How do I know if my wrist is broken or sprained?

In short

You cannot tell a broken wrist from a sprained one at home, because both swell, both bruise, and both often still move. An x-ray settles it, and sometimes a scan is added. Pain that sits over a bone and is still there after a few days is the sign to have the wrist examined.

Written for patients by The Hand and Wrist Institute. Prepared for review by John T. Knight, MD. Last updated September 5, 2026How we write and review

Call (817) 382-6789 to have this looked at, or book online with Dr. Knight.

What a sprain is, and what a break is

Turn your hand palm down and run a fingertip from the base of your thumb across the back of your wrist. Under that skin sit eight small bones in two rows, and they rest on the two forearm bones. Short, tough straps hold those bones to one another, and when one of those straps is overstretched or torn, that is a sprained wrist, or what we call a ligament injury.¹ A break is a crack through one of the bones themselves, and the one that goes most often is the forearm bone on the thumb side at the wrist, or what we call the distal radius.² Both injuries come from the same moment, which is a fall onto a hand that is out in front of you taking your weight.

Pain and swelling do not sort a break from a sprain

This is the part people get wrong. A sprain can hurt more on day one than a crack in a bone does, a broken wrist often still bends, and swelling shows up either way, so none of those three tell you which one you have. Here is what to note before your visit, as observations to hand over rather than a test that decides anything. Point one finger at the single sorest spot and see whether it sits over bone or over the softer area between bones. Note whether the wrist has changed shape next to the other side, whether you can take weight through the hand, and whether the pain is settling day by day or holding steady. Then let an x-ray answer the question, because the exam plus imaging is what separates the two.

What happens at the visit, in order

1. The exam. Dr. Knight works out where the tenderness sits, how the wrist moves, and what the injury did to the hand around it.
2. X-rays. They are taken in both the Southlake and Dallas offices and you review them with Dr. Knight minutes later, in the same visit.
3. A scan, where the x-ray leaves a question. Dr. Knight uses a CT scan when he needs to see whether a crack runs up into the joint surface.
4. Treatment. A sprain starts conservatively, and Dr. Knight states his own order for wrist problems below. A break is treated on how well the bone is lined up, which is covered in Does a broken wrist need surgery?.

If the x-ray comes back normal and the wrist still hurts, that is its own situation and it has its own page: Why does my wrist still hurt when the x-ray was normal?

When to call us

• The wrist looks bent, crooked, or different in shape from the other one.
• You cannot move the wrist or the fingers, or you cannot take any weight through the hand.
• The fingers are numb, tingling, pale, or cold after the injury.
• The pain and swelling are not settling over the first few days.
• The wrist is still sore two weeks after a fall, whatever the first x-ray showed.
• Skin is broken over the injury.