We treat all sorts of wrist and hand problems at North Shore Spine and Sport, ranging from cumulative strain injuries like tendinosis/tendinitis or wrist/finger joint pains, to inflammatory conditions like De Quervain’s Tenosynovitis, as well as peripheral nerve irritation issues like Carpal Tunnel Syndrome. If your wrist or hand is hurting and you aren’t sure what to do, let us know, we’d love to help!
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Hand and wrist pain are extremely common issues that Dr. Melander treats daily at North Shore Spine and Sport. These days people spend so much time typing, texting, and scrolling, amongst multiple other hand dominant tasks that overuse and repetitive strain injuries to the hand and wrist are a common occurrence.
Wrist pain causes are variable and range from trauma to repetitive strain to referred pain circumstances. Trauma examples include falling on an outstretched hand for example.
As mentioned previously in this article, repetitive strain examples include excessive typing, texting, and phone scrolling. Referred pain examples include problems at the neck area that cause symptoms experiences as far as the wrist or hand.
Wrist pain when twisting, Wrist pain when bending, Wrist pain when bent:
In many situations of wrist pain, a cumulative strain injury develops to the group of wrist extensors (along back of forearm) or wrist flexors (along front of forearm) that causes limited range of motion and pain in the wrist area.
These pains may manifest when twisting the wrist, bending the wrist in either direction, or maintaining a bent position at the wrist. Dr. Melander can help you identify what has happened and how to counter the dysfunction and pain quickly.
Wrist pain when lifting, Wrist pain from lifting:
Just about anyone who has spent time lifting weights has experienced some kind of pain in the wrist area due to the stresses on the wrist inherent to different lifts. In most cases these pains are self-limiting and will go away within a few days without any intervention or lifestyle changes needed.
In situations of wrist pain from lifting that does not go away relatively quickly, Dr. Melander can help you identify what was strained, irritated, dysfunctional, etc. and craft an individualized plan to counter those issues quickly.
Wrist pain when gripping:
It is extremely common in wrist pain situations to experience aggravation with gripping. This is most likely due to irritation of muscle and connective tissue near the wrist as well as a decreased tolerance for load (weight) on the wrist region. These situations are easily managed with therapy and exercise.
Wrist pain thumb side:
Wrist pain near the thumb often indicates there is a condition called DeQuervain’s Tenosynovitis occurring where two tendons along the back of the thumb have become irritated and inflamed. This condition is sometimes called “Mommy’s thumb” as it frequently occurs in new parents that are lifting their baby in a manner that stresses the thumb tendons in a manner that individual is not well adapted to yet.
While this condition can be quite painful (and sometimes stubborn due to the amount we use our hands!) it is generally a fully resolvable issue with the right load management, activity modification, and hands-on manual therapy.
Wrist pain pinky side:
Wrist pain on the pinky side of the hand is not super common, but there are two possible diagnoses worth monitoring. One diagnosis is an ulnar nerve entrapment as it passes through the “tunnel of Guyon” at the base of the hand on the pinky side. This condition could cause pain, numbness, tingling, and even weakness into the hand and pinky or ring finger.
Dr. Melander treats ulnar nerve entrapments largely using Active Release Techniques® nerve protocols. The other diagnosis is a Triangulofibrocartilage Complex Tear (TFCC) which refers to damage to a group of connective tissue structures that reside amongst the small carpal (wrist) bones between the hand and the forearm. TFCC injuries are usually traumatic due to falls or lifting injuries and may require surgery.
Wrist pain from typing:
Probably the most common cause of wrist area pain that Dr. Melander sees with any regularity is due to typing. For some people a lot of typing can trigger an overuse injury scenario that often coincides with wrist pain. These conditions are usually easily managed!
Wrist pain treatment, Wrist pain relief:
As with all injuries that Dr. Melander treats at North Shore Spine and Sport, his approach to wrist pain treatment is non-surgical. He uses a combination of hands-on manual therapy like Active Release Techniques®, Functional Range Release®, Instrument-assisted soft tissue mobilization, along with mobility or strength training.
Wrist pain exercises:
The wrist is considered a fundamentally mobile joint system, which is to say, the wrist can accommodate fairly large ranges of motion. Therefore, Dr. Melander believes that any wrist pain exercises should be geared toward restoring and ultimately better controlling range of motion. Dr. Melander uses Functional Range Conditioning® principles to help restore and control wrist range of motion.
Why does my wrist hurt all of a sudden?
Unless there was a trauma that clearly preceded wrist pain, chances are sudden wrist pain is due to a cumulative strain injury. In these situations there has likely been a strain occurring to the wrist area for an extended period of time that may have recently hit a “threshold” moment followed by pain. Give some consideration to what movements and activities aggravate the wrist pain, and modify those activities in whatever manner helps reduce the pain aggravation.
How can I relieve wrist pain?
Generally speaking, a safe means of trying to counter wrist pain is to perform wrist CARs through the largest non-painful range of motion possible, and perform isometrics at the wrist where you will hold resistance near a painful range of motion but not within a painful range of motion. If you have any questions, we highly recommend a consult with a trained healthcare provider who can evaluate your wrist.
