Wrist Pain in Women: Causes, Menopause, Babies and Relief

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E after an injury (don't drive yourself) if the arm, wrist or hand is numb, tingling or has pins and needles; a bone is sticking out or a bad cut is bleeding heavily; or the arm or wrist has changed colour or shape, or is at an odd angle.
Go to an urgent treatment centre or A&E if you heard a crack or snap when you hurt it, or the pain is severe and you can't move the thumb or hold things.
Call 999 or go to A&E: sudden, severe pain in a muscle of the forearm or hand, which may be worse when you stretch it, with swelling, numbness, weakness or pins and needles, or tightness or difficulty moving the fingers. This can be acute compartment syndrome, which needs surgery as soon as possible. It usually follows an injury, a crush, or a cast or bandage that is too tight. Do not drive yourself to A&E.
Call 999, even if it passes: sudden weakness or numbness in one arm, with a drooping face or slurred speech. These are signs of a stroke.
Call 999: chest pain that spreads to your arm, neck or jaw. It could be a heart attack.
Same day (NHS 111, an urgent treatment centre or an urgent GP appointment): a wrist or hand injury that is very painful, getting worse, very swollen or bruised, stiff, or that you can't use. It may be broken. Get the same help if you also have a very high temperature, or feel hot, cold or shivery: this could be an infection.
Same day: after a fall onto an outstretched hand, pain or tenderness at the base of the thumb on the back of the wrist (the hollow called the snuffbox), even if the wrist moves well or the first X-ray was normal. A broken scaphoid can hide on the first X-ray and is slow to heal if it's missed, so ask what follow-up is planned.
Same day (urgent GP appointment or NHS 111): sudden, severe pain in one joint, with swelling, a change in skin colour or difficulty moving it, especially if you feel unwell, hot, cold or shivery or have a high temperature (although not everyone has one). It could be an infection in the joint, gout or calcium crystals (pseudogout), and only a sample of fluid from the joint can tell them apart.
Same day: you have lost the feeling in part or all of your hand.
Same day: both hands numb or clumsy (dropping things, trouble with buttons or handwriting), especially with unsteady walking or falls. Pressure on the spinal cord in the neck can do this, and it is often first mistaken for carpal tunnel syndrome.
While it heals, get help from NHS 111 the same day if the pain gets worse; your temperature is very high or you feel hot, cold or shivery; the cast breaks or feels too tight or too loose; your fingers, wrist or arm feel numb, look swollen or turn blue or white; or there is a bad smell or fluid coming from under the cast.
Get urgent medical help: you're pregnant or have given birth in the last few weeks and have symptoms of pre-eclampsia, such as pain below the ribs, a severe headache that does not go away with simple painkillers, vision problems such as blurred vision or seeing flashing lights, sudden swelling of the face, hands or feet, heartburn that does not go away with heartburn medicines, being sick, or feeling very unwell. If you're pregnant, call your maternity unit if you have the number; if you've recently given birth or cannot call your maternity unit, call 111.

See a doctor or physiotherapist if

Carpal tunnel symptoms that are getting worse, not going away, or not helped by treatment at home; sooner if the thumb is weak or the muscle at the base of the thumb looks thinner.
Any tingling or loss of feeling in the hand or wrist.
Not improved after 2 weeks of looking after it at home, getting worse, keeps coming back, or stopping you doing normal activities. In many areas you can refer yourself to NHS physiotherapy.
See a GP if thumb-side wrist pain is stopping you doing normal activities, is getting worse or keeps coming back, hasn't improved after 2 weeks of treating it at home, or comes with tingling or loss of feeling in your hand.
See a GP if your wrist is painful, warm, swollen and stiff, or you have wrist pain and also feel unwell with a high temperature.
Swollen, stiff joints in several fingers or both hands, with morning stiffness lasting more than 30 minutes. NICE asks GPs to refer suspected rheumatoid arthritis urgently when the small joints of the hands or feet, or more than one joint, are affected, or there has been a delay of 3 months or longer between the symptoms starting and seeking medical advice, even if blood tests are normal.
A lump that gets bigger, is hard or doesn't move.
You have diabetes and a hand problem: the NHS says hand problems can be more serious if you have diabetes.
You're 50 or over and broke your wrist in a fall from standing height or less: ask about a fracture liaison service or a bone health check, and about a falls assessment if you fell.
Joint aches around the menopause, with symptoms such as hot flushes, poor sleep or low mood: contact your GP if you want to know your options.
After an injury or operation, pain that is getting worse instead of better or far worse than you'd expect, with swelling, colour or temperature changes, or skin that is very sensitive to touch: contact your fracture clinic, physiotherapist or GP promptly. It can be complex regional pain syndrome (CRPS), and early treatment may help.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

Tingling, numbness or aching in the thumb, index and middle fingers, worse at night or holding a phone, book or steering wheel

Usually carpal tunnel syndrome, about twice as common in women and most often at 45 to 54. Shaking or hanging the hand often eases it. Our carpal tunnel guide has splints and a plan.

