Wrist & hand pain
The bones of the hand and wrist provide our body with support and flexibility to be able to move our hands freely. One hand contains 27 bones and gives us the range and precision of motion needed for daily functioning.
There are eight small carpel bones in the wrist that are firmly bound in two rows of four bones each. These articulate with the ulna and radius at the wrist. The five long metacarpal bones of the palm extend from the carpus to each of the digits of the hand. Movement of the metacarpals by tiny muscles in the hand allows the palm to be stretched, compressed, and folded as needed. Nerves and blood vessels are forced to run through a narrow opening in the wrist. They can sometimes become inflamed leading to Carpel Tunnel Syndrome which results in abnormal sensations in the hand(s).
Common wrist problems include bone fractures (usually from falls) and dislocations of the various component joints. Another condition is inflamed tendons and ligaments from overuse, known as Repetitive Strain Injuries (RSI).
How is wrist & hand pain diagnosed?
A physiotherapist will ask you some questions to assist in their diagnosis and plan for your treatment. These include:
- Where exactly is the pain located?
- Is there pain in both hands & wrists or just one?
- Are there any pins and needles running through your hand?
- Is the pain sharp, or a dull ache?
- Do you have any limited movement of the wrist or hand?
- Is there any swelling or has there been?
- How intense is the pain?
- Is it there constantly or intermittently?
- How does it affect your day to day activities?
- Do you have any elbow, shoulder or neck pain?
These questions together with a physical examination will aid your physiotherapist in diagnosing the cause of the pain and determining a treatment plan. If the pain does not subside within a few weeks your therapist may refer you for an X-ray or MRI scan to assist their diagnosis and treatment strategy.
Possible causes of wrist & hand pain:
- Osteoarthritis
- Fracture of the radius or ulna (Colles’ or Smith fracture)
- Fracture of any of the metacarpal bones
- Rheumatoid arthritis
- Sports that involve wrist movement
- Repetitive work such as typing
- Carpal tunnel syndrome
- Tendonitis
- Bursitis
- Muscular strain
- Ligamentous sprain
- Ganglion cysts
- Peripheral nerve injuries
- De Quervain’s disease
- Hypermobility syndrome
- Referral of symptoms from the cervical spine, thoracic spine, shoulder, or elbow
- Cancer: rare
How to treat wrist & hand pain
Suggested treatments include:
- Heat therapy
- Ice therapy
- Physiotherapy
- Pain medication
- Rest and activity modification
- Wearing a splint
- Keeping wrist and hand raised in a sling if there is swelling
- Reviewing your seated position at the computer
How we can help your wrist & hand pain
We will do whatever we can to get you on the fastest route to recovery. Some of the treatment methods we use include:
- Mobilisation
- Strengthening exercises
- Myofascial trigger point release
- Pilates
- Cross-friction massage
- Stretching and range of movement exercises
- Acupuncture
- Functional exercises
- Taping