Signs of a broken wrist versus a sprain

A broken wrist and a sprain can both cause pain, swelling and bruising, so severe tenderness, deformity or loss of function needs medical assessment. You cannot confirm the difference from appearance alone.

A fracture may cause very focal bone tenderness, a change in shape, grating or inability to use the hand. A sprain more often produces tenderness around supporting ligaments, although the patterns overlap. [Wrist Pain](/symptoms/wrist-pain/) and [Hand Swelling](/symptoms/hand-swelling/) after a fall can occur with either injury. An X-ray or other imaging may be needed to identify a [Distal Radius Fracture](/conditions/distal-radius-fracture/).

Remove rings before swelling increases. Keep the wrist still in a comfortable position, support the hand, and avoid testing it repeatedly or trying to straighten a deformity. Elevation and a wrapped cold pack may reduce discomfort. A clinician may use [Closed Reduction](/treatments/trauma-and-fracture-care/closed-reduction/), [Fracture Casting](/treatments/trauma-and-fracture-care/fracture-casting/) or [Fracture Fixation Surgery](/treatments/trauma-and-fracture-care/fracture-fixation-surgery/) depending on alignment and stability. [Hand Therapy](/treatments/physiotherapy-and-rehabilitation/hand-therapy/) can support recovery after healing begins.

Seek urgent assessment for a visibly bent wrist, an open wound near the injury, severe or worsening pain, numbness, inability to move the fingers, or fingers that become pale, blue or cold. Assessment is also sensible after a significant fall or direct blow, even when swelling seems modest. Do not use pain relief or preserved movement as proof that the wrist is not broken.

Do I need an X-ray or repeat imaging? Is the wrist aligned and stable? What support should I use, and when can hand therapy or movement begin?