Are you experiencing wrist pain that persists throughout the day and worsens with specific movements? Have you lost grip strength and have reduced range of motion? Do you know what is causing your wrist pain?
Wrist (and thumb) pain is a common occurrence, resulting from traumatic injury, long-term wear and tear, repetitive strain, workplace, or genetic predisposition.
Inadequate rehabilitation or ignoring pain can cause long-term consequences that affect your ability to perform everyday tasks.
The main pathologies we treat at Medicofit clinic for wrist and finger pain are carpal tunnel syndrome, De Quervain’s tenosynovitis, wrist instability syndrome, skier’s thumb, mallet finger, and jersey finger.
Did you know that a burning pain in the wrist accompanied by a tingling sensation is a symptom of nerve damage?
Comprehensive treatment of wrist pain at Medicofit clinic begins with diagnostic therapy and continues into the physiotherapy and kinesiology phase of rehabilitation.
The wrist is a complex joint that connects the palm (carpal) bones and the forearm bones (Latin: radius and ulna). The wrist contains numerous bones, muscles and their tendons, and nerves, all of which are potential causes of wrist pain.
The small carpal bones in the wrist are divided into two rows (each row has four bones). Each bone has articular cartilage, which allows for easier movement and transmission of forces (injury or wear can lead to wrist arthritis).
Numerous muscle tendons pass through the wrist, which are responsible for flexing (flexors) and extending (extensors) the wrist and fingers. Nerves (radial, medial, and ulnar) also pass through, which, when compressed or irritated, cause a painful wrist and a tingling sensation.
A bone fracture, ligament sprain, tendinitis, nerve compression, or cartilage wear/damage can cause wrist pain, and it is crucial to identify the cause of the pain.
Did you know that the cause of wrist pain is discovered through special diagnostic therapy?
WHEN TO OPT FOR MEDICOFIT DIAGNOSTIC THERAPY?
When pain persist for several days, it is necessary to undergo diagnostic therapy to prevent permanent damage.
Wrist pain is accompanied by tingling, weakness, and limited mobility.
If you have had similar problems before and the symptoms persist, it indicates that the condition has not been properly treated.
At Medicofit clinic, we provide patients with scientifically supported specialist physiotherapy, which begins with booking a diagnostic therapy appointment.
The most common conditions that cause pain in the wrist and fingers are carpal tunnel syndrome, wrist instability, arthritis, and De Quervain’s tenosynovitis.
Carpal tunnel syndrome
Carpal tunnel syndrome is a medical condition that affects the wrist and fingers. It occurs because of a compression of the median nerve, which runs through the carpal tunnel (the canal inside the wrist).
Typical symptoms of carpal tunnel syndrome are burning pain that radiates from the wrist towards the fingers and the forearm. The pain is accompanied by a feeling of numbness and tingling in the thumb, index finger, middle finger, and part of the ring finger.
Over time and as the disease progresses, the range of motion and muscle strength in the wrist decrease. Coordination in the wrist is lost and the ability to perform fine motor tasksis reduced (writing with a pencil, buttoning a shirt).
Carpal tunnel syndrome occurs due to the anatomical structure of the wrist (women have smaller wrists and are more susceptible to developing the syndrome), repetitive motion with additional strain (production workers, office workers, auto mechanics), pregnancy, and genetic predisposition.
The diagnosis of carpal tunnel syndrome is made using electromyography (EMG), which assesses the conductivity of the median nerve or the degree of narrowing of the carpal tunnel.
Wrist instability is a medical condition that occurs in the wrist when it becomes weakened and damaged, causing abnormal range of motion or changing the position of the carpal bones.
Wrist instability occurs because of traumatic injury (a fall on an outstretched hand, a sports injury affecting the ligamentous structure and causing microtrauma to the connective tissue), repetitive stressful movements (production workers, construction workers, installers, auto mechanics), and chronically loose ligaments (leading to instability more quickly).
Typical symptoms include sharp pain, inflammation and swelling around the wrist, decreased muscle strength and grip strength, and audible crepitus during movement. Symptoms are accompanied by a clear feeling of instability in the wrist.
Surgical treatment is recommended when the wrist retains less than 80% of mobility and muscle strength. Postoperative physiotherapy rehabilitation is crucial in regaining full range of motion and muscle strength in the wrist after surgery.
In the primary phase after surgery, symptom control (reduction of pain, reduction of inflammation and swelling) is carried out with the help of instrumental physiotherapy in combination with manual therapy and specialised physiotherapy training (isometric training that progressively progress to more complex motor movements).
De Quervain’s tenosynovitis
De Quervain’s tenosynovitis is a medical condition that causes inflammation and irritation of the tendons of the muscles on the thumb side of the wrist.
