Wrist and Hand Pain

The wrist is made up of two forearm bones, known as the ulna and radius, which articulate with the 8 small bones in the hand known as carpals; which are arranged in a linear fashion. They support a tube like structure known as the carpal tunnel, which contains nerves and and tendons. Wrist pain is very common and can occur in everyday tasks such as typing, sewing and racket sports; due to the repetitive nature of the movements. Sudden impact onto an outstretched hand, such as in a sporting environment, can cause strains to the muscles, sprains to the ligaments and even fractures to the carpal bones or forearm structures.

Common Acute Injuries

Scaphoid fracture
A fracture to the carpal bone which sits just under the thumb, this is the most common carpal fracture and can take up to 6 weeks for it to show on an x-ray. This usually presents as pain in the hand, especially when moving the thumb or wrist and swelling at the base of the thumb. Often this injury is misdiagnosed as a sprain, unless the pain is severe.

Boutonniere deformity
Injury to a tendon in one of the fingers, resulting in a deformed shape. This usually occurs after an impact to a bent finger.

Colles Fracture
Involves a fracture to the radius and presents with severe wrist pain with rapid swelling. The joint may look deformed and with very severe wrist fractures bone may pierce the skin, known as an open fracture.

Mallet Finger
Occurs due to injury to the finger, where the tendon ruptures and thus results in an inability to straighten the end joint of a finger without pain or assistance. Pain in the end of the finger will be felt with particular tenderness when touching the back of the finger.

TFCC Tear
The triangular fibrocartilage complex (TFCC) is a cartilage structure located on the small finger side of the wrist that, cushions and supports the small carpal bones in the wrist. The most common mechanism of injury to cause a type 1 tear involves falling on an outstretched hand and excessive arm rotation.Symptoms include wrist pain on the little finger side, tenderness over the back of the wrist, pain when moving the wrist side to side, painful clicking and loss of grip strength. Type 2 TFCC tears are degenerative or chronic and they can occur over time and with age. The degenerative process wears the cartilage down over time and some inflammatory disorders, such as rheumatoid arthritis or gout may predispose you to this type of injury.

Common Chronic Injuries

Carpal Tunnel Syndrome
This injury develops when there’s increased pressure on the median nerve as it passes through the carpal tunnel, a passageway in the palm side of your wrist. This is one of the more common causes of wrist pain and symptoms include a dull ache in the wrist and forearm which may radiate into the hand and fingers over time. Pain is often worse at night and weakness in the fingers and hand may occur.

Ganglion Cyst
A small lump which appears in the wrist, often attached to a ligament. Some are not painful but others may require treatment.

Trigger Finger
This is a form of tenosynovitis which results in the finger becoming bent in towards the palm of the hand. This can also occur in the thumb.

De Quervain’s Tenosynovitis
This is a painful condition which affects the the tendon on the thumb side of the wrist. The symptoms include pain when turning your wrist or gripping/ making a fist and repetitive activity of the hand and wrist can aggravate the symptoms

Tendinopathy of The Wrist
Any of the tendons around the wrist may become painful and swollen with overuse. Injuries will present with tenderness and occasional swelling.

All sports injuries are treated at one of our local clinics. Treatment can include sports massage, soft tissue mobilisations, knee joint mobilisation techniques, ultrasound and exercise therapy.