Read: Carpal tunnel syndrome →Pain on the thumb side of the wrist, worse lifting with your thumbs up, wringing or using scissors

Often De Quervain's, several times more common in women and most often after a birth or at 40 to 59. Our De Quervain's guide covers splints, injections and a plan.

Read: De Quervain's tenosynovitis →An ache at the base of the thumb when you pinch, turn a key or open a jar, usually from 45

Usually thumb base arthritis, more common in women. Our thumb arthritis guide has the thumb exercises.

Read: Thumb arthritis →Bony bumps on the finger joints, stiff for less than 30 minutes in the morning

Usually hand osteoarthritis, which often starts in the years around the menopause. Our hand arthritis guide covers it.

Read: Hand and finger arthritis →Aches in several joints around the menopause

Our joint pain in the menopause guide covers aches in several joints and what hormone replacement therapy (HRT) does; this guide covers the wrist.

Read: Joint pain in menopause →A smooth lump on the back or palm side of the wrist that comes and goes

Usually a ganglion, much more common in women and harmless; many go on their own. Our ganglion guide covers it.

Read: Ganglion cyst →After a fall onto an outstretched hand: pain, swelling or a changed shape

A sprain or a broken wrist; tenderness in the hollow at the base of the thumb needs checking for the scaphoid. Check the warning signs first. Our sprained wrist guide sorts them.

Read: Wrist sprain or fracture →Recovering from a broken wrist, especially after 50

Our broken wrist guide covers the cast and the exercises; after 50 or the menopause, ask about a bone check, as this guide explains.

Read: Broken wrist →

Several swollen, warm finger or wrist joints in both hands, stiff for well over 30 minutes each morning

Possibly rheumatoid arthritis, about twice as common in women: see a GP soon, as the warning signs say.

A finger that clicks or locks

Usually trigger finger. Our trigger finger guide covers it.

Read: Trigger finger →Tingling hands in pregnancy, or the thumb side of the wrist after the birth

Our wrist pain in pregnancy guide covers splints, feeding and lifting your baby.

Read: Wrist pain in pregnancy →Wrist pain or tingling that wakes you at night

Our wrist and hand pain at night guide covers night splints and how to sleep.

Read: Wrist and hand pain at night →An ache from typing or a mouse

Our typing guide covers the desk, breaks and a plan.

Read: Wrist pain from typing →Wrist pain in push-ups, planks or downward dog

Our push-ups guide covers hand positions and building back up.

Read: Wrist pain in push-ups and yoga →Tingling in the ring and little fingers, worse with the elbow bent

Usually the ulnar nerve at the elbow, not the wrist. Our ulnar nerve guide covers it.

Read: Ulnar nerve entrapment →

Understand it

Carpal tunnel syndrome: about twice as common in women, peaking in midlifeStrong evidence

In UK general practice, new carpal tunnel syndrome was diagnosed in about 193 women and 88 men per 100,000 a year, peaking in women at 45 to 54 and in men at 75 to 84; the gap between women and men has narrowed over 20 years. In an Italian area, where nerve tests confirmed it, 80% of cases were women.

It causes tingling or numbness in the thumb, index, middle and part of the ring finger, pain in the wrist or hand, and later a weak grip, worse at night and eased by shaking or rubbing the hand. The NHS lists being overweight, pregnancy, repetitive bending or forceful gripping, arthritis or diabetes, a family history and a past wrist injury as risks; NHS inform adds the menopause and thyroid problems.

Sources 1, 2, 3, 4, 5, 6

The menopause and HRT: linked, but not shown to cause itEmerging evidence

NHS inform lists the menopause as a carpal tunnel risk factor, and women's carpal tunnel peaks at the usual age of the menopause. But no study has measured carpal tunnel across the menopause, so the link is timing, not proof.

HRT showed no clear link either way: across 7 studies of 270,764 women after the menopause, the odds were not significantly higher, and the only randomised data suggested lower odds. The evidence is mixed.