It occurs due to repetitive movements that put strain on the wrist (lifting heavy loads, gripping and twisting movements), direct traumatic impact (fall, injury), or genetic predisposition.
Patients report pain on the thumb side of the wrist, where swelling, tingling sensations, and crepitus occasionally occur. The pain increases with certain movements (extreme extension and extreme abduction of the thumb) and travels up the forearm.
The diagnosis of De Quervain’s tenosynovitis is made based on anamnesis, clinical testing, and diagnostic ultrasonography. A specific test to determine the presence of pathology is the Finkelstein test.
Modern physiotherapy treatment of De Quervain’s tenosynovitis lasts in most cases at least 10 to 20 weeks, but the duration of treatment depends on the chronicity of the problem and the general functional condition of the forearm muscles.
Osteoarthrosis
Wrist osteoarthrosis (osteoarthritis) is a degenerative disease that affects the cartilage and adjacent structures in the wrist. The main symptom is wrist pain, which may worsen with movement or strain. The disease often occurs with age, when cartilage wears down and loses its flexibility.
Causes of wrist osteoarthrosis include genetic predisposition, excessive strain on the joints, injuries, and wear and tear over time – hairdressers, masseurs, seamstresses, and office workers are particularly susceptible to this condition.
The diagnosis is made based on a clinical examination, imaging studies such as X-rays, and the patient’s history of problems.
Treatment for wrist osteoarthrosis includes a combination of conservative methods, such as physiotherapy, analgesics and anti-inflammatory medications, and lifestyle adjustments. In some cases – particularly in patients who have delayed physiotherapy treatment for too long – surgery may be necessary.
Rheumatoid arthritis
Rheumatoid arthritis is a type of arthritis where our immune system attacks our own joints, causing inflammation, joint pain, and swelling. Unlike arthrosis, it is not caused by cartilage wear, but by inflammatory processes.
The wrist is an extremely common site of arthritis, and can become very limited in movement, especially in the morning or after prolonged rest and inactivity. The pain can escalate to unbearable levels and greatly affect everyday activities – some patients are unable to even perform basic everyday tasks.
Treatment of rheumatoid arthritis includes anti-inflammatory medication, immunomodulators, and physiotherapy. Early detection and physiotherapy treatment are crucial for managing symptoms and preventing joint damage – untreated arthritis can cause irreversible joint damage.
Regular visits to a rheumatologist and strict adherence to the instructions of a physiotherapist are key to effectively managing rheumatoid arthritis and improving quality of life.
Comprehensive treatment of wrist pain begins with a diagnostic examination, physiotherapy, and concludes with kinesiology.
Long-term effectiveness of treatment is achieved by active physiotherapy, meaning that every patient is actively involved in the treatment process.
In treatment, we focus on eliminating the cause of wrist pain and not just the symptoms, which do not eliminate the cause.
Each patient undergoes a 60-minute individualised treatment with a physiotherapist and later with a kinesiologist, as well as a 30-minute instrumental therapy session.
Special diagnostics
The start of every treatment for wrist pain begins with special diagnostics, where the physiotherapist gains insight into the functional state of your body.
It begins with an initial interview conversation (in-depth anamnesis) about the duration of wrist pain, when it gets worse, your assessment of the pain, and other concurrent diseases.
The clinical examination continues with inspection and palpation, where we check for any swelling, inflammation, tenderness, skin temperature and skin colour, and observable muscle atrophy.
We perform measurements of mobility and arthrokinematics in the directions of flexion, extension, abduction/radial flexion (movement towards the body), adduction/ulnar flexion (movement away from the body), and rotation.
We perform measurements of wrist muscle strength, gaining insight into potential deviations from the norms, reduced muscle strength, endurance, and inadequate intermuscular relationships.
It is important to assess the load-bearing capacity of the wrist, which is typically too low or too high (the wrist’s ability to withstand loads).
We perform specific tests that are designed to test specific structures in the wrist, such as the Finkelstein test or the Phalen’s test.
It is important to perform a neurovascular examination, which assesses sensitivity, circulatory function, and nervous system function (possible presence of sensory loss, abnormal reflexes, or muscle weakness).
In certain cases, it is recommended to undergo imaging diagnostics to confirm the diagnosis by a medical specialist and to reject differential diagnoses.
Acute physiotherapy
Based on the diagnostic report, we design an individualised physiotherapy programme, which is prepared for each patient separately (the cause of their wrist pain, elimination of symptoms, limitations and abilities).
Physiotherapy experts perform manual therapy and joint mobilisation to improve mobility and arthrokinematics in the wrist, trigger point therapy, and myofascial release to reduce pain and muscle tension in the wrist.
