Wrist Tendinopathy

Wrist Tendinopathy

Wrist Tendonitis/Wrist RSI

What is Wrist Tendinopathy?

Wrist tendinopathy is the umbrella term for wrist injuries that include:

Wrist tendonitis/tendinitis (an inflammed tendon).
Wrist tendinosis (a non-inflammed degenerative tendon).
Wrist tenosynovitis (an inflammed tendon sheath).

Old habits die hard, and wrist tendinopathies have a history of wrist tendonitis or wrist RSI. This terminology is probably due to the most common mechanism of injury, which is repetitive overuse of the wrist tendons that results in an inflammatory reaction. Modern physiotherapists and doctors will describe injuries as wrist tendinopathy.

Where Are Your Wrist Tendons?

The anatomy of the wrist and forearm is essential in understanding wrist tendinopathy. The wrist and forearm are rectangular in shape. It has two wider sides (dorsal and volar/palm side). The thinner thumb side is your radial side, and the pinky finger is on the ulnar side. These two sides names derive from the bones that run on those aspects.

Your wrist extensor muscles and tendons bend your hand backwards. Your wrist flexors close your fingers to create a fist.

Your wrist muscles are located high on the forearm towards the elbow. They act upon your tendon, which traverses your wrist and hand. The tendons travel through synovial sheath tunnels and across bone interfaces, where most inflammation – usually friction-related – occurs.

What Causes Wrist Tendinopathy?

Wrist tendinopathy is primarily an overuse, tendon impingement, or repeated tendon slide issue. Therefore, it depends upon the workload and posture of your upper limb that may cause the tendon to bend excessively over a period. It is common in sports that involve gripping. Occupations that require repetitive work, e.g. typing, are at risk.

What are the Symptoms of Wrist Tendinopathy?

Wrist tendonitis and tendinopathy sufferers will commonly report:

Pain in the region of the wrist tendons, occasionally radiating down to the hand or up into the elbow.
Gripping or typing activities usually reproduce pain, especially those positions that combine wrist bending or twisting, e.g. keyboard typing with an unergonomic setup.
The pain aggravates with repeated finger or wrist movement.
Some patients describe clicking, grating or snapping with hand or wrist movements. Thumb movement issues may be de Quervain’s Tenosynovitis.
Muscle weakness can be associated with neural entrapment, e.g. Carpal Tunnel Syndrome.
The symptoms alleviate with rest and ice.

How is Wrist Tendinopathy Diagnosed?

Based on your symptoms and history, your physiotherapist or doctor may suggest wrist tendinopathy. Ultrasonography and MRI are the best investigations to confirm the diagnosis. For specific diagnostic advice for your wrist injury, please consult your trusted upper limb healthcare practitioner.

Wrist Tendinopathy Treatment

Rest & Patient Education

Resting from the aggravating cause is essential. Education and awareness about the symptoms and what positions or activities potentially cause wrist tendinopathy is necessary.

Night Wrist Splint

A nighttime wrist splint is beneficial to eliminate wrist bending and, therefore, wrist tendinopathy symptoms. Your physiotherapist may recommend a brace. A suitable wrist block splint will help you.

Physiotherapy

Physiotherapy is beneficial for most wrist tendinopathy sufferers.

Your physiotherapist will address:

Carpal bone mobilisation
Nerve and tendon gliding exercises to ensure full unrestricted nerve motion is available.
Muscle and soft tissue extensibility.
Cervicothoracic spine to correct any referral or double crush syndromes.
Grip and pinch, thumb abduction and forearm strengthening in later phases.
Extensive upper limb, wrist and hand ROM, strengthening and endurance exercises.
Posture, fine motor and hand dexterity exercises.
Ergonomic assessment.

Ultrasound Therapy, Acupuncture, Massage & Yoga

Ultrasound therapy may assist in wrist tendinopathy. Acupuncture or dry needling may decrease wrist tendinopathy pain.

Targeted massage can assist grip strength in wrist tendinopathy sufferers.

Yoga focusing on upper body flexibility can improve grip strength quicker than wrist splints alone.

Ergonomic Assessment

If your wrist tendinopathy has interrupted your work, then an ergonomic assessment of the workplace and work practices may be worthwhile to prevent a recurrence. Activity modification may be required. Larson & Ellexson (2000).

See Online Ergonomic Assessment.

TENS Machine

A TENS machine (transcutaneous electrical muscle stimulation) may ease the pain associated with wrist tendinopathy. Discover more information about TENS machines here: Tens Machine

Carpal Tunnel Surgery

The American Academy of Orthopaedic Surgeons (AAOS) recommends non-surgical treatment initially. Before you undertake wrist tendinopathy surgery, you must check all the other possible sources. Corticosteroid injection may be trialled.

Prognosis?

Wrist tendinopathy sufferers have a favourable prognosis via conservative treatment. The best results occur within the first few weeks of treatment.