Sources 5, 1, 7

Not all tingling is carpal tunnelStrong evidence

In 2,466 Swedish adults, 14.4% had tingling in the carpal tunnel's area of the hand, but only 3.8% had clinically certain carpal tunnel syndrome. The NHS lists sprains and breaks, De Quervain's, arthritis, carpal tunnel and ganglions as causes of wrist pain and says "Do not try to diagnose the cause of the pain yourself". Problems in the neck can be felt in the wrist and hand, "even when you don't feel pain in your neck", NHS inform says.

Sources 8, 9, 10

De Quervain's: several times more common in women, and after a birthStrong evidence

In US records, women were diagnosed 2.6 to 4.7 times as often as men, most often at 40 to 59. In the year after giving birth, 0.7% of 357,534 US women were diagnosed with it, against 0.2% of similar women who hadn't given birth.

"Mothers of small babies seem particularly prone to it, but whether this is due to hormonal changes after pregnancy or due to lifting the baby repeatedly is not known", UK hand surgeons say. It hurts on the thumb side of the wrist when you lift with your thumbs up, grip, wring or use scissors.

Sources 11, 12, 13, 14, 15

Thumb base and hand osteoarthritis: more common in women, from about 50Strong evidence

In 3,595 Finnish adults, thumb base arthritis showed on X-ray in 15% of women and 7% of men. In UK adults aged 50 and over in the community, 22.4% had painful thumb base arthritis, the commonest type, and every type of hand osteoarthritis was more common in women. Women's risk of hand osteoarthritis rises most around the menopause.

X-ray changes are common without pain: they show in "about 25% of women over the age of 55, but many people with arthritis of this joint have no significant pain", UK hand surgeons say.

Sources 16, 17, 18, 19

A broken wrist after a fall: commoner in women, and a sign to check your bonesStrong evidence

From age 35, women broke the wrist about 4 times as often as men (36.8 against 9.0 per 10,000 a year in six UK areas), rising from the perimenopause. Most breaks in later life follow a fall from standing height, and "A fragility fracture is often the first sign that a person has weak bones", the American Academy of Orthopaedic Surgeons (AAOS) says.

Later fractures are common after a broken forearm (55% within 10 years in one US cohort), and fracture risk is about doubled after a previous fracture, highest in the first 2 years. The National Institute for Health and Care Excellence (NICE) counts the wrist as a "major osteoporotic fracture", asks for a fracture risk assessment for everyone 50 and over, and women past the menopause, who have had a fragility fracture, and offers a bone density scan after one in the last 2 years. Osteoporosis "is not usually painful until a bone is broken", the NHS says.

Sources 20, 21, 22, 23, 24, 25, 26

Ganglions and rheumatoid arthritisStrong evidence

Ganglions are "much more common in women than in men" and "are harmless and can safely be left alone", UK hand surgeons say. Rheumatoid arthritis is about twice as common in women (0.93% against 0.40% of UK adults); it "usually affects the hands, feet and wrists", often on both sides, with morning stiffness that often lasts longer than 30 minutes. NICE asks for urgent referral when the small joints of the hands or feet, or more than one joint, are affected, even if blood tests are normal.

Sources 27, 28, 29, 30, 31

Pregnancy and new parenthoodStrong evidence

About 1 in 3 pregnant women (34% of 639 in one study) report carpal tunnel symptoms, mostly after 32 weeks, and they usually settle in the weeks to months after the birth, though in clinic samples more than half still had symptoms at a year. Diagnosed carpal tunnel wasn't more common in the year after the birth; De Quervain's was. Our wrist pain in pregnancy guide covers both.

Sources 32, 33, 13, 34, 6

When a scan or test helpsStrong evidence

Carpal tunnel is diagnosed by "asking about your symptoms and checking your hand"; nerve tests "are not essential" but help when the diagnosis is uncertain, with diabetes or nerve damage, when another nerve may be involved, or for symptoms that come back after surgery, and the UK pathway asks clinicians to check for diabetes and an underactive thyroid. De Quervain's needs no scan, and thumb and hand osteoarthritis are diagnosed without an X-ray at 45 and over when they fit the usual pattern.

After a fall, an X-ray looks for a break, with follow-up for the scaphoid. After a fragility fracture, a fracture risk assessment and a bone density (DXA) scan. For suspected rheumatoid arthritis, referral shouldn't wait for blood tests.

Sources 6, 5, 35, 36, 37, 24, 31

How it usually goesEmerging evidence

Carpal tunnel "sometimes gets better by itself in a few months, particularly if you have it because you're pregnant". De Quervain's "gets better on its own, but may take several weeks or months to settle", an NHS Scotland leaflet says. In thumb and hand arthritis, average pain changes little over 10 years, though some people's hand function worsens, and the symptoms "often stabilise over the long term". Ganglions usually go in "several months up to a year", and a broken wrist takes "around 6 to 12 weeks to recover". No one can promise a timescale.

