ConditionBones, joints & muscles
Wrist Stiffness: Causes and Recovery
Wrist stiffness is reduced ability to bend, straighten or rotate the wrist, often with a tight or achy feeling. The most common causes are stiffness after a wrist fracture or time in a cast, arthritis (osteoarthritis or rheumatoid arthritis), sprains and tendon inflammation such as De Quervain's tenosynovitis. Morning stiffness lasting more than an hour with swelling suggests inflammatory arthritis. Most stiffness improves with targeted exercises and hand therapy; persistent or worsening stiffness needs assessment.
Also called: Stiff wrist, reduced wrist motion, wrist tightness, limited wrist range of motion
At a glance
- What it is
- Loss of normal wrist movement, often with a tight or achy feeling.
- Most common causes
- After a fracture, cast or sprain; osteoarthritis; rheumatoid arthritis; tendon inflammation.
- Key clue
- Morning stiffness over 1 hour with swelling suggests inflammatory arthritis.
- What helps
- Gentle range-of-motion exercises, warmth, hand therapy, treating arthritis.
- See a doctor
- After a fall with snuffbox tenderness, persistent stiffness, swelling, or numbness.
When to get help
Call 911 or go to the ER
- A deformed wrist after a fall, or a cold, pale or numb hand. Call 911 or your local emergency number or go to the ER
See a doctor within a day or two
- Pain at the base of the thumb (anatomical snuffbox) after a fall, even if X-rays were normal (possible scaphoid fracture)
- A hot, red, swollen wrist with fever (possible joint infection or gout)
- Severe pain, swelling or numbness under a cast
Book a routine appointment
- Wrist stiffness that is not improving 2 to 4 weeks after a cast is removed
- Morning stiffness in the wrists lasting more than an hour, especially in both wrists or with swollen finger joints
- A lump on the wrist that limits movement
- Gradually worsening stiffness and pain over months
Usually safe to manage at home
- Mild stiffness after a busy day of gripping or typing that eases with movement and rest
Why wrists get stiff
The wrist is a complex joint where the two forearm bones (radius and ulna) meet eight small carpal bones. Normal movement includes bending forward and back, side to side, and rotating the forearm. Stiffness comes from:
- the joint itself: cartilage wear, inflammation, fluid
- the capsule and ligaments: tightening after injury or immobilization
- tendons: inflammation or adhesions that restrict gliding
- muscles: weakness and guarding after pain
Common causes of wrist stiffness
| Cause | Typical features |
|---|---|
| After a fracture or cast | Stiffness and weakness after 4 to 8 weeks of immobilization; improves over months with exercise |
| Wrist sprain | Pain and stiffness after a fall or twist; ligament injury |
| Osteoarthritis | Gradual stiffness and aching, often after an old injury; morning stiffness under 30 minutes |
| Rheumatoid arthritis | Both wrists, warm swelling, morning stiffness over an hour, finger knuckle involvement |
| De Quervain's tenosynovitis | Pain and stiffness on the thumb side, worse with gripping and lifting a baby |
| Ganglion cyst | Smooth lump on the back or palm side, may limit bending |
| Scaphoid fracture | Thumb-side pain after a fall; can be missed on first X-ray and lead to arthritis |
| Gout and pseudogout | Sudden hot, swollen, very painful wrist |
| Kienböck disease | Loss of blood supply to the lunate bone; gradual pain and stiffness in young adults |
| Diabetes and scleroderma | Thickened tissues limiting hand and wrist motion |
Stiffness after a wrist fracture
A wrist fracture, most often of the end of the radius, is one of the most common broken bones. After 4 to 6 weeks in a cast, nearly everyone has stiffness, weakness and some swelling. Most movement returns over 2 to 3 months, and strength over 6 to 12 months. A hand therapy program speeds recovery. Ongoing stiffness may be due to malunion, arthritis, or complex regional pain syndrome, which causes severe pain, swelling, color changes and stiffness out of proportion to the injury.
How doctors assess a stiff wrist
A doctor will ask about injuries, how long stiffness has lasted, morning stiffness, swelling, numbness and other joints. They will measure wrist and forearm movement, check grip, feel for tenderness and lumps, and test the nerves.
Tests may include:
- X-rays for fractures, arthritis and alignment
- MRI for hidden scaphoid fractures, ligament tears and Kienböck disease
- ultrasound for tendons, ganglia and inflammation
- blood tests (ESR, CRP, rheumatoid factor, anti-CCP, uric acid) if inflammatory arthritis or gout is suspected
Exercises to loosen a stiff wrist
Do these gently, several times a day, after warming the wrist in warm water for a few minutes. Stop if pain is sharp.
- Wrist bends: rest your forearm on a table with the hand over the edge; bend the wrist up and down. 10 times.
- Side to side: with the forearm supported, move the hand toward the thumb and little finger sides. 10 times.
- Forearm rotation: with the elbow at your side bent 90 degrees, turn the palm up and down. 10 times.
- Prayer stretch: press palms together in front of your chest and lower them slowly until you feel a stretch. Hold 15 to 30 seconds.
- Wrist extensor stretch: with the arm straight, gently bend the wrist down with the other hand. Hold 15 to 30 seconds.
- Grip strengthening: squeeze a soft ball or putty once motion improves.
After a fracture, follow the program from your surgeon or hand therapist, as timing matters.
Treatment
- hand therapy: guided exercises, splinting, scar and swelling management
- heat before exercise, ice after activity if it swells
- pain relief: acetaminophen or NSAIDs, following the label
- splints for rest during flares of arthritis or tendinitis
- steroid injections for tendinitis or arthritis flares
- disease-modifying medicines for rheumatoid arthritis
- surgery for some fractures, ganglia, tendon release, or advanced arthritis (partial fusion, proximal row carpectomy, total wrist fusion or replacement)
Frequently asked questions
Why is my wrist stiff in the morning?
Brief morning stiffness that eases within 30 minutes is common with osteoarthritis or after overuse. Stiffness lasting more than an hour, especially in both wrists with swelling or finger joint pain, can be a sign of rheumatoid arthritis and should be checked.
How long does wrist stiffness last after a cast?
Most people regain much of their movement within 6 to 12 weeks of cast removal with regular exercises, and strength over 6 to 12 months. Hand therapy helps. If stiffness is not improving after a few weeks, or pain is severe, see your doctor.
How do I loosen a stiff wrist?
Warm the wrist, then do gentle range-of-motion exercises: bending up and down, side to side, and rotating the forearm, several times a day. Stretch gently and progress to grip strengthening. Avoid forcing painful movements.
When should I see a doctor for a stiff wrist?
See a doctor for stiffness after a fall, especially with pain at the base of the thumb, stiffness with swelling or warmth, prolonged morning stiffness, a lump, numbness, or stiffness that is not improving after a few weeks.
Sources
This guide was written from current patient and clinical guidance, including:
- American Society for Surgery of the Hand: Wrist arthritis; Hand therapy
- American Academy of Orthopaedic Surgeons (OrthoInfo): Distal radius fractures; Arthritis of the hand and wrist
- American College of Rheumatology: Rheumatoid arthritis
- NHS: Hand and wrist pain
- MedlinePlus: Wrist injuries and disorders