When should I see a doctor for wrist pain?
As a general rule, you should see a doctor for wrist pain if the pain concerns you, if there is no identifiable preceding circumstance, or if rest and activity modification do not help.
What does arthritis in the wrist feel like?
Arthritis in the wrist is often apparent if there is a “hard limit” to range of motion. A hard limited to range of motion is evident when a joint can not move past a certain range despite that range being less than normal. Wrist arthritis does not always involve pain but many people may report pain.
What does tendonitis feel like in the wrist?
Tendonitis in the wrist will likely feel like pain that occurs when moving the wrist through certain ranges of motion, pain with gripping and squeezing, or pain when pressing on the musculature through the forearm and wrist area.
Repetitive strain wrist injury refers to any condition that has developed over an extended period of time due to a recurring stress/strain on the wrist. Repetitive strain wrist injury symptoms includes wrist, hand, or forearm area pain, tightness, limited range of motion, and in some cases may include numbness, tingling, or weakness.
Repetitive strain wrist injury causes include for example, excessive typing, texting, phone scrolling, mouse usage, musical instrument practice, and sometimes lifting.
Repetitive strain wrist injury treatment may include activity modification, load management, hands-on manual therapy, exercise, or in more severe cases, medicinal interventions.
Repetitive strain wrist injury stretching is dependent on the tissues that have been strained and injured, but generally Dr. Melander would recommend isometrics and eccentrics in place of static stretching due to the increased load being placed on the relevant tissues.
How long does a repetitive strain injury take to heal?
Completely variable and individualistic based on a person’s age, general good health, physical fitness, injury severity (inflammation), etc. In Dr. Melander’s experience, most RSI heal within a few weeks with proper management.
How do you treat repetitive strain injury?
Dr. Melander opts for a combination of hands-on manual therapy like Active Release Techniques®, Functional Range Release®, Instrument-assisted soft tissue mobilization, along with mobility or strength training.
What is an example of a repetitive strain injury?
The list is long, but generally tendinosis and tendonitis are great examples of RSI.
Carpal tunnel syndrome is due to irritation or entrapment of the median nerve that travels through the forearm and eventually underneath the transverse carpal ligament at the base of the hand between the thumb and pinky pads.
Carpal Tunnel Syndrome symptoms include pain, numbness, tingling into the palm of the hand, and in more severe cases, atrophy of the musculature in the thumb pad (thenar pad).
Carpal Tunnel Syndrome causes can be traumatic in so far as a fall on an outstretched hand might impact the median nerve as it passes through the tunnel, or cumulative whereby a repetitive strain has occurred to muscle and connective tissue through the forearm that causes friction or entrapment of the median nerve.
Carpal tunnel syndrome treatment at North Shore Spine and Sport usually involves Active Release Techniques® nerve protocols to the forearm musculature that is adjacent and relevant to the pathway of the median nerve. Many people undergo surgery for carpal tunnel syndrome despite evidence indicating this is not likely the best approach to managing CTS.
Carpal tunnel syndrome exercises and carpal tunnel stretches are ill-advised without monitoring from a healthcare professional because certain maneuvers may place tension on the median nerve that could exacerbate the condition.
How do I know if I have carpal tunnel syndrome?
A true case of carpal tunnel syndrome requires entrapment of the median nerve along with pain, numbness, tingling, into the wrist and palm of the hand, along with weakness or atrophy of the thumb pad.
What will happen if carpal tunnel syndrome is not treated?
Carpal tunnel syndrome is actually a fairly poorly diagnosed condition, therefore, the first question that should be asked is whether true compromise of the median nerve is present. If true compromise of the median nerve exists, then there is a potential for long-term nerve damage if CTS is not treated.
Can carpal tunnel syndrome go away on its own?
The short answer is yes, provided proper activity modification occurs that negates any strains occurring to the forearm, wrist, and median nerve. If the median nerve is entrapped, a consult with a healthcare professional trained in managing this sort of injury is advisable.
How long does carpal tunnel usually last?
With proper management of carpal tunnel syndrome, resolve should be possible within a few weeks. However, if median nerve compromise exists then there is a potential for long-term nerve damage.
What does tendonitis feel like in the wrist?
Tendinitis in the wrist feels like pain or tenderness with certain ranges of motion, gripping, squeezing, lifting, etc.
What is the fastest way to heal tendinitis in the wrist?
Reduce or modify the activity or activities that are aggravating the wrist in the first place, coupled with treatment and exercise as needed.
Do I have carpal tunnel or tendinitis?
Carpal tunnel involves nerve compromise that may cause numbness, tingling, weakness, and atrophy, whereas tendinitis likely only involves pain and limited range of motion.
How long does it take to heal tendinitis in the wrist?
Assuming proper management and activity modification, hopefully no more than a few weeks are needed for adequate healing.
What is DeQuervain Tenosynovitis?
