When should you ice your wrist?

Scapholunate ligament sprain - aftercare

Wrist sprains can be mild to severe. They are ranked by how severely the ligament is pulled or torn away from the bone.

Grade 1 -- Ligaments are stretched, but not torn. This is a mild injury.
Grade 2 -- Ligaments are partially torn. This is a moderate injury and may require splinting or casting to stabilize the joint.
Grade 3 -- Ligaments are completely torn. This is a severe injury and usually requires medical or surgical care.

Chronic wrist sprains from poorly treated ligament injuries in the past can lead to weakening of the bones and ligaments in the wrist. If not treated, this can lead to arthritis.

Symptoms such as pain, swelling, bruising and loss of strength or stability are common with mild (grade 1) to moderate (grade 2) wrist sprains.

With mild injuries, stiffness is normal once the ligament begins to heal. This can improve with light stretching.

Severe (grade 3) wrist sprains may need to be looked at by a hand surgeon. X-rays or an MRI of the wrist may need to be done. More severe injuries may require surgery.

Chronic sprains should be treated with splinting, pain medicine, and anti-inflammatory medicine. Chronic sprains may need steroid injections and possibly surgery.

Follow any specific instructions for symptom relief. You may be advised that for the first few days or weeks after your injury:

Rest. Stop any activity that causes pain. You may need a splint. You can find wrist splints at your local drugstore that may be appropriate for your injury.
Ice your wrist for about 20 minutes, 2 to 3 times a day. To prevent skin injury, wrap the ice pack in a clean cloth before applying.

Make sure to rest your wrist as much as you can. Use a compression wrap or splint to keep the wrist from moving and to keep the swelling down.

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.

Talk with your provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
Do not take more than the amount recommended on the bottle or by your provider.
Do not give aspirin to children.

To build strength once your wrist starts to feel better, try the ball drill.

With your palm up, place a rubber ball in your hand and grab it with your fingers.
Keep your hand and wrist still while you gently squeeze the ball.
Squeeze for about 30 seconds, then release.
Repeat this 20 times, twice a day.

To increase flexibility and movement:

Warm up your wrist by using a heating pad or warm washcloth for about 10 minutes.
Once your wrist is warm, hold your hand out flat and grab your fingers with the uninjured hand. Gently bring the fingers back to bend the wrist. Stop just before it begins to feel uncomfortable. Hold the stretch for 30 seconds.
Take a minute to let your wrist relax. Repeat the stretch 5 times.
Bend your wrist in the opposite direction, stretching downward and holding for 30 seconds. Relax your wrist for a minute, and repeat this stretch 5 times, as well.

If you feel increased discomfort in your wrist after these exercises, ice the wrist for 20 minutes.

Do the exercises twice a day.

Follow up with your provider 1 to 2 weeks after your injury. Based on the severity of your injury, your provider may want to see you more than once.

For chronic wrist sprains, talk to your provider about what activity may be causing you to re-injure your wrist and what you can do to prevent further injury.

Call the provider if you have:

Sudden numbness or tingling
A sudden increase in pain or swelling
Sudden bruising or locking in the wrist
An injury that does not seem to be healing as expected

Franco VS, Kim HT. Wrist and forearm injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 43.

Marinello PG, Gaston RG, Robinson EP, Lourie GM. Hand and wrist diagnosis and decision making. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 67.

Last reviewed on: 5/12/2022

Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Applying a heat treatment or cold treatment is a common method for treating hand and finger injuries, stiffness, swelling, and pain. When used for fingers, hands, and wrists, these treatments can be very helpful for:

Recent injuries (bruises or fractures)
Old injuries that are painful
Swelling
Stiffness
Irritation
Recovery after surgery

Heat or warmth will help get stiff or sore hands moving by increasing the blood flow and speeding up the molecules in tissues. Heat is helpful for some stiff joints and muscles, and it can be useful prior to an activity. We often see an athlete warming up before a workout, and your hand therapist may use heat to help loosen up your hands before your session.

A warm shower or bath can help some sore, stiff joints, especially in the early morning. A warm compress (moist heat) or heating pad (dry heat) can also relieve stiffness (Figure 1); however, too much heat could cause injury such as fainting, swelling, or burns to skin and tissues. A good guideline that is not absolute is that heat should not be used for more than 15 minutes at a time to prevent unwanted side effects. Heat should never be so hot that it is painful.

Benefits of a Cold Treatment for Hands

If pain, swelling, and irritation are present after an activity or surgery, a cold treatment can reduce these symptoms. Cold temperatures slow down the molecules in tissues and reduce blood flow.The most common cold treatment is ice or something that has been made cold by placing it in the freezer, such as a gel pack (Figure 2) or ice therapy machine. Similarly, a general but not absolute rule is to apply ice for 15 minutes and then allow a 15-minute rest before reapplying.

As with heat, too much cold can slow down healing and stiffen sore joints, so use this treatment with moderation and typically only in the period just after injury. Applying ice or anything extremely cold to bare skin can cause a frostbite injury. Always wrap the source of cold in some sort of fabric. If a bandage or splint is too thick and the cold is not getting through, apply the cold near the area on exposed skin. Stop using ice if you feel extreme pain or numbness due to the cold. Talk to your surgeon about whether and for how long they recommend ice after hand surgery or injury.

Special Cold and Hear Treatments for Hands

Some special and more advanced heat or cold treatments may be used under the supervision of a therapist or physician. Some options include:

Therapeutic ultrasound: A qualified trained therapist may use ultrasound to heat deeper tissues slowly to help motion. The ultrasound waves can move through the tissue and cause the molecules to speed up and release heat.
Contrast bath: The patient soaks their hand or fingers and alternates between hot and cold exposure. This expands and contracts the tissue to help it heal by “pumping” out swelling and inflammation.
Paraffin wax or warm wax: This can be used to apply moist heat via machines that are highly regulated for safe temperatures and use a wax mixture that avoids skin burns and holds warmth over the area for a period of time until it cools and hardens. This treatment is also used by health spas for hands and feet relaxation.

In summary, use caution when implementing a heat treatment or cold treatment after hand surgery. Monitor time and the condition of your skin. Always test the hot or cold item before applying so you avoid injury. Contact your physician or therapist for questions, guidance, and assistance.

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.Find a hand surgeon near you.