Wrist and Hand Pain
Carpal tunnel syndrome
This syndrome relates to compression of the median nerve at the wrist on the palmar side of the wrist. The carpal tunnel is made up of the bones in the wrist (tunnel) and the ligament (road) which holds the ligaments and nerves/blood vessels within the tunnel. Carpal tunnel syndrome can occur as a result of a history of repetitive wrist movements (such as typing, banana picking or lots of push ups) . Carpal tunnel syndrome will start with mild symptoms within the hand including feelings of pins and needles, cold hands, pain and reduced strength or fine motor control. Initial treatment is aimed at reducing inflammation, loosening up tight structures that might be contributing to the compression and activity modification. Sometimes carpal tunnel requires surgical release of the compressed structures. If surgery is required, physiotherapy is important after the operation to prevent scar tissue from the surgical incision sites further compressing structures and to regain full wrist range of motion and strength.
Is a painful thumb condition due to inflammation in the tendons at the base of the thumb. At this level of the thumb, two tendons share a pathway and can result in friction leading to inflammation and restriction of movement This condition results from repetitive activities that require movement of the thumb away from the hands such as looking after a baby, playing golf, office work and other repeated gripping activities. This condition results in a painful ache at the base of the thumb which worsens with activity that moves the thumb closer to the palm of the hand. Physiotherapy treatment aims to decrease inflammation, reduce muscular tension at the base of thumb and correction of mechanics. Occasionally bracing can help in the early stages of treatment to ease stressful and repetitive movements of the thumb.
This injury results from a trauma to the ligaments on the inside of the thumb, however, can come from chronic stress to the ligaments. This injury is not reserved to Skiers and can often be seen in contact sports or due to a fall onto an outstretched hand. This results in an instability of the thumb with accompanied pain and weakness. Initial treatment usually involves supportive bracing to prevent further injury to the thumb and ligament. Following this manual therapy is used to improve the tendon healing, and hand and wrist strength is restored through a graded and specific exercise program including return to weight bearing.
Triangular Fibrocartilage Complex (TFCC) injury
The TFCC is a weight bearing, supportive ligament which is found on the outside of the wrist below the little finger. TFCC injuries usually result from trauma from falling onto an outstretched hand, however, can be as a result of chronic degenerative injury. When this ligament complex is injured, you may feel clicking, weakness or the feeling of your hand falling off your arm. Treatment of this injury is aided by specific braces which help to support the ligament complex and assist with reducing stress on the complex. Sometimes this injury is severe enough to require surgery. Following this physiotherapy is important to restore range of motion and strength in the wrist.