Central Wrist Pain

Written By: Chloe Wilson BSc (Hons) Physiotherapy
Reviewed By: SPE Medical Review Board

Central Wrist Pain: Causes, Symptoms & Treatment for pain in the middle of the wrist including carpal tunnel syndrome, wrist fractures and wrist tendonitis

Central wrist pain is a common problem causing pain in the middle of the wrist and hand.

It may affect the front or the back of the wrist, or both depending on the underlying cause.

Central wrist pain may develop suddenly following an injury such as falling onto an outstretched hand, or gradually from repetitive overuse. In some cases, it may be linked with an underlying medical condition.

It may affect your normal daily activities, particularly gripping and twisting actions and may lead to weakness in the hand.

Here we will look at the different causes of central wrist pain, common symptoms, when you should see a doctor and the best treatment options for middle of wrist pain. If your pain is in a different part of the wrist, have a look at the inner wrist pain and outer wrist pain articles or our wrist pain diagnosis charts.

What Causes Central Wrist Pain?

There are a number of possible causes of pain in the middle of the wrist, which each present slightly differently:

1. Carpal Tunnel Syndrome

Carpal tunnel syndrome is a common cause of central wrist pain with tingling and numbness in the palm

One of the most common causes of central wrist pain is carpal tunnel syndrome (CTS).

CTS is caused by pressure on the median nerve as it passes through the carpal tunnel at the front of the wrist.

Typical symptoms include tingling and numbness in the palm side of the wrist, hand, thumb and fingers (except the pinky), weakness and shock-like sensations. It often makes it difficult to grip or pick things up. Carpal tunnel symptoms are often worse at night.

Central wrist pain from carpal tunnel syndrome is more common in women than men, particularly pregnant women or people over the age of 40.

Find Out More: Carpal Tunnel Syndrome

2. Wrist Fractures

Another common cause of central wrist pain, which develops suddenly after an injury is a wrist fracture.

Wrist fractures are usually caused by a fall onto an outstretched hand or a direct blow to the wrist. There is usually immediate localised pain at the time of injury with progressive swelling and bruising. There may be an obvious deformity and hand and wrist movement is often limited.

There are lots of different types of wrist fracture. The most common is a Colles fracture, which accounts for 90% of all wrist fractures. Other types of wrist fracture that can cause central wrist pain include distal radius, lunate and triquetrum fractures.

Find Out More: Wrist Fractures

3. Wrist Tendonitis

Wrist tendonitis is a common cause of pain in the middle of the wrist.

Pain in the middle of the wrist may also be due tendonitis in one of the wrist/hand tendons.

Tendonitis usually develops from repetitive wrist and hand movements which causes irritation and inflammation of the tendons. Activities such as typing, racket sports, manual labor and basketball are common causes of wrist tendonitis.

Symptoms usually develop gradually over time and may include central wrist pain, usually directly over the affected tendon, swelling, tenderness, weakness, stiffness and reduced grip strength.

Flexor tendonitis will cause central wrist pain on the front of the hand (palm side), whereas extensor tendonitis will cause pain in the middle of the back of the hand and intersection syndrome causes pain in the back of the wrist and forearm.

Find Out More: Wrist Tendonitis

4. Ganglion Cysts

If your central wrist pain is associated with small, hard lump in the wrist, you may have a ganglion cyst.

A ganglion cyst is a fluid-filled lump that forms near a joint or tendon, often appearing on the back but occasionally on the front of the wrist. These cysts are typically painless but can cause discomfort, weakness, or limited movement if they start to press on nearby nerves. They can vary in size and may feel firm or spongy, sometimes changing in size over time.

The exact cause of ganglion cysts is unknown, but they are often linked to joint irritation, repetitive wrist movements, or previous injuries. They are usually completely harmless and will often go away eventually by themselves.

5. Gout

Another possible cause of middle of wrist pain is gout wrist.

Gout in the wrist is a type of inflammatory arthritis caused by a build-up of uric acid crystals in the joint. It typically causes sudden, severe wrist pain, swelling, redness, and stiffness, often making wrist movement difficult.

Sometimes, tophi develop, hard deposits of uric acid crystals that form under the skin, often causing visible lumps. They most commonly develop on the back of the wrist but can develop on the front too.

Common causes of gout wrist include high uric acid levels due to diet, genetics, kidney problems, or conditions like obesity and diabetes. While gout most often affects the big toe, it can occur in the wrist, especially in those with chronic or severe gout.

6. Arthritis

Arthritis is a common cause of stiffness and pain in the middle of the wrist in people over 60.

Arthritis occurs when the cartilage in the mid-wrist joints wears down, leading to pain, stiffness, and reduced mobility. Wrist arthritis is may be due to osteoarthritis (age-related wear and tear), rheumatoid arthritis (an autoimmune condition), or post-traumatic arthritis (from previous injuries like fractures or ligament damage).

