The hand and wrist are vital for helping us manipulate objects, express emotions and perform every day tasks like brushing our hair and carrying groceries. They are the most active part of the upper body, but their mobility can leave them vulnerable to injury. With a total of 28 bones and 20 muscles crossing the wrist, there’s a lot that can go wrong. A wrist injury can happen from a sudden accident, overuse or nerve compression. Here are some of ones we tend to see most frequently:
Carpal Tunnel Syndrome: Compression of the median nerve at the base of the palm that often occurs due to overuse or repetitive trauma. This injury is more common in females than males and it may occur during pregnancy. Someone with this injury might have impaired sensation, numbness and tingling in the hand, especially at night. Thumb weakness may occur and the person may have difficulty moving their thumb or activities such as typing on a computer, writing, gripping/grasping objects. Night wrist splints may be recommended along with physical therapy and in worst cases, surgery.
Pronator Syndrome: Compression of the median nerve under the pronator muscle. Someone with this injury may complain of heaviness in their forearm and difficulty/pain with turning the palm up. The way to differentiate between the two types of median nerve compression is pain presentation. Carpal tunnel will present with increase in pain and numbness at night, but night pain will not be present with the pronator syndrome.
Trigger finger: A condition where a finger gets stuck in a bent position. This condition can cause pain, clicking, catching when trying to straighten the finger as well as loss of range of motion. Although this condition can occur in anyone, it is seen more frequently in the diabetic population and in women, typically in the fifth to sixth decade of life. The diagnosis is usually straight forward, as most patients complain of clicking or locking of the finger, but other pathological processes such as fracture, tumor or other traumatic soft tissue injuries must be excluded. Treatments for trigger finger depend on the severity of symptoms and include splinting, corticosteroid injection or surgical release.
Colles’ and Smith fracture: Wrist fractures of the radius, the forearm bone that aligns with the thumb. These fracture often occurs with a fall onto an outstretched hand (FOOSH). The difference between a Colles’ and a Smith fracture is position of the wrist during the fall. A Colles’ fracture occurs with fall onto a wrist in extension and Smith’s is fall with the wrist in flexion. Upon injury, the injured person is usually brought to the emergency room and the fractures are treated.
De Quervain’s Tenosynovitis aka Gamer’s thumb: Condition affecting two tendons of the thumb, extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons. A person with this injury has irritation of the muscles of the thumb, causing pain and swelling over the radial (thumb) side of the wrist. This injury usually happens due to repetitive pinching or grasping of the objects, such as game controllers or smart phones. Symptoms may radiate into the forearm and pain will increase with moving the thumb. Treatment depend on the severity of symptoms, but come common ones are corticosteroids, NSAIDS and splinting.
Raynaud’s Syndrome/Phenomenon: Clinical syndrome causing characteristic color changes in fingertips as a result of poor blood flow. It is commonly brought on as a reflex to cold environment or emotional stress. Fingertips may turn white, blue or both when exposed to the stressors and the symptoms may last for up to an hour. Person will not present with any range of motion, strength or sensation impairments.
Although these are the most common wrist injuries in our clinic, we treat a wide variety of injuries! If you have a wrist injury and want to see some of our techniques, check out our wrist KT tape video. If you are having any symptoms described in this article or have a new pain, numbness, stiffness or tingling in any part of your body, arms or legs, contact us today! With Direct Access in NJ we can get you in for an evaluation without you having to see your Doctor, probably quicker than you could get that appointment, while also saving you both time and money!
Please, call us to schedule your evaluation at one of BeneFIT’s locations, Bridgewater (908.203.5200) or Chester (908.879.5700) with one of our highly trained Doctors of Physical Therapy!
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