Sources 6, 14, 38, 19, 39, 27, 40

What helps, and how strong the evidence is

Carpal tunnel: a night splint first, injections and surgery for someStrong evidence

A splint that keeps the wrist straight at night is the NHS's first step: "You may need to wear a splint for up to 6 weeks before it starts to feel better." The evidence for splints is low certainty, but they have "no plausible long-term harms". In a UK trial of 234 adults (about two-thirds women), one steroid injection eased symptoms faster than 6 weeks of night splints at 6 weeks but not at 6 months, and 46% had a more painful hand or wrist afterwards; pregnant and breastfeeding women weren't included.

Surgery gives more long-term improvement than splinting (moderate certainty) and is offered when symptoms are severe or don't improve: "Surgery usually cures CTS" (carpal tunnel syndrome), the NHS says.

Sources 6, 41, 42, 43, 4

De Quervain's: an injection and a splint help mostStrong evidence

"Steroid injection relieves the pain in about 70% of cases", UK hand surgeons say. Across 30 studies (1,663 people, 80% women), adding 3 to 4 weeks in a thumb splint to an injection gave a small extra gain. In 18 pregnant or breastfeeding women, all 9 who had an injection had complete relief, and most who wore a splint settled once breastfeeding ended. A splint should be worn for the jobs that hurt and "for as short a period as possible", as too much can stiffen and weaken the thumb, an NHS leaflet says.

Sources 14, 44, 45, 36

Thumb and hand arthritis: exercise, joint protection and gelsEmerging evidence

NICE offers exercise to everyone with osteoarthritis, a gel anti-inflammatory for joints other than the knee, and splints only when the joint is unstable and exercise isn't enough; a steroid injection gives "short-term relief (2 to 10 weeks)". Hand exercise eased pain a little across 5 trials, and 3 months of home exercise helped 80 Norwegian women with hand osteoarthritis. Joint protection helped more people than usual care (33% against 21%) in a UK trial of 257.

Adding a thumb splint to a self-management programme made no difference in a UK trial of 349 people, and a steroid injection at the base of the thumb did no better than salt water in a trial of 40. NHS inform says a gel containing ibuprofen is "The most effective painkiller for this condition".

Sources 37, 46, 47, 48, 49, 50, 51

Grip aids, splints used wisely and desk set-up: consistent advice, little testedEmerging evidence

Health services agree on gadgets for jars and taps, chunkier handles, using both hands, a trolley or backpack, and switching between harder and easier jobs; on not wearing a splint all the time ("this could weaken your hands", Arthritis UK says); on keeping the wrist straight and loosening the grip on a buggy, mop or phone; and on a keyboard "just below elbow height" with short, frequent breaks. Only joint protection has been tested, in one trial.

Sources 52, 9, 5, 34, 53, 54

After a broken wrist: a bone check, and strength and impact for boneStrong evidence

If you're 50 or over, or past the menopause, and broke your wrist in a fall from standing height, NICE asks for a fracture risk assessment and offers a bone density scan; fracture liaison services should be available for everyone with a fragility fracture, the UK osteoporosis guideline says, and the NHS suggests asking your GP surgery about one. A falls assessment follows a fall that needed treatment. Historically few women were checked: only 2.8% had a scan in one US study.

Sources 24, 23, 40, 55, 56, 57

Hand exercises: doses from NHS inform and UK leafletsEmerging evidence

NHS inform starts with "2 to 3 repetitions at a time" and builds to 2 sets of 8, "2 to 3 times a day", up to "a maximum of 2 sets of 15". For thumb arthritis, the OTTER II booklet's exercises are done "at least 3 times a week for at least 20 minutes each time". For carpal tunnel, nerve and tendon glides rest on very low-quality evidence, and the Chartered Society of Physiotherapy (CSP) suggests its hand exercises for "at least 6-8 weeks". NICE suggests a hand exercise programme in rheumatoid arthritis too.

Sources 58, 59, 60, 61, 31

How much pain is OK while you exercise?

Up to about 5 out of 10, settled within half an hour and no worse the next morning; tingling from glides that fades within the hourEmerging evidence

Some discomfort during the exercises is fine, up to about 5 out of 10, settling within half an hour or so, with the hand no worse the next morning; if it is, do fewer, smaller or lighter next time, not nothing. That is the wrist hub's rule (editorial numbers). NHS inform uses the same scale ("0 to 3 - minimal pain; 4 to 5 - acceptable pain; 6 to 10 - excessive pain"), asks that pain be "no worse the morning after you've exercised", and says stop exercises that make your symptoms worse or cause new pain.