In their work, they use state-of-the-art instrumental therapy, which actively reduces wrist pain and accelerates the natural healing and self-renewal processes. We perform:
Specialised physiotherapy training is primarily focused on strengthening the extensors and flexors of the wrist and improving wrist mobility.It is important to establish sufficient load-bearing capacity of the wrist and correct muscle balance.
The acute phase of carpal tunnel syndrome requires physiotherapy treatment with special training aimed at improving the mobility of the carpal tunnel and correcting asymmetries in muscle strength and activation of the muscles of the forearm and wrist.
Special training in the treatment of carpal tunnel syndrome requires neuromobilisation of the nerves of the upper extremities, especially the median nerve, which causes the symptoms!
Physiotherapy treatment for De Quervain’s tenosynovitis involves a combination of instrumental devices (to reduce pain and swelling), manual therapy (to relax the muscles of the forearm and improve the gliding of the thumb tendons), and special therapeutic training (improving grip strength, wrist rotation, isolated strengthening of thumb abductors and extensors).
DANGERS AND PITFALLS OF DELAYED REHABILITATION
Medicofit specialists
Delayed rehabilitation can increase the risk of developing carpal tunnel syndrome.
Chronic pain can lead to tendon injuries, such as tendinitis or tendinosis, further prolonging recovery time.
Prolonged delay leads to invasive surgeries, which carry their own risks and require a long recovery.
Inadequate or delayed rehabilitation seriously jeopardises an individual’s long-term physical health and is the main culprit for unsuccessful results and permanent movement limitations.
Post-acute kinesiology
After successfully completing acute physiotherapy treatment, kinesiology experts take over your treatment in the second phase and guide you to full wrist movement function!
Specialised kinesiology training is aimed at strengthening the flexors and extensors of the wrist and fingers. It is important to strengthen the strength of pincer and spherical grips.
Specialised kinesiology training for the treatment of De Quervain’s tenosynovitis is first performed in an isometric regimen and progressively transitions to concentric and eccentric forms of contraction.
The main goal of the kinesiology programme is to achieve complete symmetry of muscle strength in both wrists (to achieve proper muscle function), full mobility in the wrist, and appropriate gliding of the nerves.
Progressive kinesiology training gradually involves the injured wrist in more complex motor movements and starts gradually including the entire body in the training.
Before the end of treatment, a TEST BATTERY is conducted, testing your movement patterns and assessing whether your muscles are strong enough and ready for everyday stresses.
Preventive kinesiotherapy
At Medicofit clinic, we have created a post-kinesiology programme for all patients who successfully complete our comprehensive treatment.
The post-kinesiology programme aims to prevent the recurrence of old pain and as active prevention of new problems or pain.
The preventive kinesiology programme includes strength training for the rehabilitated area and the entire body.
How can you prevent wrist pain?
The physiotherapists at Medicofit clinic have prepared some tips for you that can help you prevent wrist pain:
Ergonomics in the workplace: Adjust your work environment and use ergonomic devices – such as a mouse that relieves strain on your wrist.
Posture: Avoid excessive wrist flexion.
Physical activity: Do hand-strengthening exercises and stretch your wrists regularly – this is especially true for professions that often involve overuse of the wrist.
Resting and stretching: Take a short break every hour to stretch and warm up your wrists. Move your wrists in a circular motion to maintain mobility.
Correct lifting technique: When lifting heavy objects, use correct technique and distribute the load evenly.
With proper care and preventive measures, you can reduce the risk of wrist pain and maintain healthy and flexible joints. If pain occurs, always consult a physiotherapist for a proper assessment and subsequent measures.
WHY CHOOSE SPECIALIST PHYSIOTHERAPY TREATMENT?
We ensure high treatment success and long-term results.
Up to 90% lower risk of wrist surgery!
We offer state-of-the-art non-invasive treatment methods that provide optimal conditions for complete recovery and return to activities.
Comprehensive treatment at Medicofit clinic is recommended by numerous renowned orthopaedic surgery specialists.
Book an appointment for wrist pain treatment
References
Genova, A., Dix, O., Saefan, A., Thakur, M., & Hassan, A. (2020). Carpal Tunnel Syndrome: A Review of Literature. Cureus, 12(3), e7333. https://doi.org/10.7759/cureus.7333
Goel, R., & Abzug, J. M. (2015). de Quervain’s tenosynovitis: a review of the rehabilitative options. Hand (New York, N.Y.), 10(1), 1–5. https://doi.org/10.1007/s11552-014-9649-3
Satteson E, Tannan SC. De Quervain Tenosynovitis. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442005/
Taqi M, Lim Y. Wrist Instability. [Updated 2023 Feb 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572073/
Wipperman, J., & Goerl, K. (2016). Carpal Tunnel Syndrome: Diagnosis and Management. American family physician, 94(12), 993–999.
