Wrist Injuries
Are you experiencing wrist pain? You may have one of the following:
De Quervain’s Syndrome:
This condition involves inflammation of the tendons of the thumb. Pain is very noticeable in the wrist and thumb during general thumb use and during gripping and pinching activities. Conservative management usually consists of splinting the wrist and thumb, along with the use of anti-inflammatories (oral and/or injection). Occupational therapy may also be introduced to restore flexibility to the wrist and thumb, evaluate causative factors, educate on the prevention of symptoms, and strengthen the wrist and thumb to regain function. Therapy may also be prescribed to use thermal or electrical modalities to control inflammation and pain.
Tendonitis:
Tendonitis, simply put, is inflammation of the tendon. A tendon is what connects muscles to bone, and it typically crosses a joint. Overuse of the joint or muscle causes inflammation of the tendon. Tendonitis is very common in the wrist and hand. Tendonitis of specific tendon(s) can have different names (i.e. DeQuervain’s tenosynovitis, Intersection syndrome, finger tendonitis), but treatment is generally the same.
Tendonitis is generally treated with anti-inflammatories to reduce pain and swelling as well as by immobilizing the joints the tendon crosses. Occupational therapy may be prescribed to use thermal or electrical modalities to decrease pain and inflammation, for custom splint fabrication, to learn exercises and stretches to restore muscle and tendon flexibility, and to strengthen the wrist and hand to resume normal use. Your workstation and daily activities may need to be modified to prevent further injury and overuse.
Carpal Tunnel Syndrome:
The carpal tunnel is a narrow passageway in your wrist that allows nine tendons in the fingers and thumb, as well as the median nerve, to travel into the hand. Pressure inside the carpal tunnel may be increased by repetitive wrist motions, gripping, or sustained wrist and finger positions. This increased pressure on the nerve may cause wrist pain, numbness and tingling in the thumb and first two fingers, and eventual hand weakness.
Carpal Tunnel Syndrome may be managed with anti-inflammatories and with splinting to immobilize the wrist and decrease pressure in the carpal canal. A patient may be referred to an occupational therapist for splinting, nerve and tendon exercises, thermal or electrical modalities to decrease inflammation, and education on prevention of symptoms and activity modification. Our professional staff may also visit your worksite to adjust your workstation and fully optimize good technique to avoid future injury or recurrence. If conservative management is unsuccessful, surgery may be required to decompress the nerve.
Arthritis:
There are many forms of arthritis with most forms being categorized as either Osteoarthritis or Rheumatoid arthritis. Osteoarthritis generally occurs from “wear and tear” on the joints, while Rheumatoid arthritis is actually an autoimmune disorder that attacks the lining of the joints. Both forms of arthritis frequently occur in the wrist and hand. In addition to medical management, occupational therapy may be prescribed. Therapy goals are to decrease joint inflammation, improve joint range of motion, and provide education on joint protection techniques as well as to provide equipment to relieve strain on the affected joints during daily activities. Therapists may also fabricate rigid splints to rest and immobilize joints during a “flare-up” and recommend a variety of soft splints that support joints during hand use.
Fractures to Hand or Wrist:
A common mechanism of injury is falling on an outstretched arm with the wrist hyper-extended. Proper alignment of the bone(s) is essential for normal healing and restoration of motion. In addition, because of important vessels and nerves surrounding these structures, it is very important to follow-up with an orthopedic surgeon or a hand specialist. Treatment generally consists of casting or surgery to stabilize the fracture, followed by therapy to regain range of motion of the joints.
Guyon Canal Syndrome:
This condition involves the ulnar nerve and artery as they pass into the hand at the wrist (on the small-finger side of the hand). It is also known as “handlebar palsy”—named for pressure on the ulnar nerve in the hand from the handlebars of a bicycle during long-distance cycling. Pressure on this nerve causes numbness and tingling in the ring and small finger, pain on the small-finger side of the hand, and eventual hand weakness.
Treatment generally consists of conservative management with the use of anti-inflammatories and/or therapy. Therapy may include splinting of the wrist until the irritation of the nerve subsides, use of modalities to decrease inflammation, activity and tool modification to reduce pressure on the nerve, and strengthening of weak muscles.
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