For thumb arthritis, "Any discomfort should stop after 24 hours" (OTTER II). With nerve glides, "some increase in symptoms is expected, however this should not last more than one hour", an NHS leaflet says; stop and get advice if numbness spreads or lasts, or your grip or thumb gets weaker. With De Quervain's, "do not push through increasing pain". A changed shape after a fall, lost feeling, or a hot, swollen wrist aren't pain-rule questions: they are warning signs.

Sources 58, 59, 62, 38

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle: rest the task, splint at night if you tingle, keep the hand moving

About the first 2 weeks, little and often. For carpal tunnel, wear a night splint for up to 6 weeks, as the NHS says; for De Quervain's, a thumb splint for the jobs that hurt. The thumb exercises have no 3D demo, so they are written steps below. No trial has tested a plan for wrist pain in women; the doses come from NHS inform, NHS leaflets and the move pages, as named. In pregnancy and the first months after the birth, our wrist pain in pregnancy guide's plan comes first; after a break, the fracture clinic's plan does.

Wrist & forearm flow demonstrated on the 3D figure

3D demoWrist & forearm flowBeginner · No equipment

2 to 3 at a time, building to sets of 8, up to 2 sets of 15, 2 to 3 times a day · NHS inform's pacing for wrist and hand exercises

Easier: Wrist circles · Harder: Wrist flexor stretch

Tendon glides (hand tendon gliding exercises) demonstrated on the 3D figure

3D demoTendon glides (hand tendon gliding exercises)Beginner · No equipment

4 to 6 of each position, holding each for 5 s, up to 4 times a day · The move page's dose, from an NHS hand therapy leaflet

Harder: Ball squeeze

Median nerve glide (six hand positions, for carpal tunnel) demonstrated on the 3D figure

3D demoMedian nerve glide (six hand positions, for carpal tunnel)Beginner · No equipment

For tingling in the thumb and first fingers: about 7 s in each position, 5 times through, 3 times a day · The move page's dose, from a carpal tunnel trial; an NHS pregnancy leaflet goes through it 8 to 10 times, three times a day. Skip the last step with thumb base arthritis or De Quervain's, as the move page says

Easier: Median nerve slider (neck-to-arm nerve glide)

Wrist circles demonstrated on the 3D figure

3D demoWrist circlesBeginner · No equipment

10 slow circles each way, a few times a day · Editorial, as in the wrist hub

Harder: Wrist flexor stretch

Move on when: Daily tasks are easier, the hand is no worse the next morning, and any tingling from the glides fades within an hour (the wrist hub's check).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Build: grip, thumb and forearm strength

About weeks 2 to 8, every other day, with light weights. Keep the thumb exercises going 3 times a week if your thumb base is sore.

Ball squeeze demonstrated on the 3D figure

3D demoBall squeezeBeginner · Other / check instructions

Squeeze a soft ball and hold for 5 s, 10 times · The CSP's hold; 10 repetitions is editorial. Use a soft ball with thumb arthritis, and leave hard squeezing if a finger catches, as the move page says

Easier: Tendon glides (hand tendon gliding exercises) · Harder: Band finger extension

Band finger extension demonstrated on the 3D figure

3D demoBand finger extensionBeginner · A band

For thumb arthritis, the band round the thumb only: lift against it and hold for 5 s, then lower slowly, up to 10 times; otherwise 2 sets of 10 · The OTTER II booklet's band exercise; the general dose is editorial

Easier: Ball squeeze · Harder: Plate pinch

Reverse wrist curl demonstrated on the 3D figure

3D demoReverse wrist curlBeginner · A dumbbell + A bench or box

A tin of beans, then a little heavier: sets of 8, up to 2 sets of 15, every other day · The CSP's wrist lift ("Gradually increase the weight you hold"), with NHS inform's pacing

Easier: Wrist-extensor eccentrics · Harder: Plate pinch

Wrist curls demonstrated on the 3D figure

3D demoWrist curlsBeginner · A dumbbell

The same, palm up · NHS inform's pacing (editorial match)

Easier: Wrist-extensor eccentrics · Harder: Plate pinch

Dumbbell forearm rotation demonstrated on the 3D figure

3D demoDumbbell forearm rotationBeginner · A dumbbell + A bench or box

2 sets of 10, a light dumbbell held near one end · Editorial, as in our carpal tunnel guide

Easier: Wrist-extensor eccentrics · Harder: Plate pinch

Wall push-up demonstrated on the 3D figure

3D demoWall push-upBeginner · A wall

2 sets of 8 to 12, only if bending the wrist back doesn't bring on tingling or thumb-side pain · Editorial, as in our carpal tunnel guide. Move back to a steeper angle if the wrists complain, as the move page says

Harder: Push-up

Move on when: The moves pass the pain rule, and lifting a full kettle or a shopping bag is comfortable (our suggestion).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Strengthen and return: carrying, lifting and your bones

From about 6 to 8 weeks, 2 or 3 sessions a week, then keep going. Carrying shopping and children, gardening, yoga and the gym come back one at a time, a little more each week (our suggestion). After the menopause or a broken wrist, the heel drops and the squat add impact and strength for bone, as the move pages and our osteoporosis page describe.

