The carpus of the wrist is made up of 8 small bones and these bones are secured together by a complex set of ligaments. Over time, often due to repeated FOOSH in sport, these individual bones can become less securely connected to each other, leading to ligamentous instability. The most common carpal instability is Scapho-Lunate instability, which involves excessive movement between the scaphoid and the lunate bones.
This problem tends to develop slowly over time and can eventually lead to painful gripping, difficulty taking weight through the hand particularly with the wrist in extension (bent back) and painful clicking. Pain and slight swelling is usually noted over the middle of the back of the wrist.
It’s important to diagnose this problem as early as possible as it can lead to long-term wrist problems if it continues unabated. A detailed manual examination will lead to accurate diagnosis of this problem, often earlier than conventional imaging can. Treatment may involve manual therapy, activity advice, exercise and splinting.