Often called Mommy Thumb, this painful condition involves irritation and inflammation of two tendons along the back of the thumb. Commonly caused by lifting objects while the thumb is extended, this condition can be diagnosed by making a fist around the thumb and deviating the fist away from the thumb side. If a burning-like pain occurs during the fist phase or deviation phase, DeQuervain Tenosynovitis is a likely diagnosis.
Dr. Melander has often described his work as new-school rehab, which is to say, an amalgamation of current best practices regarding pain or injury management, hands-on manual therapy or strength/mobility training, and endless advocacy and support for his patients.
In Dr. Melander’s opinion, the best providers in the field of musculoskeletal injury are able to draw from multiple disciplines to create the most efficient and impactful care strategy for their patients. If you are injured or hurting and not sure what to do, please reach out, it will be our greatest pleasure to help you.
We've compiled a list of common chiropractic questions to help you get all the answers you are looking for. If you have additional questions if our chiropractic and treatment services in North Shore would be a good fit for you, please contact our team.
Chiropractors are trained in the evaluation and management (IE: treatment) of issues affecting the neuromusculoskeletal system (muscles, joints, connective tissue, nerves). Many people associate chiropractic care with the spine only, but this is an inaccurate reflection of many chiropractors in the 21st century who are experts in treating spinal issues AND extremity issues (arms and legs). As a general rule of thumb, if you have a painful condition that does not get better given a few days of activity modification you may want to consult a professional like a chiropractor. Your chiropractor should be able to evaluate your painful condition, offer you some perspective and guidance relative to the painful condition, and help you care for the painful condition if treatment is warranted. Like any profession though, each chiropractor has different clinical experience and different post-graduate education that may lend their practice toward a focus on sports injuries or pregnancy/neonatal care or neurologic issues or nutritional issues to name just a few. If you are considering seeing a chiropractor, make sure that their experience and skill set seems like a proper match for your complaint and your ultimate goals.
Choosing a good chiropractor does not have to be a complicated process. To begin with, ask your friends or family if they know someone they trust and can vet for you. Next, check online as most chiropractors should have fairly informative websites relative to their clinical interests and experience that may help indicate whether they are a good fit for your issue. If you are still not sure who to see after taking those steps, call your prospective chiropractor’s office as either the staff or the chiropractor will be more than happy to answer any questions and tell you if your issue is something commonly treated in that office. Many people also like to read online reviews and while some online reviews can be misleading, if the significant majority of a chiropractor’s reviews are super positive then chances are you can trust the expertise of that provider. Lastly, and arguably the most important step in choosing a good chiropractor, remember that you are in total control of your healthcare decision making. If you go to an initial or follow-up appointment and you are not absolutely confident in the assessment and plan your chiropractor has rendered, then seek a second opinion.
A chiropractor can help you fix a wide variety of painful conditions related to the neuromusculoskeletal system such as headaches, back/neck pain, shoulder/elbow/wrist/hand pains, hip/knee/ankle/foot pains to name just a few. Injuries of actual orthopedic compromise like fractures are best handled by orthopedists, but chances are if your pain/injury is non-surgical in nature then a chiropractor may be a great option to help you. The best chiropractors will explain what they can about your pain/injury, offer guidance and likely treatment as efficiently as possible (days to weeks, maybe months in extreme situations), and then remove themselves and let your brain/body do the rest. A great deal of research these days indicates that in many healthcare interactions providers should try and limit their patient’s dependency on them, opting instead for interventions and language that fosters resiliency and self-efficacy (independence).
Your first chiropractic appointment should include a detailed discussion of your health history and presenting complaint(s), an examination of your complaint(s), a discussion regarding what is indicated by the examination relative to prognosis and treatment plan, and finally some form of treatment/intervention assuming time permits. Many painful conditions can be evaluated thoroughly and completely in a matter of minutes and certain treatment interventions could yield immediate relief, while other conditions may require more complex evaluations and more lengthy treatment plans. Above all, you should leave your first chiropractic appointment feeling confident that your chiropractor is the best option to help you with your problem and you should leave feeling confident that you are on the road to recovery.
You should see a chiropractor as often as you want or need. Perhaps the most common criticism of chiropractors is that chiropractors “need to see you for the rest of your life”, and while there are unfortunately examples of chiropractors who advocate for this kind of dependency, the significant majority of chiropractors today want to help you as quickly as possible with no long-term commitments of any kind. The best chiropractor will see you the minimally necessary number of times to help you overcome your issue and suggest you follow-up if there are any residual issues or new complaints sometime in the future. Many patients however recognize how good they feel after chiropractic care and therefore wish to see their chiropractor with some kind of recurring frequency (IE: once/month, twice/year, or more). These examples though should be dictated by the patient based on their assessment of their body’s needs and absolutely not dictated by the chiropractor based on some kind of pseudoscientific reasoning.
In many cases, yes, insurance will help pay for chiropractic care assuming the chiropractor is participating with your health insurer. If your chiropractor is not participating with health insurance, then it is still possible you have an out-of-network benefit with your insurer and can seek reimbursement that way.
At NSSS our approach to health, fitness, movement, and pain is unique. We can’t wait to show you how much better you can feel. Call, email, or stop by today!
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