Farmer's carry demonstrated on the 3D figure

3D demoFarmer's carryIntermediate · A dumbbell + A kettlebell

2 to 3 walks of 20 to 30 m, light, with padded or thick handles if the thumb is sore · Editorial; the move page suggests thick or padded handles with thumb arthritis

Harder: Suitcase carry

Hammer curl demonstrated on the 3D figure

3D demoHammer curlBeginner · A dumbbell

2 sets of 10, light, and last with De Quervain's · Editorial. Leave thumb-up curls until the thumb side has settled, as the move page says

Easier: Seated dumbbell curl · Harder: Alternating hammer curl

3D demoBand rowBeginner · A band + An anchor point

3 sets of 10 to 15, stopping 2 to 3 reps short of failure · The move page's dose, an editorial starting point

Harder: Supported single-arm dumbbell row

Incline push-up demonstrated on the 3D figure

3D demoIncline push-upBeginner · A bench or box

2 to 3 sets of 8 to 12, on fists or push-up handles if the wrist complains · Editorial, then knee push-ups, whose page suggests fists, handles or dumbbells to keep the wrists straight

Easier: Wall push-up · Harder: Push-up

Dumbbell goblet squat demonstrated on the 3D figure

3D demoDumbbell goblet squatIntermediate · A dumbbell

2 sets of 8 to 12, a light weight held close with straight wrists · Editorial: practice for lifting a child or shopping from low down

Easier: Bodyweight squat · Harder: Barbell front squat

Heel drop (impact for bone) demonstrated on the 3D figure

3D demoHeel drop (impact for bone)Beginner · No equipment

After the menopause or a broken wrist, once the wrist is comfortable: 20 to 30 drops, building towards about 50 on most days · The move page's dose, which it credits to the UK osteoporosis consensus. Keep it gentle with spinal fractures, as the move page says

Harder: Jump rope (basic bounce)

Move on when: Our suggestion: your usual week passes the pain rule. Keep two strength sessions a week, as the NHS advises for all adults, and go back to the first stage for a few days if symptoms come back.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Splints, grip and everyday tasks (written steps)

Our 3D figure can't show these. They come from the NHS, NHS inform, NHS leaflets and Arthritis UK.

1. Cut down the task that brings it on for a few days, then build back; keep the hand moving (the NHS).
2. Carpal tunnel: a splint that keeps the wrist straight at night, for up to 6 weeks; don't wear it all day (the NHS; NHS inform).
3. De Quervain's: avoid wringing, turning and twisting, keep the wrist in line with the forearm, and take short breaks (NHS Scotland).
4. Loosen your grip and change position when pushing a buggy or trolley, sweeping, mopping, reading or holding a phone (St George's, an NHS leaflet).
5. Thumb arthritis: gadgets for jars and taps, chunkier handles, both hands, a backpack or trolley instead of bags, and switching between harder and easier jobs (Arthritis UK).
6. An ice pack in a towel for up to 20 minutes every 2 to 3 hours, and paracetamol or ibuprofen gel; take off rings if the hand looks swollen (the NHS).

Sources 9, 6, 5, 52, 38, 34

The thumb exercises (written steps)

From the OTTER II thumb booklet, for thumb base arthritis. They have no 3D demo yet, so here they are in words.

1. Warm up: put your hand in a bowl of warm water and gently circle your thumb one way, then the other, for at least 2 minutes.
2. Thumb lift: keeping the thumb joints slightly bent, lift the thumb and hold for 10 seconds; repeat up to 10 times.
3. Do the exercises at least 3 times a week for at least 20 minutes, and make them harder only when they feel easy (our suggestion).
4. Any discomfort should stop within 24 hours; if it doesn't, ease off and ask your therapist.

Source 59

Babies, desks, painkillers and your bones (written steps)

These come from the NHS, an NHS leaflet, the Health and Safety Executive (HSE) and NICE, except where marked as our suggestion.

