Physical Therapy Services

Wrist Pain

Perhaps the most common cause of wrist pain, especially for those who use their hands a lot, is repetitive strain injuries, or RSIs.

Repetitive Strain Injury is a blanket description of conditions that involve “cumulative trauma” to soft tissue structures resulting in pain and inflammation. Bursitis, carpal tunnel syndrome, tenosynovitis, tendonitis, epicondylitis, and sprains and strains are all forms of RSIs.

The hand and wrist is a complex structure with many moving parts. The muscles that control primary hand and finger movement are the forearm muscles. Long tendons course down through the wrist and attach to each digit. Contraction of the forearm muscles pull on the tendons to open and close the hand and allow fine dexterity movements.

In some people, problems occur when the hands and wrists are overused. Tendons chafe and develop micro tears. An inflammatory response follows and pain and swelling sets in. This increases the internal pressure of the area, creating a hypoxic (loss of oxygen) condition, further exacerbating the problem. Over time, tendons may become sclerotic (thickened and hardened) from the chafing and press against the median nerve. If nerve tissue is subject to pressure for a prolonged period, it begins to degenerate- numbness, tingling, pain, weakness and muscle atrophy soon follow. This common condition is known as carpal tunnel syndrome. It is a more serious condition that can lead to permanent disability.

It is best to take a proactive stance so as not to develop wrist pain in the first place. Common activities that can lead to wrist pain include:

– Computer keyboarding
– Hard gripping (machines)
– Assembly line work
– Pulling/Pushing heavy items
– Carrying things with wrist extended (waitressing)
– Using vibrational equipment

Giving your hands a rest every few minutes is important. If your job involves a lot of time typing, make sure that your workstation is set up ergonomically: monitor at eye level; keyboard tray to allow arms to fall naturally to your side while typing; and a chair with good back support, and foot stool to take some pressure off your thighs. Keep your elbows at a 90-100 degree bend and keep your wrists straight, inline with your forearms. Keep your mouse and other accessories within a small arc from your keyboard to minimize repetitive reaching. Lastly, stretch your wrists, shoulders, neck and back every hour. If at all possible, try to rotate tasks every other month to avoid repetitive stress to your wrists.

We have several therapeutic approaches to treating acute and chronic wrist pain, including Inter-X active stim, Solaris light-wave therapy, active release technique, joint mobilization, chiropractic extremity manipulation, and traction.