Elbow, Wrist & Hand

What It Is

The wrist is made up of 10 bones: the eight small carpal bones, arranged in two rows of four, and the ends of the two forearm bones, the radius and the ulna (AAOS, n.d.a). A carpal bone fracture is a break in one of the eight carpal bones, such as the scaphoid on the thumb side of the wrist. The term "broken wrist" is also often used for a break at the end of the radius (a distal radius fracture), which is one of the most common broken bones (AAOS, n.d.b). This sheet focuses on carpal bone fractures, with some general advice for any broken wrist.

By far the most common cause of injury is a fall onto an outstretched hand (AAOS, n.d.a; AAOS, n.d.b). Injuries can also happen during sport (e.g. hitting a tree stump during golf, or trauma during contact sports) or in a road traffic accident (AAOS, n.d.a).

Carpal Bone Fracture Anatomy

Nestled between the hand and the forearm, the wrist extends from the pronator quadratus muscle, which lies across the lower ends of the radius and ulna, to the carpometacarpal joints, where the wrist meets the bones of the hand. The eight carpal bones are held together by a network of interwoven ligaments.

The blood supply of the scaphoid is especially important. Blood enters the end of the scaphoid nearest the thumb and flows "backwards" towards the end nearest the forearm. Because of this, breaks near the forearm end of the scaphoid heal more slowly, and a fracture can cut off the blood supply to part of the bone so that it dies. This is called avascular necrosis, and it can cause long-term problems in the wrist (AAOS, n.d.a).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Symptoms

How It Feels

Signs & Symptoms

A scaphoid fracture usually causes pain and swelling on the thumb side of the wrist, just below the base of the thumb, and pinching, gripping, pushing or pulling often make it worse. Some scaphoid fractures are not very painful and can be mistaken for a sprain, so wrist pain that does not go away within a day of an injury should be checked by a doctor (AAOS, n.d.a).

Treatment

Self-Care & Treatment

What to Do If You Think You Have Fractured Your Wrist

Get medical help as soon as possible if you think you have broken your wrist (NHS, 2026). Call 911 or go to the emergency room at your nearest hospital if:

your hand or wrist is numb, tingling or has pins and needles
you have a bad cut that is bleeding heavily
a bone is sticking out of your skin
your wrist has changed colour or shape, or is at an odd angle

(NHS, 2026)

Otherwise, get urgent medical advice the same day (for example, from an urgent care centre or your family doctor or nurse practitioner). While you wait to see a doctor, the NHS (2026) suggests you:

support the arm in a sling made from a towel
gently hold an ice pack (or a bag of frozen peas) wrapped in a tea towel on the injured area for up to 20 minutes every 2 to 3 hours
remove rings and watches, as your hand and wrist may swell
do not eat or drink anything, in case you need surgery

A doctor will examine your wrist and arrange an X-ray if needed. A scaphoid fracture does not always show on the first X-ray (AAOS, n.d.a), so an MRI scan may be considered for a suspected scaphoid fracture (NICE, 2016), or your wrist may be put in a splint or cast and X-rayed again a little later (AAOS, n.d.a).

Treatments you may want to discuss with your family doctor, nurse practitioner or medical team

Options outside my scope

Cast or splint: many carpal fractures are treated by holding the wrist still in a cast or splint. For a scaphoid fracture the cast usually stays below the elbow and includes the thumb, but it sometimes extends above the elbow. Scaphoid fractures tend to heal slowly, and follow-up X-rays are used to check healing (AAOS, n.d.a).
Surgery: when the bones have moved out of alignment, do not stay aligned, or are at higher risk of not healing, surgery may be used to put the pieces back in place and hold them with screws, wires, pins or plates, sometimes with a bone graft (AAOS, n.d.a; AAOS, n.d.b).

How I can help (see the My Approach tab)

Easing the forearm, shoulder and neck while your wrist is in a cast
Swelling, stiffness and scar care once your team allows
Wrist and grip strength exercises in step with your team's plan

Therapy

Once your cast has been removed, the wrist is likely to be stiff and weak, and physiotherapy can help with this (NHS, 2026; AAOS, n.d.b). I can help too, with hands-on work to ease tension in the forearm muscles and exercises to get your wrist moving and strong again. See the My Approach tab for how I work.

Follow the exercise advice your hospital gives you.

