Diagnosis Of Pain In Wrist And Thumb
A detailed clinical history and clinical examination can help in identifying the problem and probable causes of pain in wrist and thumb. Enquiry and evaluation of pain around the wrists and thumb, swelling, difference in sensation like burning or tingling and presence of any weakness are important. Investigations like X-rays and scans may be ordered depending on the possible causes and to rule out certain conditions, injuries or fractures. Blood investigations may be done if infection or autoimmune disorders are suspected.
Treatment And Prevention Of Wrist Pain
Treatment for wrist pain depends on the cause of the pain and its severity. Options include:
- Home treatment: Often, simply resting the wrist as much as possible to allow it time to heal is effective. Doctors may also recommend pain-relieving medication and ice to reduce inflammation and pain.
- Splints: In some cases, wearing a wrist splint can help. Splinting may prevent certain wrist movements that cause irritation. A splint might also reduce the squeezing of the nerve.
- Exercises: Wrist exercises may help to manage wrist pain, depending on the type of pain. Certain exercises can stretch and lengthen muscles and tendons.
- Additional treatment: Corticosteroid injections, which decrease inflammation and reduce pain, can be effective in treating wrist pain.
- Surgery: The type of surgery a doctor may recommend will depend on the cause of the pain.
In some instances, doctors may recommend a person undertake physiotherapy as part of ongoing treatment.
Small lifestyle alterations may reduce a persons chances of developing wrist pain. These include:
- using proper posture when sitting at a workstation and keeping the wrists in a relaxed position
- considering a wrist-friendly keyboard, if a person spends long hours at the keyboard
- learning how to use hand tools properly, placing less stress on the hands and wrists
- taking regular breaks from using a keyboard
- using wrist guards to prevent injuries when participating in sports, such as skateboarding, snowboarding, and rollerblading
Why Do I Have Sharp Pain In My Wrist
What causes severe wrist pain? When you are experiencing a symptom like increased pain when bending your hand or wrist, it may be due to a significant amount of pressure or repetitive movement thats placed on your hand and wrist joints, where joints are bent for an extended period of time. This can be caused by your sleep position, activities such as repetitive hand movements over time, arthritis, or a possible wrist injury, or wrist fracture. On the palm-side of your wrist, youll find a nerve tunnel known as the carpal tunnel. Nerves run all throughout the tunnels in our hands and wrists, and a nerve called the median nerve runs through this particular carpal tunnel. When the carpal tunnel in the wrist is squeezed for extended periods of time, or swollen nerves pinch it, youll begin to experience severe pain in your wrists. Other common symptoms can include numbness, tingling, and wrist swelling.
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Grip And Pinch Strength
- Grip and pinch strength usually return by about 2 to 3 months after surgery.
- If the condition of your median nerve was poor before surgery, grip and pinch strength may not improve for about 6 to 12 months.
- In very severe cases, the normal strength you had before you developed carpal tunnel syndrome may not completely return. However, surgery is still important in these cases to prevent worsening of the condition and function of your nerve.
When Should I Call The Doctor
You should call your healthcare provider if you experience:
- Inability to move your hand, wrist or fingers.
- Pain that lasts after two weeks of at-home treatments.
- Painful tingling up or down your arm.
- Unusual redness or swelling in your forearm, wrist, hand or fingers.
A note from Cleveland Clinic
Many people experience wrist pain at some point. Outside of a sprain or fracture, carpal tunnel syndrome, tendonitis and arthritis are major causes of wrist pain. Your healthcare provider can help pinpoint whats causing your wrist pain and recommend appropriate treatments. Often, nonsurgical therapies like wearing a splint, modifying activities and doing hand exercises can ease symptoms. If wrist pain interferes with your ability to work, sleep or do daily activities, you might benefit from surgery.
Last reviewed by a Cleveland Clinic medical professional on 11/03/2017.
References
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What Is The Treatment For Pain In Wrist And Thumb
Wrist and thumb are one of the most often used joints and can take time to heal if not given proper rest. In most causes of wrist and thumb pain, the treatment includes resting the wrist joint and the thumb, with a splint or a bandage, depending on the severity, for around 4 to 6 weeks or until it is healed.
Anti-inflammatory medications, pain relieving medicines, ointment and treatment to fight infections, arthritis or other conditions, depending on the cause may be given for wrist and thumb pain. Supplements of calcium, vitamin D and multi vitamins may be considered.
Physical therapy for pain in the wrist and thumb may include hot and cold compresses, wearing wrist and thumb braces for minor sprains, limiting and modifying activities to relieve pressure and reduce pain. Exercises to help strengthening of the supporting muscles may be advised by a trained physical therapist to improve functioning and flexibility of muscles and tissues.
When Should I See A Doctor For Wrist Pain
A professional doctorate ofphysical therapy can help evaluate the cause of your wrist problems and assist with solutions. If you have tried the above home treatments and are still experiencing chronic pain in the wrist or looking for additional ways to prevent sharp pains while bending the wrist in the future, a physical therapist or occupational therapist can help.
