Sprained wrist: how long it takes to heal and when to X-ray
A fall onto an outstretched hand is the usual cause of a wrist sprain, whether from sport, a bike, a trip on the footpath or a tumble on the mats. Most sprains settle within a few weeks. The reason to take wrist injuries seriously is that some fractures are easy to miss.
How long does a sprained wrist take to heal?
A mild sprain usually improves over one to two weeks. A moderate sprain, with a partial ligament tear, swelling and bruising, commonly takes four to six weeks. Significant ligament injuries can take several months and sometimes need specialist care.
How do I know if it's sprained or broken?
You often can't tell without an examination and X-ray. Signs that make a fracture more likely include obvious deformity, significant swelling or bruising, tenderness directly over bone, pain when gripping or twisting, and being unable to bear weight through the hand. Children and older adults with osteoporosis fracture more easily.
What is a scaphoid fracture and why does it matter?
The scaphoid is a small bone at the base of the thumb. It's commonly fractured in falls onto the hand, and the fracture frequently doesn't show on the first X-ray. Because the bone has a limited blood supply, a missed fracture may not heal, leading to long-term pain and arthritis.
What are the signs of a scaphoid fracture?
Pain and tenderness in the hollow at the base of the thumb on the back of the wrist (the 'anatomical snuffbox'), pain when pressing along the thumb towards the wrist, and pain when gripping or pinching. Swelling may be minimal, which is why it's often dismissed as a sprain.
What if the X-ray is normal but it still hurts?
Go back. When a scaphoid fracture is suspected and the first X-rays are normal, the usual approach is a splint or cast and either repeat X-rays in 10 to 14 days or further imaging. A Cochrane review compared CT, MRI and bone scans for suspected scaphoid fractures with normal X-rays; all three are used to reach a definite diagnosis, and the review noted that a substantial number of patients are otherwise treated unnecessarily (Mallee et al., Cochrane, 2015).
What should I do in the first few days?
Rest the wrist from painful activities, use ice and compression for comfort, and keep the fingers moving. A removable wrist splint for a few days can help. If there's any doubt about a fracture, get it checked before you start loading it.
When should I start moving it?
For a simple sprain, begin gentle movement within a few days: bending the wrist forwards and back, side to side, and turning the palm up and down. Prolonged immobilisation of a sprain leads to stiffness.
What exercises help a sprained wrist?
After range of motion returns: squeezing a soft ball or putty, wrist curls and reverse curls with a light weight, forearm rotation with a hammer or light dumbbell, and gradually bearing weight through the hand, starting against a wall, then a bench, then the floor.
When can I lift, do push-ups or train?
When you have near-full movement and grip without pain. Start with neutral-wrist positions, such as push-ups on fists or handles, and build load gradually.
See our post on wrist pain from push-ups and bench press.
Why does the little-finger side of my wrist still hurt?
Pain on the little-finger side after a fall or twist can involve the TFCC, a cartilage and ligament structure that stabilises that side of the wrist. It hurts with twisting and weight-bearing and can take longer to settle. Persistent pain or clicking there should be assessed.
Why is my wrist still sore after six weeks?
A wrist that isn't clearly improving by four to six weeks needs reassessment. Possible reasons include a missed fracture, a ligament tear, a TFCC injury or tendon irritation.
Should I wear a brace?
A removable splint is useful for comfort in the first week or two and for activities that aggravate it. Take it off regularly to move the wrist, and wean off it as pain allows.
How can an osteopath help?
We examine the wrist carefully for signs of fracture or ligament injury and refer you for imaging or to your GP or a hand specialist when indicated. For sprains, we treat hands-on to restore movement and guide strengthening and return to activity.
When is it urgent?
Go to an emergency department for a wrist that looks deformed, severe pain and swelling, numbness or tingling in the fingers, or a hand that is cold or pale. See a doctor within a day or two for pain at the base of the thumb after a fall.
See our elbow and wrist pain guide. Book an assessment at our Berwick clinic. A 60-minute initial consultation is $149, with no referral needed and HICAPS on-site.
Sources
Book an initial consultation at RISE Sports & Spinal in Berwick. Clear diagnosis, hands-on treatment, and a plan that actually gets you better.
Related articles
