At What Point Will My Ulnar-Sided Wrist Pain Require Surgery (and Do I Have Less Invasive Options)?

Ulnar-sided wrist pain — discomfort on the pinky side of your wrist — can be frustrating and limit your ability to grip, lift, or perform everyday tasks. This type of pain can range from mild to severe, whether caused by an injury, overuse, or an underlying condition. 

But at what point should you consider surgery? Read on as our two board-certified surgeons at Sequoia Institute for Surgical Services — Dr. Jonathan Liu and  Dr. Huey Yuan Tien — answer that question in more detail. 

What causes ulnar-sided wrist pain?

Your ulna is a long, thin bone that runs from your elbow to your wrist. Your ulna is on the same side of your arm as your pinky finger, and figuring out what’s causing your pain is the first step in determining if surgery is needed.

 Several issues can lead to pain on the ulnar side of your wrist, including:

Triangular fibrocartilage complex (TFCC) tears 

Your TFCC, which includes tendons and ligaments, stabilizes your wrist and connects your ulna to your radius. If you damage or tear the tendons and ligaments supporting your wrist, you may have pain near your ulna. 

TFCC tears are common, especially in adults over the age of 70. Of those diagnosed with TFCC tears, 49% of people aged 70 or older were affected, compared to 27% of those aged 30 or younger.

You might suspect that you’ve torn your TFCC if you fall (a common cause of TFCC tears), have difficulty rotating your wrist, and have weakness when gripping objects.

Ulnar impaction syndrome 

If your ulna bone is too long, it can press against your TFCC and cause pain. If this is the case for you, you may need surgery to shorten the ulna bone to prevent this from happening.

Arthritis

There are over 100 types of arthritis, and the most common — osteoarthritis and rheumatoid arthritis — can affect your wrists. 

Tendonitis

Tendonitis can develop in your wrist from injury or overuse. Certain professions, including carpenters and plumbers, may develop ulnar wrist pain because they often use tools in small spaces. Using their wrists in awkward positions over and over again can lead to repetitive injuries. 

When to seek medical care for ulnar-side wrist pain

Mild pain that improves with rest, ice, and over-the-counter medication may not require immediate medical attention. However, you should give us a call if you experience:

• Persistent pain lasting more than a few weeks
• Swelling, weakness, or a clicking sensation in your wrist
• Pain that worsens with activity and doesn’t improve with rest
• Pain that affects your quality of life 

The bottom line is that if you have wrist pain, don’t hesitate to contact us.

Nonsurgical solutions for ulnar-sided wrist pain

Even if you have all these red flags, surgery isn’t always the first line of defense. Your Sequoia Institute for Surgical Services provider may first recommend physical therapy, activity modification, bracing, corticosteroid injections, or medication. 

In the case of arthritis, we also offer hyaluronic acid injections.

When to consider surgery

If conservative treatments fail to provide relief and your pain affects daily function, surgery may be the best option. You may need surgery if:

• You have a severe TFCC tear
• You have ulnar impaction syndrome, and the bone structure requires correction
• Your arthritis has progressed to the point where joint damage is causing chronic pain

Dr. Liu and Dr. Tien recommend surgery when the benefits outweigh the risks. Once we confirm that surgery is right for you, our team prepares you for your procedure. 

Depending on the cause of your pain, our team may recommend arthroscopic debridement or repair (a minimally invasive procedure to clean out or repair damaged tissue), ulnar shortening osteotomy, or ligament reconstruction. 

If ulnar-sided wrist pain interferes with your daily life, don’t ignore it. Call us in Visalia, Reedley, or Porterville, California, to speak with our team. You can also book an appointment online.