The Ivy Rehab Network has many clinics and therapists that are experts in the hand & wrist, and can help alleviate chronic hand and wrist pain. Our specialists know how to treat sharp pain in the wrist and other common symptoms with nonsurgical treatment so relieve swelling and numbness.
Whether you may require nonsurgical treatment or hand surgery, our physical therapy specialist will help get you on the right path towards recovery. So if you seek care such as wrist or hand therapy, you can request an appointment at your nearest location by clickinghere.
Article Reviewed by Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA
Holly Lookabaugh-Deur, PT, DSc, GCS, CEEAA is a practicing physical therapist and a partner and Director of Clinical Services at Ivy Rehab Network. Deur is board certified as a geriatric clinical specialist and certified exercise expert for aging adults with more than 35 years of clinical experience. She is certified as an aquatic and oncology rehabilitation specialist and serves as adjunct faculty at Central Michigan University and Grand Valley State University.
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What Causes Pain In Wrist And Thumb
Pain in wrist and thumb often involves painful movements of the wrist, thumb and may also affect movements of other fingers. Holding or grasping of objects, fine motor skills may get affected due to wrist and thumb pain. Pain may sometimes be associated with numbness, burning sensation or a feeling of soreness in the area between the wrist and the thumb. Depending on the cause of the pain in wrist and thumb, there may be redness or swelling in a particular area or a noticeable bump may appear on the wrist, back of the palm, fingers or thumb.
Some of the common causes of pain in wrist and thumb include:
Pain in Wrist and Thumb Caused Due to Injuries Injury to the wrist joint, thumb or the hand can cause pain in and around the wrist and thumb, making hand and wrist movements difficult. Injuries often include trauma to the wrist joint, fracture, ligament or muscle strains and other soft tissue injuries around the wrist and thumb. Overuse injuries occur due to repeated trauma to the joint or tissues from repetitive motion, occurring again and again. It often causes pain, swelling, inflammation of the wrist, thumb and causes painful movements of the wrist, thumb and fingers.
Pain in Wrist and Thumb Caused Due to Tendinitis Tendons of the wrist and thumb can get inflamed due to injury, overuse or other problems and small tears may result causing pain. It may also affect the ability to hold objects and use wrist and thumb properly.
Contusion Of The Wrist
A bruise is the damage of the blood vessels that return blood to the heart , which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the wrist are common, often due to minor injuries.
You can treat this at home with R.I.C.E – rest , ice , compression , and elevation.
Rarity: Rare
Top Symptoms: wrist injury, pain in one wrist, wrist pain from an injury, swelling of one wrist, wrist bruise
Symptoms that always occur with contusion of the wrist: wrist injury
Urgency: Self-treatment
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What To Expect At Your Office Visit
Your provider will perform a physical exam. You will be asked about your symptoms. Questions may include when the wrist pain began, what may have caused the pain, whether you have pain elsewhere, and if you have had a recent injury or illness. You may also be asked about the type of job you have and your activities.
X-rays may be taken. If your provider thinks that you have an infection, gout, or pseudogout, fluid may be removed from the joint to examine under a microscope.
Anti-inflammatory medicines may be prescribed. Injection with a steroid medicine may be done. Surgery may be needed to treat some conditions.
What Are The Best Exercises To Help Wrist Pain
Wrist pain is very common especially amongst people who either work in or participate in physically demanding jobs such as manual labourers or athletes . Numerous types of exercises have shown to be of great benefit to wrist pain but is dependent on the type of injury that the wrist has sustained or ongoing condition . Strengthening of the forearm, shoulder and muscles around the wrist can help with wrist pain and specifically certain exercises such as isometric holds for wrist conditions like tendinopathies or tendonitis can be great pain relievers. However, prior to doing exercises, you should have your condition assessed by a relevant health care professional to see which exercises can be beneficial for your condition.
If you have just sustained a wrist sprain or strain, you should follow the RICER protocol to help manage the pain. Ice in particular can help to reduce swelling in the wrist, if present.
The gentle stretches shown below can be beneficial to help increase range of movement and pain in the wrist if the wrist feels stiff or restricted .
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How Can I Treat Wrist Pain At Home
You may need to limit or stop activities that worsen wrist pain. Other at-home therapies include:
- Cold compress for acute injuries.
- Warm compress for chronic conditions.
- Hand exercises guided by occupational- or physical therapy-certified hand therapists.
- Over-the-counter nonsteroidal anti-inflammatory drugs , topical NSAIDs applied to the skin .
- Oral or injected corticosteroid medication.
Common Causes Of Wrist And Hand Pain We Treat
Sprain or Strain
A sprain is a stretching or tearing of ligaments, which are the bands of tissue that connect two bones together in your joints. A strain is a stretching or tearing of muscle or tendon, a tendon is a cord of tissue that connects muscles to bones. Cold laser therapy is helpful to speed up the healing process and reduce the swelling quicker, whereby eliminating pain faster.
Tendinitis
Inflammation of a tendon that frequently causes a sharp, stabbing pain.