1. Lift and carry your baby with both hands and your palms up rather than your thumbs, and use a sling for longer spells (our suggestion, as in our pregnancy and De Quervain's guides).
2. When feeding, use pillows or cushions so your shoulders and arms are relaxed and your wrist isn't bent for long (the NHS; St George's).
3. At a desk, keep the keyboard just below elbow height and the mouse in line with your elbow, and take short breaks often, such as 5 to 10 minutes every hour (HSE).
4. In pregnancy, paracetamol is usually the best painkiller; when breastfeeding, check with a pharmacist before using ibuprofen (the NHS).
5. If you're over 50 and have broken your wrist, ask your GP surgery about a fracture liaison service; NICE offers a fracture risk assessment and a bone density scan after a fragility fracture (the NHS; NICE).

Sources 63, 34, 53, 54, 64, 65, 40, 24

Positions to swap, and why

Habit or position	Why it matters	Instead
Assuming all wrist pain is carpal tunnel	The thumb side, the base of the thumb and a fall each point elsewhere.	Use the map above, then the condition's guide.
Wearing a splint all day for weeks	It can stiffen and weaken the hand, Arthritis UK and an NHS leaflet say.	A night splint for carpal tunnel, a task splint for De Quervain's, and daily hand moves.Try: Tendon glides (hand tendon gliding exercises)
Lifting a baby, a kettle or pans with your thumbs pointing up	It is one of the movements that brings on De Quervain's.	Palms up, both hands, close to your body.
Holding a phone, book or steering wheel with the wrist bent for long	It brings on carpal tunnel symptoms, NHS inform says.	Change position often; a stand or a headset (our suggestion).
Hard, repeated pinching and gripping: jars, wringing, secateurs	It loads the thumb base and the thumb tendons.	Gadgets, thicker handles, both hands and breaks.Try: Ball squeeze
Hitting or bursting a ganglion	The NHS says don't try to burst one, and hitting it with a heavy object such as a book can injure your hand, AAOS says.	Leave it, or see a GP if it grows, is hard or hurts.
Push-ups with the wrists bent back while it's sore	It loads the sore wrist at the end of its range.	Fists or handles, or a higher surface.Try: Incline push-up
Treating a broken wrist after 50 as bad luck	NICE counts it as a major osteoporotic fracture and asks for a bone check.	Ask for a fracture risk assessment, and add strength and impact exercise.Try: Heel drop (impact for bone)
Ibuprofen while pregnant	The NHS says paracetamol is usually the best painkiller in pregnancy.	Paracetamol, or ask a pharmacist.
Pushing the thumb exercises through pain that lasts into the next day	The OTTER II booklet says discomfort should stop within 24 hours.	Fewer, gentler repetitions.

Routines to follow

Wrist and forearm routine

Wrist mobility and forearm strength for desk work, climbing, push-ups and handstands.

10 minBeginner7 movesA wall, A dumbbell

Grip strength workout: squeezes, curls, carries and hangs

A 20-minute grip session: warm up the wrists and fingers, train the hand and forearm muscles, then carry and hang to load your grip the way everyday life does.

20 minBeginner10 movesOther / check instructions, A band

Hand exercises for rheumatoid arthritis (the SARAH programme)

The daily stretches and strengthening moves from the SARAH hand trial and NHS hand therapy leaflets: finger bends, finger walking, wrist circles, squeezes and pinches.

15 minBeginner7 movesA dumbbell, A bench or box

Yoga for carpal tunnel: a 25-minute wrist-free class with nerve and tendon glides

A 25-minute wrist-free yoga class for carpal tunnel: slow breathing, nerve and tendon glides, seated moves, standing poses with hands free, and forearm poses.

25 minBeginner17 movesA bench or box

Bone-strengthening workout

Impact, strength and balance for stronger bones, following UK osteoporosis consensus advice, with options for every level.

40 minBeginner14 movesA kettlebell, Other / check instructions

More moves for this area

Questions people ask

What causes wrist pain in women?

Most often carpal tunnel syndrome (tingling in the thumb and first fingers), De Quervain's (the thumb side, often after a birth), thumb base arthritis (from about 50), a ganglion, or a fall. Several of these are more common in women. Where it hurts and when is the best clue, and the map above sends each to its guide.

Why is carpal tunnel more common in women, and can the menopause cause it?

It is about twice as common in women, peaking at 45 to 54. NHS inform lists the menopause and pregnancy as risk factors, but no study has shown the menopause causes it; weight, diabetes, an underactive thyroid and hand-heavy work also matter.

Can HRT help or cause carpal tunnel?

