If you have pain in your wrist when carrying a bag, turning a doorknob, or experience numbness in your fingers, you may require treatment. Wrist pain can be caused by a sprain, traumatic or overuse injury, or due to a medical condition (ex: arthritis).
When the muscles in the hand become overused, these tendons can become inflamed and compress the median nerve as it passes through the carpal tunnel. This can cause numbness into the middle and index fingers, as well as the thumb and weakness in the hand. Night-time symptoms are common among people who sleep with their wrists bent and symptoms can wake you up. Other causes include hormonal changes during pregnancy, and health conditions such as diabetes, rheumatoid arthritis, and thyroid gland imbalance. Women and seniors are the most likely to develop carpal tunnel syndrome.
De Quervain’s tenosynovitis
This condition is an inflammation of the tendons on the side of the wrist at the base of the thumb.
Symptoms include pain and swelling at the base of the thumb, a sticking sensation in your thumb when you move it, and pain during activity that requires repetitive thumb or wrist movement such as working in the garden, and playing golf or tennis.
Arthritis of the wrist joint or base of thumb (CMC joint)
Wear and tear, an injury or aging can all contribute to the development of arthritic symptoms, such as swelling, redness and pain,
The TFCC keeps the forearm bones (radius and ulna) stable when grasping with the hand or when the forearm rotates. An injury or tear to the TFCC can be traumatic when falling on an outstretched hand or degenerative, occurring over time.
Symptoms of TFCC include:
Pain at the base of the small finger side of the wrist
Pain worsens when pushing off with the wrist or side-to-side movement
Painful clicking of the wrist
Swelling of the wrist
Management of the above conditions has been proven to be helpful in relieving pain, speeding up recovery, and rehabilitating chronic issues.
Frequently Asked Questions About Wrist Pain & Carpal Tunnel Syndrome
What are some techniques used for carpal tunnel syndrome?
Techniques used to treat CTS depend on the cause, which a registered physiotherapist can help you determine. Patient education on ergonomics, postural awareness, and activity modification lays the foundation. Manual therapy techniques such as joint or nerve mobilization, and soft tissue release are often used on the wrist and forearm muscles, as well as the neck and upper back. These secondary sites can often be a source of neuromuscular tension contributing to the main nerve irritation or compression at the wrist. Modalities such as acupuncture, ultrasound or laser are used for pain control and to stimulate circulation to aid healing.
What are some techniques used for wrist therapy?
Common wrist conditions include carpal tunnel syndrome, DeQuirvan’s tenosynovitis, thumb joint (CMC) arthritis, strains and sprains or subluxations. Treatment can vary depending on the condition and it’s cause, but will typically involve patient education, activity modification, and bracing or therapeutic taping to offload the irritated tissue. In some cases, custom wrist braces are made with an occupational therapist to ensure proper fitting and comfort for one’s daily activities. Exercise therapy focuses on regaining functional mobility and strength of the hand and wrist, particularly grip strength which can often be compromised with a wrist condition. Manual therapy techniques such as joint mobilization and soft tissue release, as well modalities like acupuncture, ultrasound and laser are also utilized.
Are wrist braces good for carpal tunnel syndrome?
A wrist brace is often recommended for those with CTS, especially for acute cases or for those suffering with symptoms overnight. This can help to stabilize the wrist in a comfortable position and ease the nerve compression caused by excessive wrist bending while sleeping. In rare cases, a patient may wear the brace during the day, but movement is quite restricted. How often they choose to wear the brace in the day, therefore, depends on balancing one’s daily activities with the severity of symptoms.
What will happen if carpal tunnel syndrome is not treated?
If the median nerve is irritated for long enough and the root of the problem is not addressed, the symptoms can become more severe and lead to weakness and atrophy of the hand muscles. Functionally, this can result in loss of grip strength and clumsiness i.e. dropping objects one is carrying. The milder symptoms such as tingling or occasional numbness may turn into chronic loss of sensation. In some cases, surgical release of the carpal ligament to decompress the nerve is needed, but should be seen as a last resort. Conservative treatment is always recommended first in order to fix the root cause and to avoid possible surgical complications.
What causes carpal tunnel syndrome to flare up?
There are several causes of CTS. Some contributing factors include pregnancy, diabetes, arthritis, hypothyroidism, wrist fractures or dislocations, cysts or tumours. Most often the cause is due to repetitive strain of he wrist with activities that involve gripping, repetitive hand movements, awkward wrist or hand positions or mechanical stress on the palm or wrist. This includes desk or assembly work, sewing, hand weeding, using certain tools and playing musical instruments.
How can I prevent carpal tunnel syndrome?
"We recommend taking these steps to prevent CTS:
Ensure proper ergonomics and postural awareness
Take frequent breaks from desk or assembly work, or other repetitious activities that involve gripping, pinching or awkward wrist and hand positions
Do flexibility exercises for the muscles of the forearm, and even the neck or upper back
Do regular weight training to improve grip strength and postural stability"
What agravates carpal tunnel syndrome?
When initially triggered, CTS can be aggravated by the same type of activities that caused it to begin with. As described above, this include gripping, repetitive hand movements, awkward wrist or hand positions. Other aggravators include bending the wrist toward its limits or by exposure to pressure or vibration. If highly irritability, one’s symptoms could be brought on more easily with several daily activities, i.e. typing, writing, other fine motor activities, working with tools or carrying groceries.
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