Wrist Pain – A Common Problem 
Did you ever see a problem so often you started to ignore it? I have. In fact wrist pain is so common there are few people who have not had a problem with their wrist at one time or another. I recently had a gentleman whose wrists were bothering him from golfing. It’s been a dry summer and the ground was so dry that getting under the ball was like hitting concrete. Ouch! His wrists hurt! Another patient had fallen and his wrist hurt. At first it just hurt off and on but then it became a regular pain that would not go away. Unfortunately, his wrist got to the point where it became quite annoying. Wrist injuries, tendonitis, and pain are very, very common. However they should not be ignored. Wrist problems can lead to weakness for gripping and pinching and even disability. Really! What are some of the causes of wrist pain and problems? Before we answer those questions we need to understand how the wrist becomes painful. Aching and pain in the wrists should not be ignored. Especially if certain activities like typing, working, home activities, and sports make them worse! Almost everyone who has wrist or hand pain or numbness is diagnosed with carpal tunnel. I think it is because it is so well known that it is just a handy label to put on the problem. Let’s get a good understanding of the wrist. The anatomy of the wrist is fairly straightforward. There are eight wrist bones in two rows that separate the hand from the two arm bones. There are many ligaments (bone to bone attachments) which hold together the wrist and attach the hand to the arm. These can be sprained (stretched) or torn in a fall when you reach out your hand or twist your wrist. In cases where you overuse your hand for activities such as typing, carpentry, factory work, gardening, etc. it is a different type of problem. There are nine tendons that flex the fingers and the thumb, four that move the wrist and still more that straighten the fingers. Any of these can rub together to the point where they get inflamed (tendonitis) or they actually begin to fray like an overused rope in a pulley (tendinosis). These may be the most difficult to get better. That is why it is so important to treat these problems right away and not wait until the tissues are severely damaged. I’ve seen people lose the use of their hands because they chose to ignore the problems of pain in the wrist and hands. Treatment is different for each problem of the wrist. If you sprain your wrist or twist it so the ligaments are injured we start out with custom bracing to allow the micro tears to heal. Ice for the first week can be helpful to reduce swelling. Also we use electrical stimulation to reduce pain and swelling. Once the pain gets better and the swelling improves (about 3 ˝ weeks to 6 weeks) we begin range of motion and eventually strengthening or joint mobilization and massage to help restore function. The same general routine is true for wrist fractures, generally. Treatment for overuse problems may involve splint wearing initially to stop the wrist from bending which allows the tendons and soft tissues to heal. We also use iontophoresis (electrical stimulation with a medicine to reduce inflammation), phonophoresis (ultrasound with medicine to reduce inflammation). We also use electrical stimulation to stimulate blood flow and reduce pain. Stretching and specific programs can help healing and reduce pressure on the tendons and also reduce pain. HELPFUL TIPS Change your mouse, many like the Logitec Optical Marble Mouse Common sense avoidance or at least reducing pain producing activities. Rest breaks from typing. A good stretching program to relieve muscle tension in the forearms and increase blood circulation, particularly stretching muscles in the shoulder and neck. If your wrist aches do something! Call us. Call your doctor. Waiting and doing nothing when your pain persists is not the answer. Your mouse and keyboard need to be at the same level at sitting elbow height Also try the “Mouse Trapper” which can attach to your keyboard. It really works. Tool handles should be larger in diameter. Tool handles 1 1/2 “ to 2” in diameter require less muscle force. Good Grip devices are great in the kitchen. For wrist problems in yoga try the Gripitz. Most importantly do something to handle your problem. Unresolved problems are worries and worries are unresolved problems. Take charge of your problem and give us a call. We can help. Call 301-759-4263 for an appointment or question. Thank you. I look forward to your call. |
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© Tri State Hand and Occupational Therapy, Inc
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