Studies disagree: overall there was no clear link, and the only randomised data suggested HRT may lower the odds. HRT isn't a treatment for carpal tunnel; a night splint is the first step. Talk to your GP if you want to know your options for menopause symptoms.

Why does my wrist hurt after having a baby?

Usually De Quervain's on the thumb side, about 5 times as likely in the year after a birth, or carpal tunnel that started in pregnancy. Lift with your palms up and support your arms when feeding. Our wrist pain in pregnancy guide covers splints, feeding and lifting.

Is it carpal tunnel or arthritis at the base of my thumb?

Carpal tunnel causes tingling or numbness in the thumb and first fingers, often at night. Thumb arthritis causes an ache at the base of the thumb when you pinch, turn a key or open a jar, usually from 45. You can have both.

I broke my wrist in a fall. Should I have my bones checked?

Yes, if you're 50 or over or past the menopause: NICE asks for a fracture risk assessment and offers a bone density scan after a broken wrist in the last 2 years. Ask your GP surgery about a fracture liaison service.

Can osteoporosis cause wrist pain?

Not usually: the NHS says osteoporosis "is not usually painful until a bone is broken", and the wrist is one of the commonest places to break. A wrist that hurts after a fall needs checking for a break.

Should I wear a wrist splint?

For carpal tunnel, yes at night, for up to 6 weeks. For De Quervain's, a thumb and wrist splint for the jobs that hurt. Don't wear one all day for long, as the hand can stiffen and weaken.

What is the lump on my wrist?

Usually a ganglion, a harmless fluid-filled lump, much more common in women; many go on their own. See a GP if it grows, is hard or doesn't move, and get help the same day if it is very painful, hot or red.

Why does my left or right wrist hurt? Could it be my heart?

The side usually reflects the hand you use or the one you fell on; hand arthritis is often worse in the hand you use most. Wrist pain on its own isn't a sign of a heart attack, but call 999 for chest pain that spreads to your arm, neck or jaw. In the US, call 911 where this page says 999.

Do steroid injections help?

For De Quervain's, often: about 70% get relief. For carpal tunnel, an injection works faster than a splint but no better at 6 months, and nearly half had a more painful hand for a while afterwards in a UK trial. At the base of the thumb, the relief is short-term at best.

When should I see a doctor?

Go to A&E for a wrist that has changed shape or a hand that is numb after a fall, and get help the same day for lost feeling in the hand or a hot, swollen wrist with a high temperature. See a GP if it isn't better after 2 weeks, for tingling that keeps coming back, a weak thumb, or several swollen, stiff joints.

When to get help first

Get urgent medical help if

See a doctor or physiotherapist if

Where does it hurt?

Understand it

Carpal tunnel syndrome: about twice as common in women, peaking in midlifeStrong evidence

The menopause and HRT: linked, but not shown to cause itEmerging evidence

Not all tingling is carpal tunnelStrong evidence

De Quervain's: several times more common in women, and after a birthStrong evidence

Thumb base and hand osteoarthritis: more common in women, from about 50Strong evidence

A broken wrist after a fall: commoner in women, and a sign to check your bonesStrong evidence

Ganglions and rheumatoid arthritisStrong evidence

Pregnancy and new parenthoodStrong evidence

When a scan or test helpsStrong evidence

How it usually goesEmerging evidence

What helps, and how strong the evidence is

Carpal tunnel: a night splint first, injections and surgery for someStrong evidence

De Quervain's: an injection and a splint help mostStrong evidence

Thumb and hand arthritis: exercise, joint protection and gelsEmerging evidence

Grip aids, splints used wisely and desk set-up: consistent advice, little testedEmerging evidence

After a broken wrist: a bone check, and strength and impact for boneStrong evidence

Hand exercises: doses from NHS inform and UK leafletsEmerging evidence

How much pain is OK while you exercise?

Up to about 5 out of 10, settled within half an hour and no worse the next morning; tingling from glides that fades within the hourEmerging evidence

The exercise plan: 3 stages

Settle: rest the task, splint at night if you tingle, keep the hand moving

Build: grip, thumb and forearm strength

Strengthen and return: carrying, lifting and your bones

What to change for now

Splints, grip and everyday tasks (written steps)

The thumb exercises (written steps)

Babies, desks, painkillers and your bones (written steps)

Positions to swap, and why

Routines to follow

Wrist and forearm routine

Grip strength workout: squeezes, curls, carries and hangs

Hand exercises for rheumatoid arthritis (the SARAH programme)

Yoga for carpal tunnel: a 25-minute wrist-free class with nerve and tendon glides

Bone-strengthening workout

More moves for this area

Questions people ask

Related exercise guides

Other pain guides

Sources