Wrist & Hand Pain

Bespoke treatment for all hand problems

Treatments include:

• Ergonomic assessment/modification
• Wound care/dressing

Conditions discussed further:
Arthritis is a common condition that causes pain and inflammation in a joint.

The two most common types of arthritis are:
Osteorarthis and Rheumatoid arthritis.

Osteoarthritis

Osteoarthritis initially affects the cartilage lining. It becomes rough and thinner which makes movement more difficult than usual, leading to pain and stiffness.

Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position.

Rheumatoid Arthritis

Rheumatoid Arthritis occurs when the body’s immune system targets affected joints, which leads to pain and swelling.

The outer covering (synovium) of the joint is the first place affected. This can then spread across the joint, leading to further swelling and a change in the joint’s shape. This may cause the bone and cartilage to break down.

Hand therapy can help with pain reduction, increase in movement and strength.

Dupuytrens Contracture/Disease

Dupuytrens Contracture/Disease is a benign condition that affects the connective tissue between the palm of the hand and the fingers. It often starts as a lump and is commonly associated with the ring or little finger.

As the disease progresses the nodules can grow and cords develop along the tendons, which bend the affected fingers towards the palm. This can stop the fingers from being able to straighten, and is called a ‘contracture’. The contracture can be more aggressive if there is a familial history of the condition.

Hand therapy intervention is predominantly post surgery to maintain the extension and regain full movement and strength as well and managing any scar tissue.

Fractures | dislocations | fixations

The hand and fingers are made up of many bones that form a framework.

Fractures occur because a force is applied to the bone strong enough to break it. The site and pattern of the fracture depends on how that force has been generated and applied. Some people may be embarrassed by what happened but it is important to be truthful as treatment can be influenced by how the injury occurred.

Musician’s injuries

Instrumental injuries often include the same conditions experienced from computer overuse. Incorrect posture, non-ergonomic technique, excessive force, overuse, stress, and insufficient rest contribute to chronic injuries that can cause great pain and disability.

Skiers Thumb

This is an injury to the ulnar collateral ligament of the metacarpo-phalangeal joint. This is a strong ligament that supports the thumb when pinching or gripping and if it is damaged may lead onto to a chronic instability of the thumb, which causes problems with function.

The injury happens when you fall onto the outstretched thumb. Falling when skiing while holding a ski pole is a common cause hence the name frequently given to this injury. Hand therapy is recommended to regain full range of motion, strength, reduced swelling and sometimes scar management.

Distal Radius Fracture

One of the most common distal radius fractures is a Colles fracture, in which the broken fragment of the radius tilts upward. The most common cause of a distal radius fracture is a fall onto an outstretched arm. There are many treatment options for a distal radius fracture. The choice depends on many factors, such as the nature of the fracture, age and activity level, and the surgeon’s personal preferences. Hand therapy is recommended to regain full range of motion, strength, reduced swelling and sometimes scar management.

Sports injuries

A jammed finger during a ball game. A painful elbow after a game of tennis. A sore thumb following a fall while skiing. Injuries like these may not seem serious at first, but left untreated, can put athletes of all levels on the sidelines for months—and have a lasting effect on function. Treatment for fractures of the wrist or finger joints varies with the severity of the break.

Tendinopathies

Tendinopathies involving the hand and wrist are common.
Common conditions involving the tendons of the hand and wrist include trigger finger, tenosynovitis of the extensor tendons (De Quervains), and flexor carpi radialis tendonitis. Management strategies include nonsurgical treatments, such as splinting, ultrasound therapy, acupuncture and kinesiology taping.

Repetitive strain injury (RSI)

Repetitive strain injury (RSI), also called Work-Related Upper Limb Disorder, is a general term used to describe the pain from muscles, nerves and tendons caused by repetitive movement and overuse.

Symptoms can include some or all:
Tenderness aches and pain, weakness, tingling, numbness, cramp, swelling.

It is difficult to obtain a diagnosis for Type II RSI conditions due to the lack of good pathology for these conditions; diagnosis relies on eliminating potential conditions where the detailed symptoms and circumstances do not match.

Type II RSI conditions can be the result of intensive computer operation, particularly if care is not taken with posture and positioning of equipment. In particular many sufferers of this condition consider that intensive use of the mouse has been a major cause of their RSI condition. The initial early signs and symptoms of aches in the fingers, hand or arm at the end of a long day are often not recognised. It will often not be recognised until acute and possibly debilitating pain is experienced.

Recovery from Type 2 RSI conditions may be achieved. The earlier the condition is recognised and effective action taken, has a significant impact on recovery time. Recovery in some cases can be achieved in a few months, but it is often measured in several years. Recovery can also occur in stages, allowing a gradual return to normal activity. However, full recovery is not always possible.

Some fractures will require surgery prior to seeing a hand therapist for healing management and then regaining full range of motion, strength, reduced swelling and sometimes scar management.

Contact us