Peripheral Neuropathy
Peripheral Neuropathy is a painful condition caused by damage to the nerves that radiate out of your spine to your arms and legs. This potentially debilitating condition interferes with your bodys ability to deliver messages between your brain, muscles, joints, skin, or other organs. When the brain and nerves are not communicating properly, you may feel unusual and often painful sensations.
Peripheral Nerve Entrapments
Peripheral nerve entrapments are conditions where a nerve is pinched or entrapped by the surrounding bone, muscle, tendon or cartilage. Following are some of the common nerve entrapments conditions that affect wrists and hands.
Pressure put on the median nerve causes pain and numbness or tingling in the thumb and first two fingers.
Radial Tunnel Syndrome
The radial nerve becomes compressed in a canal in the elbow called the radial tunnel and is often mistaken for tennis elbow. Pain radiates to the wrist and hands.
Cubital Tunnel Syndrome
Tunnel of Guyon
Arthritis
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When To See A Healthcare Provider
Certain signs and symptoms can indicate a more serious cause of your wrist pain. Get medical help if you have:
- Pain that lasts more than a few days
- Inability to straighten or flex the joint
- An inability to carry objects or use the arm
- Pain at night or while resting
- A deformed joint
- A hand or fingers that are bluish
When It Is An Emergency
Seek emergency severe wrist pain treatment if:
- You have any of the following symptoms after an acute injury:significant swelling tenderness to pressure at one specific spot tingling or weakness in your fingers or an abnormal angle of the wrist.
- You have the following symptoms and a fever: You have rapid-onset severe wrist pain, swelling, and warmth, and/or had a recent injury that broke the skin over the wrist.
In some cases, even though emergency care isn’t necessary, you may need evaluation and treatment.
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What Causes Wrist Pain
If you have wrist pain after a fall, an X-ray may show that you have a fracture, sprain or partial ligament disruption, but sometimes mysterious aches and pains appear. These symptoms may come and go, get worse throughout the day or never seem to go away. Finding the cause of chronic wrist pain can be a challenge. You should see your healthcare provider who will perform a careful examination and obtain appropriate imaging studies.
You may have wrist pain due to:
Unusual and rare sources of wrist pain include:
- Avascular Necrosis of a carpal bone.
- Cervical nerve compression.
How Are The Hands And Wrists Structured
There are 27 small bones that make up each hand and wrist. Eight of those bones are in your wrist. Each finger has three bones, and the thumb has two. There are five bones in the palm of your hand, connecting each finger and the thumb with the wrist.
There are more than 30 muscles that control the hand and wrist. These are in your hands, wrists and forearms.
Muscles are attached to bones by tendons. These are small but very tough pieces of connective tissue. Tendons pass through a bony passage in your wrist, known as the carpal tunnel. The median nerve also passes through this tunnel.
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Treating And Preventing Wrist Tendinitis
In very minor cases of wrist tendinitis, you may be able to recover after a period of rest from the activity that is straining your wrist. However, many people with wrist tendinitis require assistance from professionals like physical therapists for treatment.
Physical therapists can guide you through stretches, exercises and other techniques to help reduce and prevent tendinitis pain. They develop customized treatment plans, so your recovery takes place at a pace that is most comfortable and effective for you. The end goal of your treatment will be to reduce pain in the wrist and help you regain your range of motion.
In addition to treatment, you can take some measures to prevent tendinitis from affecting you. Try gently stretching your hands and wrists before activities and take frequent breaks to rest and stretch. You may also want to wear a splint or brace to support the wrist during strenuous activities.
What To Do About De Quervain’s Tenosynovitis Aka Mommy Thumb
By Michael Hwang, MD, orthopedics and sports medicine
Follow the outer edge of your thumb down past the knuckles to where it meets your wrist, and youll land in a spot that is a common cause of pain for many adults. This is where two tendons that run along the thumb side of the wrist pass through a narrow tunnel to connect to the base of the thumb. These tendons help you grip, grasp and pinch with your hand, but if the tunnel becomes inflamed, the tendons can become pinched and inflamed themselves. The result is a painful condition known as De Quervains tenosynovitis.
I see this condition regularly in my practice. Its most common in people aged 30-50, and especially in women, who outnumber male patients by about six to one. Those most likely to get it are people who overuse these tendons through repetitive activities, such as gardening, playing tennis, or lifting and carrying a new baby. Among new mothers, in fact, De Quervains is so common that its often referred to as mommy thumb.
Relieving the pain of De Quervains
For pain relief, bracing and anti-inflammatories are good places to start. Using topical or oral anti-inflammatories will relieve pain and inflammation, and immobilizing the wrist and thumb in a brace will give the tendons a rest. These measures may be all you need for notable improvement over the course of three to four weeks.
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When To See A Doctor
Make an appointment with your medical provider if:
- Your wrist pain is preventing you from carrying out your usual daily activities
- Your sleep is affected: You are waking up at night due to pain.
- Your wrist pain does not resolve over time or gets progressively worse
- You have additional symptoms: Such as swelling and stiffness
- You have tingling pain in your fingers