conditions.

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