Tips

Falls are the biggest cause of wrist fracture, so take care on slippery surfaces: wear appropriate footwear, walk on the grassy part of a pavement if it's icy, and take extra care in cold, snowy or icy conditions.
Contact sports increase your risk of fracturing a carpal bone.
In older people, especially those with osteoporosis (bone thinning), even a simple fall can break the wrist (AAOS, n.d.b).
If your injury was quite innocuous, ask your doctor whether you should have a DEXA (bone density) scan to check for osteoporosis. A broken wrist is one of the most common injuries in people with osteoporosis (NHS, 2022). If you are over 50, ask your family doctor or nurse practitioner whether there is a fracture liaison service in your area (NHS, 2026).
Women lose bone quickly in the first few years after the menopause, which raises their risk of osteoporosis and broken bones (NHS, 2022).

Treatment

My Approach

After a broken wrist bone, the bone needs time and protection to knit, and the scaphoid in particular can heal slowly. Your fracture team decides how long the cast or splint stays on and checks healing with follow-up X-rays. I work inside their limits, and if your fracture was treated with surgery, or it stops you doing your normal daily activities, I need your medical team's okay before any hands-on treatment.

Please bring any X-ray or scan reports and notes from your medical team to your first visit. They're an important part of planning safe treatment for you.

In the Cast

Easing the forearm, shoulder, neck and upper back, which often tense up while your arm is protected
Gentle lymphatic drainage above the cast, and keeping the hand raised, to help with swelling
Keeping your fingers, elbow and shoulder moving, within what your team allows

After the Cast

Warm and cool applications in the clinic, with gentle hands-on work for stiff, weakened forearm muscles
Skin rolling and scar work once any incision has fully healed
Pain-free wrist movement first, then gentle joint mobilisation once your team confirms the bone has healed
Grip work, light wrist curls and everyday tasks, with a home programme between visits
Later, gym-based strength work or a graded return to sport

I don't stretch or load across the fracture until your team says it has healed, and I avoid heat over any metalwork. If you have osteoporosis, I keep pressure and joint work gentle. If your fingers go numb, pale or cold, or your cast feels too tight, call 911 or go to the emergency room.

What to Expect

Typical Course

Typical course: While you're in the cast, visits are usually about once a week. Once it comes off, most people come once or twice a week, then weekly, then less often, with a reassessment at about 4 to 6 weeks. Expect the cast stage to last often 6 to 12 weeks for a scaphoid fracture, sometimes longer, then a few more months to get full movement and strength back, in line with your fracture team's plan.

What I Focus On

Working Within Your Team's Limits

Compensation Relief

Swelling & Scar Care

Wrist Mobility

Grip & Strength

Sources

References

American Academy of Orthopaedic Surgeons (AAOS) (n.d.a) Scaphoid fracture of the wrist. Available at: https://www.orthoinfo.org/diseases--conditions/scaphoid-fracture-of-the-wrist/ (Accessed: 7 October 2026).
American Academy of Orthopaedic Surgeons (AAOS) (n.d.b) Distal radius fractures (broken wrist). Available at: https://www.orthoinfo.org/diseases--conditions/distal-radius-fractures-broken-wrist/ (Accessed: 7 October 2026).
NHS (2026) Broken arm or wrist. Available at: https://www.nhs.uk/conditions/broken-arm-or-wrist/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (NICE) (2016) Fractures (non-complex): assessment and management (NG38). Available at: https://www.nice.org.uk/guidance/ng38/chapter/Recommendations (Accessed: 7 October 2026).
NHS (2022) Osteoporosis. Available at: https://www.nhs.uk/conditions/osteoporosis/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooCarpal Bone Fracture

What It Is

Carpal Bone Fracture Anatomy

How It Feels

Signs & Symptoms

Self-Care & Treatment

What to Do If You Think You Have Fractured Your Wrist

Treatments you may want to discuss with your family doctor, nurse practitioner or medical team

Therapy

Tips

My Approach

In the Cast

After the Cast

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooCarpal Bone Fracture

What It Is

Carpal Bone Fracture Anatomy

How It Feels

Signs & Symptoms

Self-Care & Treatment

What to Do If You Think You Have Fractured Your Wrist

Treatments you may want to discuss with your family doctor, nurse practitioner or medical team

Therapy

Tips

My Approach

In the Cast

After the Cast

Typical Course

References

Related Conditions

Bennett's Fracture

Boutonniere Deformity of the Finger

Colles' Fracture

Dupuytren's Contracture

Book a session