Wrist Sprain Treatment

Evaluation and Initial Treatment

The American Academy of Family Physicians recommends an initial evaluation to rule out fractures through a detailed physical examination, paying attention to signs such as excessive swelling, hematoma, pain on palpation, and specific ligament stability tests 1
It is essential to re-examine the patient between 3 and 5 days after the injury to distinguish between partial and complete ligament tears 1
The examination may be limited by pain and inflammation during the first 48 hours 1

The American Academy of Family Physicians recommends the PRICE protocol (Protection, Rest, Ice, Compression, and Elevation) for the first 72 hours, followed by functional exercises to restore movement and strength 1
Protection: Protect the injured joint to avoid further damage 1
Rest: Rest the joint for up to 72 hours to allow the ligaments to begin healing 1
Ice: Apply direct cryotherapy to reduce swelling, decrease pain, and shorten recovery time 1
Compression: Use a compressive bandage to limit inflammation 1
Elevation: Keep the hand elevated to reduce fluid accumulation 1

The British Journal of Sports Medicine recommends functional treatment over immobilization for wrist sprains 2
Implement exercises to improve function, muscle strength, and reduce pain 3, 4
Start with range-of-motion exercises and progress to strengthening exercises 3, 5

Consider using functional supports, such as splints or orthotics, to alleviate symptoms and prevent deformities 3, 6
Semirigid supports are more effective than elastic bandages 2
The American Academy of Family Physicians recommends individualized treatment based on the location of the sprain, risk factors, presence of inflammation, severity of structural change, level of pain, and disability 4
Topical treatments are preferred over systemic treatments for safety reasons 4

Education on joint protection (how to avoid adverse mechanical factors) is essential 3, 5
Functional support devices provide some protection against future sprains, particularly in individuals with a history of recurrent sprains 2