Your hand and wrist is a very complex area with the wrist alone being made up of eight small bones arranged in two rows articulating with each other and articulating with the two long bones of your forearm. As well as these joint articulations there is a network of ligaments and joint capsules connecting the bones to each other, tendons and nerves passing either side of the wrist and muscles in the hand itself. Strain or damage to any of these tissues can potentially cause pain and affect your ability to use your wrist or hand.
Sprains and fractures
Acute injuries to the wrist often occur as a result of a fall onto an outstretched hand. Common injuries include fractures of the distal radius and scaphoid bones, or ligament tears. Fractures are confirmed on x-ray and are managed with immobilisation in a cast for 4-6 weeks. A short course of physiotherapy once the cast is removed is often required to restore range of motion and to increase the strength of the muscles that move and stabilise the wrist. Sprains are managed with physiotherapy treatment, including bracing, joint mobilisation, massage, stretching and strengthening exercises.
De Quervain's tenosynovitis
De Quervain's tenosynovitis is an overuse condition affecting two of the tendons that attach to and are responsible for some of the primary movements of the thumb. Pain is felt along the base of the thumb, often extending down into the radial aspect of the wrist and forearm. De Quervain's typically responds well to physiotherapy when treated in its early stages. In some cases referral to a specialist for a cortisone injection may be required.
Carpal tunnel syndrome
The carpal tunnel is a space in your wrist in which several tendons and a nerve called the median nerve run through. In patients with carpal tunnel syndrome the median nerve gets compressed by the surrounding tendons. This causes a burning pain on the under-surface of your wrist, along with numbness or pins and needles in the thumb, index, middle and ring fingers. Occasionally pain can be felt radiating up further along the arm. Most mild cases respond well to conservative treatment including physiotherapy and splinting. In more severe cases surgery may be required.
As a result of there being multiple structures responsible for causing hand and wrist pain accurate diagnosis is crucial, Brickyard Physiotherapy practitioners are highly trained in the assessment and management of hand and wrist pain.
For more information contact one of our expert physiotherapists.