Like a Horse and Carriage – Hand and Wrist Injuries Often Go Together
By Dr. Frank J. Scerbo, PT, DPT, MS, CSCS ///
If we think about the many ways we use our hands, it’s easy to appreciate the importance of these complex structures in daily life. And since the bones, muscles, nerves, and blood vessels of our hands are connected to the wrist, often injury or pain in one may be felt in the other. Let’s look at some of the more common problems that affect these areas, and how physical therapy can help to reduce pain, promote healing, and build functional strength in hands and/or wrists.
Carpal Tunnel Syndrome
Hand pain is often related to trauma or sudden injury, but may also arise due to repetitive activities and wear and tear as we age. One of the most common conditions is carpal tunnel syndrome, caused by compression of the median nerve in the carpal tunnel of the wrist. Carpal tunnel symptoms include:
• Numbness and tingling sensations on the palm of the hand
• Symptoms worsen at night
• Driving, typing, and holding items exacerbate symptoms
• Shaking out the hand relieves symptoms
• Hand weakness or clumsiness (ie, difficulty with grip, dropping keys)
What causes carpal tunnel syndrome?
• Injuries such as wrist fractures or dislocations may decrease the size of the tunnel.
• Females have increased risk, possibly from a smaller size of the tunnel.
• Working with vibrating tools, on an assembly line, or with a computer for extended periods of time.
Wrist tendinitis is a condition where one or more tendons in the wrist become inflamed and irritated. There are several tendons in the wrist that connect the muscles of the forearm and hand to the bones of the wrist and hand. Wrist tendinitis applies to the early stages of tendon inflammation and irritation. Symptoms include:
• Pain where the arm meets the hand, which can radiate up into the elbow.
• Pain on the thumb side of the wrist (radial) or the little-finger side of the wrist (ulnar).
• Pain that only occurs when the wrist is under strain, which can become constant pain when left untreated.
• Pain when putting pressure on the hand, such as using the arms to push yourself up out of a chair to stand.
• Stiffness of the wrist, and a decreased ability to bend and extend the wrist.
• Inflammation or swelling in the wrist area.
• Tenderness to touch in the wrist and/or forearm muscles.
As with carpal tunnel, wrist tendinitis may be caused by performing repetitive activities using the hand and arm. At risk are computer users, factory workers, and athletes who throw and catch balls and play racquet sports. According to the American Physical Therapy Association, overuse tendinitis is responsible for 25% to 50% of all sports injuries. Older adults are often more at risk for wrist tendinitis due to a loss of elasticity in the wrist tendons.
How Can a Scerbo Physical Therapist Help?
For these and other hand and wrist disorders, conservative treatments by a qualified physical therapist can help relieve symptoms and promote healing. Treatments may include:
• Pain Reduction and Management
• Manual Therapy
• Range-of-Motion Exercises
• Strengthening Exercises
• Functional Training
• Planning Methods for Prevention
If surgery becomes necessary, post-surgery physical therapy treatment is important to help restore strength to the hand and wrist and teach you how to modify habits that led to the symptoms. Don’t wait for hand or wrist pain to get worse – contact us today at Scerbo Physical Therapy and Sports Rehabilitation for an individual evaluation.