Tendinopathy FAQs

Common Causes of Wrist & Hand Pain

Article by John Miller

Common Wrist & Hand Pain or Injuries

wrist hand pain physiotherapy — Wrist And Hand Physiotherapy

Wrist and hand pain can significantly impact daily life, limiting your ability to perform simple tasks. In this article, we explore the common causes of wrist and hand pain, various injuries, and effective treatment options from a physiotherapist's perspective.

Traumatic Injuries

Traumatic injuries such as broken wrists, finger sprains, and thumb sprains are common causes of wrist and hand pain. These injuries often result from falls, accidents, or direct impacts. They cause immediate pain, swelling, and difficulty in moving the affected area.

Overuse Injuries

Overuse injuries occur due to repetitive motions or prolonged strain on the wrist and hand. Common overuse injuries include carpal tunnel syndrome, de Quervain’s tenosynovitis, and repetitive strain injury (RSI). These conditions often result in pain, numbness, and tingling sensations.

Degenerative or Systemic Conditions

Conditions such as arthritis and rheumatoid arthritis can cause chronic wrist and hand pain. These conditions are typically progressive, leading to persistent pain, stiffness, and swelling in the joints.

Treatment Options for Wrist & Hand Pain

Physiotherapy offers a range of effective treatments for managing wrist and hand pain. Here are some common treatment approaches:

General Management and Early Injury Treatment
Early intervention is crucial for managing wrist and hand injuries. Avoiding harmful activities, applying ice, and resting the affected area can prevent further damage.
Ergonomics
Proper ergonomics can reduce the risk of overuse injuries. An online workstation assessment can help identify and correct poor ergonomic practices that contribute to wrist and hand pain.
Joint Mobilisation Techniques
Physiotherapists use joint mobilisation techniques to improve joint movement and reduce pain. Physiotherapy instrument mobilisation (PIM) is a specialised technique that can effectively target stiff joints.
Muscle Treatment
Soft tissue massage and strength exercises can alleviate muscle tension and improve function. These treatments help restore normal movement patterns and reduce pain.
Support & Protection
Wrist braces, supportive taping, and kinesiology tape can provide stability to injured areas, preventing further strain and promoting healing.
Pain Relief Approaches
Acupuncture, dry needling, electrotherapy, and local modalities like heat packs and TENS machines can offer significant pain relief. These methods help manage pain and promote recovery.

Conclusion

Wrist and hand pain can stem from various causes, including traumatic injuries, overuse, and degenerative conditions. Effective management through physiotherapy can significantly improve your quality of life. Remember, early intervention and proper treatment are crucial in preventing long-term issues.

What to Do?

If you experience wrist and hand pain, seek the professional advice of your physiotherapist. They can provide a personalised treatment plan to address your specific needs and help you return to your daily activities pain-free.

Ashgrove - Call 33664221

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Clayfield - Call 38624544

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Loganholme - Call 38013417

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Rochedale - Call 38410277

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Salisbury - Call 32751044

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Sandgate - Call 32691122

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Wrist & Hand Pain FAQs

What are the common causes of wrist and hand pain? Wrist and hand pain can result from traumatic injuries, overuse conditions, and degenerative diseases like arthritis.
How can carpal tunnel syndrome be treated? Carpal tunnel syndrome can be managed with physiotherapy, ergonomic adjustments, wrist braces, and sometimes surgical intervention.
What are the symptoms of de Quervain’s tenosynovitis? Symptoms include pain and swelling near the base of the thumb, difficulty gripping, and a catching or snapping sensation when moving the thumb.
How does physiotherapy help with wrist and hand pain? Physiotherapy offers treatments like joint mobilisation, muscle strengthening, and pain relief techniques to improve function and reduce pain.
When should I see a physiotherapist for wrist and hand pain? If you experience persistent pain, swelling, or difficulty in movement, it is advisable to consult a physiotherapist for a proper assessment and treatment plan.
Can ergonomic changes reduce wrist and hand pain? Yes, proper ergonomic practices can significantly reduce the risk of developing overuse injuries and alleviate existing pain.

Ergonomics and Your Workstation
Discover how proper ergonomics can prevent wrist and hand pain.
Managing Carpal Tunnel Syndrome
Learn about effective treatments for carpal tunnel syndrome.
Understanding de Quervain’s Tenosynovitis
Find out the causes and treatments for de Quervain’s tenosynovitis.
Physiotherapy for Arthritis
Explore how physiotherapy can help manage arthritis pain.
Effective Use of Wrist Braces
Understand the benefits of wrist braces for support and pain relief.
The Role of Strength Exercises in Pain Management
Discover how strength exercises can alleviate wrist and hand pain.
Benefits of Acupuncture and Dry Needling
Learn how acupuncture and dry needling can provide pain relief.
Electrotherapy for Pain Management
Find out how electrotherapy can help manage wrist and hand pain.
Understanding Repetitive Strain Injury (RSI)
Get insights into the causes and treatments for RSI.
Joint Mobilisation Techniques in Physiotherapy
Learn about various joint mobilisation techniques used in physiotherapy.