Ulnar Wrist Pain: Causes, Symptoms, and PT-Recommended Treatments

The wrist has a big job. It moves in almost every direction, which allows you to extend and flex your hand. Although it’s a very resilient joint, all this movement does make your wrist susceptible to some pain or injury on occasion. One type of wrist pain that you may encounter is called ulnar wrist pain. “This is a general term to explain pain on the pinky side of your wrist,” says Sarah Kellen, PT, DPT, a physical therapist at Hinge Health. While it’s not as common as other types of wrist pain — like pain on the radial side, near your thumb — it can be uncomfortable and interfere with some of your daily activities, she notes.

Here, learn more about ulnar wrist pain, including what causes it, what it feels like, and what treatments and exercises our Hinge Health physical therapists recommend to help you feel better sooner.

Symptoms of Ulnar Wrist Pain

It can be hard to differentiate ulnar wrist pain from other types of wrist pain. Some signs and symptoms of it include:

• Pain on the pinky side of your wrist

• Pain that occurs with wrist rotation, particularly twisting 

• A clicking or popping sound when you move your wrist

• Decreased grip strength

• Limited range of motion, especially when rotating your wrist in the direction of your pinky 

• Wrist stiffness

Ulnar Wrist Pain: A Hinge Health Perspective

Movement is medicine when it comes to ulnar wrist pain. Many people worry that activity will make their pain worse. But movement of your wrist joint is actually very necessary to heal from pain because it helps keep wrist muscles strong and prevents them from stiffening up, explains Dr. Kellen.

The other thing that may be concerning to you: popping and clicking sounds when you rotate your wrist. As alarming as the sounds may be, they’re nothing to worry about. “Popping and clicking noises (also known as crepitus) are common all over the body, and they don’t necessarily indicate that something’s wrong with your joints or that you’re causing damage,” reassures Dr. Kellen. “Usually, it’s due to pressure changes in your joints or stiffness. 

The ulnar wrist pain exercises below are a great way to address your symptoms. They are gentle and therapeutic. But if you still feel nervous about pain in your wrist or it making that Snap! Crackle! Pop! sound, you may benefit from working with a physical therapist. “They’ll be able to work with you on initial exercises to make you less nervous about movement,” says Dr. Kellen. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Ulnar Wrist Pain Causes 

There are many different causes of ulnar wrist pain, says Dr. Kellen. Some of the more common ones include:

• Tendonitis. “The tendons around your wrist can get inflamed and irritated from overuse, just like any other tendon in your body,” explains Dr. Kellen. Research shows that tendinitis is more common in people who play racquet sports or golf, as well as people who frequently use a computer mouse or keyboard. “If a computer keyboard is placed too low or too high for an individual, it can contribute to ulnar wrist pain for some people,” says Dr. Kellen.

• Arthritis. Two types of arthritis that often affect the wrist are osteoarthritis (which is characterized by normal age-related changes in cartilage) and rheumatoid arthritis (an autoimmune condition where your body attacks your joints). While rheumatoid arthritis can happen in any joint, the wrist is one of the most common spots.

• Triangular fibrocartilage complex (TFCC) injury. This is a tear in the cartilage that connects the wrist to the forearm. It can happen if you fall on your wrist, or have multiple twisting injuries, explains Dr. Kellen. A TFCC injury usually occurs among people who regularly perform tasks that can stress their wrists, like carpenters or plumbers.

• Wrist fracture. An injury such as a fall could result in a fractured wrist and cause ulnar wrist pain.

• Ulnar impaction syndrome. Some people are born with an ulnar bone (ulna) that’s slightly longer than their radial bone (radius) on the thumb side of their forearm, explains Dr. Kellen. This causes the ulna on the outside of your forearm to “bump” into your other wrist bones. Over time, this can cause surrounding tendons, ligaments, and cartilage to wear away.

Ulnar Wrist Pain Treatment 

There are many different ways to treat ulnar wrist pain. Here are some treatments you can try at home.

• Activity modifications. You may be tempted to avoid exercise if you have ulnar wrist pain, but physical therapists encourage the opposite. “Movement is medicine,” says Dr. Kellen. “Simple modifications can help you stay active with less pain.” Walking, biking, running, and other lower body workouts are great options. You may also be able to make modifications to upper body exercises, so you can continue activities such as resistance training. A physical therapist can show you how to make small changes to upper body exercises, like altering the way you grip dumbbells, that can make a big difference in your pain. 

• Wrist splints. You may benefit from wearing one for a short period of time to avoid further inflammation of sore muscles, tendons, and ligaments, says Dr. Kellen. Your physical therapist can let you know how long to wear a splint and what type of splint to look for.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for ulnar wrist pain. It’s important to make sure that you are safely able to take these medications, based on your medical history. Another option is an over the counter anti-inflammatory cream, such as diclofenac.

• Ergonomic adjustments. If your ulnar wrist pain is made worse by typing, you may want to check your computer keyboard to make sure it’s not too low or too high, Dr. Kellen advises. If it’s not positioned right for you, it can cause ulnar wrist pain. You may want to look for a split keyboard, which is designed to straighten your wrists and arms to be in a more neutral position, or an arc keyboard, which decreases unnatural wrist positioning. Most people do well with a keyboard that sits at or slightly below elbow height, and is parallel with your forearms, adds Dr. Kellen.

• Wrist exercises. Once the initial pain flare has passed, ulnar wrist pain exercises are important to help manage pain. The wrist stretches and exercises below are a good place to start. If your wrist pain doesn’t improve, or the symptoms keep coming back, try physical therapy. A PT can prescribe specific strengthening, stretching, and range of motion wrist exercises, and also teach you how to do functional movements, like typing on a computer or swinging a tennis racquet, without pain.

Hinge Health physical therapists recommend the above exercises for people who are dealing with ulnar wrist pain. These movements can help treat ulnar wrist pain and prevent it from recurring. “Even if you don’t have wrist pain, these are good exercises to keep your wrists strong and flexible,” says Dr. Kellen.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Change Your Hand Position

“It’s very important to change your hand position around whenever you do repetitive tasks,” advises Dr. Kellen — for instance, when working at a computer, cooking, gardening, writing, or lifting objects repeatedly. “Changing your hand position will help to prevent excess stress on the muscles, ligaments, and tendons near your ulnar bone, so you’re less likely to experience strain and pain.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Campbell, D., Campbell, R., O’Connor, P., & Hawkes, R. (2013). Sports-related extensor carpi ulnaris pathology: a review of functional anatomy, sports injury and management. British Journal of Sports Medicine, 47(17), 1105–1111. doi:10.1136/bjsports-2013-092835

2. Vezeridis, P. S., Yoshioka, H., Han, R., & Blazar, P. (2009). Ulnar-sided wrist pain. Part I: anatomy and physical examination. Skeletal Radiology, 39(8), 733–745. doi:10.1007/s00256-009-0775-x

3. Boggess, B. R. (2022, November 28). Evaluation of the adult with acute wrist pain. UpToDate. Retrieved from https://www.uptodate.com/contents/evaluation-of-the-adult-with-acute-wrist-pain

4. Boggess, B. R. (2023, August 28). Evaluation of the adult with subacute or chronic wrist pain. UpToDate. Retrieved from  https://medilib.ir/uptodate/show/84021