Wrist arthritis symptoms typically include deep, aching central wrist pain, swelling, weakness, stiffness and difficulty gripping or twisting objects.

Central wrist arthritis most commonly affects the following joints:

  • Radiocarpal Arthritis: where the radius (forearm bone) meets the first row of carpal bones.
  • Midcarpal Arthritis: between the two rows of small carpal bones in the wrist
  • Scapholunate Arthritis: between the scaphoid and lunate bones, often affected in degenerative or post-traumatic arthritis.
  • Capitolunate Arthritis: between the capitate and lunate bones, commonly involved in wrist osteoarthritis.

7. Scapholunate Ligament Tear

A scapholunate ligament injury can result in pain in the middle of the wrist.

Central wrist pain on the back of the hand can be caused by a scapholunate ligament sprain or tear.

This affects the ligament that connects the scaphoid and lunate bones in the wrist, leading to instability and pain in the middle of the wrist. It commonly occurs from a fall onto an outstretched hand, sudden twisting motions, or repetitive wrist strain from activities like weightlifting or racket sports.

Symptoms include swelling and top middle wrist pain, weakness, difficulty gripping, and clicking or popping sensations with movement. Central wrist pain from a sprained Scapholunate ligament often worsens with wrist extension (bending backwards) and may cause a feeling of instability in the wrist.

8. Kienbock’s Disease

A rare cause of central wrist pain is Kienbock’s Disease.

Kienbock’s disease is a condition where the lunate bone in the wrist loses its blood supply, leading to bone death (avascular necrosis) and progressive collapse. The exact cause is unclear, but it is often linked to repetitive wrist trauma, variations in wrist anatomy and wrist fractures that disrupt blood flow.

Kienbock’s disease typically causes deep, aching central wrist pain, stiffness, swelling, and weakness, which worsen over time. As the disease progresses, gripping and wrist movements become increasingly difficult, sometimes leading to arthritis and long-term dysfunction.

Common Symptoms With Central Wrist Pain

Common symptoms associated with central wrist pain include:

  • Deep, aching pain in the middle of the wrist, often worsening with movement, gripping or when bearing weight through the hands
  • Stiffness and reduced range of motion, making it difficult to bend, extend, or rotate the wrist
  • Swelling and tenderness around the central wrist area, especially after activity or prolonged use
  • Weakness or instability, leading to difficulty gripping objects or performing fine motor tasks
  • Clicking, popping, or grinding sensations with wrist movement, which may indicate joint or ligament involvement
  • Tingling and numbness in the wrist and hand if one of the nerves is affected

When To See A Doctor

See your regular doctor for central wrist pain if you have:

  • Persistent pain lasting more than a few weeks, even with rest
  • Swelling, stiffness, or reduced wrist mobility that interferes with daily activities
  • Weakness or instability making it difficult to grip or lift objects.
  • Clicking, popping, or grinding sensations in the wrist.
  • History of wrist injury or repetitive strain that may have caused ongoing discomfort

Seek urgent medical attention if you have:

  • Severe pain after an injury, such as a fall or direct impact
  • A visible deformity or a sudden change in wrist shape
  • Inability to move the wrist or fingers due to pain or stiffness
  • Numbness, tingling, or weakness in the hand, which could indicate nerve involvement
  • Significant swelling or bruising that develops rapidly

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How To Treat Central Wrist Pain

Central wrist pain treatment will depend on what is causing the pain in the middle of your wrist, but may involve the following:

  • Rest & modify activities to avoid movements that worsen pain
  • Use a wrist brace or splint to provide support and limit movement
  • Apply ice or heat therapy to reduce pain, swelling, and stiffness
  • Take over-the-counter pain relievers like ibuprofen or naproxen
  • Do gentle stretching and strengthening exercises to improve mobility and support
  • Use ergonomic tools and wrist-friendly equipment to reduce strain e.g. keyboard pads and jar openers
  • Consider medical treatments like physical therapy, corticosteroid injections, or surgery if pain persists

Central Wrist Pain Summary

Central wrist pain is a common problem that can affect the front or back of the wrist and hand - or both!

It may be caused by problems with the bones (wrist fractures, arthritis or Kienbock’s disease), soft tissues (tendonitis or ligament tears), nerves (carpal tunnel syndrome) or other issues such as ganglion cysts and gout wrist.

Common symptoms of central wrist pain include stiffness and pain in the middle of the wrist, swelling, weakness, difficulty gripping, clicking or popping sensations and tingling or numbness. In some cases there may be an obvious deformity, particularly after a fall.

Home treatment is often sufficient for treating middle of wrist pain, such as rest, ice, wrist splints and exercises, but more severe injuries may require physical therapy, injections or surgery.

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Page Last Updated: February 27th, 2025
Next Review Due: February 27th, 2027