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Wrist pain: Hand in hand

16 Jun 2021

In the current age, when using smartphones, video game consoles, computers, keyboards and mouses has become an integral part of everyday life for most people, pain in the hand and wrist has become a very common problem among people of all ages. Are you taking care of your wrist or laying avoidable strain on them?

A common myth about hand and wrist injuries is that if you can move it, it’s not really broken. That’s simply not true. And if you continue laying stress on your wrists after experiencing pain due to certain repetitive activity, you are actually complicating what could’ve healed with a little timely care. 

There are many things you can do to ward off hand and wrist pain. Try to keep your bones strong by getting enough calcium and vitamin D, which your body needs to use the calcium. Avoid repeated movements that can lay additional stress and strain on some portions of your hands, especially the fingers and wrist. Rest your hands after over use and stay away from gadgets till the pain or strain has subsided.

Hands and wrists, which are made of dozens of small bones can easily get sore. The wrist alone has eight bones lined up, four on top, four below. All eight bones are connected by ligaments that keep the joints together, while giving a wide range of motion for our hands. There are also many tendons that pass the wrist. These control the motion of our wrist, fingers, and thumb. Because each of those parts serves a purpose in movement, if even one area in the wrist gets inflamed or injured, you’re going to feel it.

Injuries or conditions affecting the hands can make tasks that were once simple  feel extremely painful and difficult. Something as mundane as lifting a coffee cup or brushing your teeth can shoot pain through your arm. The pain may even cause you to change the way you do simple things, such as buttoning a shirt, tying a shoelace and even signing your name.

Some of the most common causes of such conditions are arthritis, carpal tunnel syndrome, tendonitis, ganglion cysts and injuries. Developing any of these conditions, especially carpal tunnel syndrome, is possible for almost anyone and the treatment options could range from icing it at home to surgery in a hospital.

 

Most common problems

De Quervain’s Tendinitis

This condition is characterised by pain on the thumb side of the wrist.

The pain may develop gradually or start suddenly. It can travel the length of the thumb and up the forearm. If you have this condition, it can be painful to turn your wrist, make a fist or grasp objects easily as the pain results from irritation or inflammation of the wrist tendons at the base of the thumb. Repetitive activities and overuse are often responsible for de Quervain’s. Most patients get relief from using a splint to rest the thumb and wrist, anti-inflammatory medication, and sometimes cortisone injections.

Carpal Tunnel Syndrome

This is one of the most common nerve disorders of the hand which causes pain in the palm and some fingers, wrist, and forearm. Often the pain is worse at night and it can cause weakness, a tingling sensation or numbness in the thumb, index finger, and middle finger. The discomfort happens when swelling constricts the median nerve which controls sensation and muscle impulses in the thumb and most of the fingers.

Common treatments include resting the hand and wrist, antii-inflammatory medications, wrist splints, steroid injections as well as physiotherapy.

Diagnosis

After a physical exam and symptom review, a doctor may also diagnose wrist pain and the underlying condition by:

Imaging scans – like an X-ray, CT scan or MRI

Arthroscopy – involving introducing a small instrument via a cut on the wrist to view internal images of the damage.

Nerve conduction studies – these measure how fast nerve impulses travel through the carpal tunnel region of the wrist.

Typically, invasive diagnosis techniques are only used after rest and recovery from injury have been unsuccessful.

Treatment options

Home treatment – often simply resting the wrist as much as possible to allow it time to heal is effective. Pain medication and ice may also be recommended 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 squeezing of the nerve.

Exercises – depending on the type of pain, wrist exercises may work. Certain exercises can be prescribed to stretch and lengthen muscles and tendons.

Steroid shots – cortisone injections, which decrease inflammation and reduce pain can be effective in some cases.

Surgery – only used if less invasive treatments have not worked. The type of surgery performed depends on the cause of the pain. 

 

 

TFCC tear

The Triangular Fibrocartilage Complex, or TFCC, is an important structure in the wrist. The TFCC is made of tough fibrous tissue and cartilage. This tissue supports the joints between the end of the forearm bones (radius and ulna), adding to their stability. The TFCC also helps connect the forearm with the small bones in the ulnar side (little finger side) of the wrist. There are several different tissues that form the TFCC, and they blend together to stabilise the ulnar side of the wrist.

The TFCC also acts as a cushion between the end of the ulna and small bones  of the wrist. In patients whose ulna is longer than the radius at the wrist, the TFCC is usually thinner and more likely to tear.

A TFCC tear can happen in two different locations and is usually caused by different problems. The first type of TFCC tear is due to natural wear, and the other is usually from injury. Tears due to wear are the most common and are usually not seen in younger people. They become more common as one gets older.

Tears from injury can come from a fall on the hand or wrist, a twisting injury (like a drill bit catching, causing a twist of the arm) or a fracture at the end of the radius.

Causes

Falling onto an outstretched hand

Repeated impact on an outstretched hand (i.e. gymnastics)

Excessive torsion forces on the wrist (i.e. racket sports, pulling down on a heavy lever)

Sudden traction of the wrist

For some, a TFCC tear may not cause any pain or instability problems in a wrist. Often, MRI studies show tears in people with no pain or problems using the wrist. Others may experience either a clicking or popping while turning the forearm or moving the wrist from side to side or pain, weakness and limited motion.

Treatment

Treatment options that may give relief include use of splints, change in activity, anti-inflammatory medicine and steroid injections. If these don’t help, there may be surgical treatments depending on the specific, underlying TFCC injury. 

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