Tag Archives: wrist pain

Potential Causes of Wrist Pain

18 May

After shoulder pain, wrist complaints are among the most common reasons patients seek
chiropractic care for upper limb issues. Before treatment begins, the likely cause of the patient’s
wrist symptoms must be identified. Let’s review the most common causes of wrist pain and the
key features that help differentiate them:

  • If a patient presents with fever (suggesting possible septic arthritis), severe pain out of
    proportion to the injury or sudden neurologic changes (raising concern for acute
    compartment syndrome), or significant trauma (like a suspected scaphoid fracture),
    immediate referral to the emergency room is warranted.
  • Carpal tunnel syndrome is the most common peripheral neuropathy and is
    characterized by numbness and tingling in the median nerve distribution (thumb,
    index, middle, and radial half of the ring finger). Positive findings on physical
    examinations that involve compression of the wrist strongly support this diagnosis.
  • De Quervain’s tenosynovitis causes pain on the thumb side of the wrist and most
    commonly affects women ages 30–50, especially postpartum. A positive Finkelstein
    test (thumb in fist, bend wrist toward pinky—pain on thumb side is positive) supports
    this diagnosis.
  • Osteoarthritis of the wrist or carpometacarpal joint can cause pain and stiffness during
    gripping, pinching, and other hand-intensive activities. It may lead to visible
    deformity and is typically confirmed with X-ray imaging.
  • A fall on an outstretched hand can result in a wrist sprain or ligament injury. Pain is
    typically localized and reproduced with palpation and range-of-motion testing. Mildto-moderate swelling, no visible deformity, no neurovascular deficits, and preserved
    (though painful) range of motion help differentiate this from more serious trauma.
  • Triangular fibrocartilage complex injury presents with pain on the ulnar (pinky) side
    of the wrist, often following trauma or repetitive axial loading (motions like pushing
    up off a chair or performing a push-up that direct force through the wrist into the
    forearm). Tenderness over the ulnar fovea and pain or clicking with forceful wrist
    rotation are suggestive findings.
  • Flexor or extensor tendinopathy results from overuse of the forearm and wrist
    musculature, presenting as localized pain along the affected tendon(s), often
    aggravated by resisted movement.
    Once the likely source of wrist pain is identified, treatment typically involves a
    combination of manual therapy and targeted exercises to reduce stress on affected tissues and
    restore normal joint function. Patients who do not respond as expected may be referred for
    further evaluation or advanced imaging.

Brent Binder,

D.C. 4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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CTS “Facts”

9 Dec

How is CTS treated? For the best success, treatment should begin as early as possible. Unfortunately, most people wait a long time before they get to the point where the symptoms interfere with daily activity enough to prompt them to act quickly and make an appointment. Once the cause or causes of CTS are determined, treatment can address ALL the presenting contributing conditions. The FIRST course of care should be NON-SURGICAL, though this is not always practiced – so be aware! Non-surgical care includes the following:

Chiropractic:

Manipulation: This usually includes adjusting the small bones of the hand, the wrist, the forearm, elbow, shoulder, and/or the neck.

Soft-tissue therapy: This includes loosening up the overly tight forearm muscles where the median nerve runs through (on the palm side of the forearm).

Modalities: Such as electrical stimulation and/or laser/light therapy can be very beneficial in reducing swelling or inflammation. In chronic CTS, ultrasound may be helpful as well.

Nutritional: Nutrients such as vitamin B6 have been shown in studies to be effective in some cases. Also, anti-inflammatory herbs (ginger, turmeric, bioflavinoids) and / or digestive enzymes (bromelain, papain, and others) taken between meals are quite effective.

Anti-inflammatory: The first important distinction is that ice can be very effective depending on how long the CTS has been present. In particular, ice cupping or rubbing ice directly on the skin over the carpal tunnel is the most effective way to use ice as an anti-inflammatory agent. When doing so, you will experience four stages of cooling: Cold, Burning, Achy, Numb or, “C-BAN.” It’s important to remember this as you are REALLY going to want to quit in the burning/achy stages when it feels uncomfortable. Once the skin over the wrist / carpal tunnel gets numb (which takes about four to five minutes) QUIT as the next “stage” of cooling is FROST BITE! Most medical practitioners promote the use of NSAIDs (non-steroidal anti-inflammatory drugs) like Advil, aspirin, or Aleve. However, these carry negative side effects including gastritis (burning in the stomach that can lead to ulcers), or liver and/or kidney damage. Try the nutritional anti-inflammatory approach FIRST as they are extremely helpful without the bad side effect potential!

Diet: An ant-inflammatory diet, like the Paleo-diet or gluten free diet, serves as a great tool in reducing the inflammatory markers in the body. Though only 7-10% of the population has celiac disease (gluten intolerance), it’s been estimated that over 80% of us are gluten “sensitive.” Reducing systemic inflammation can make a BIG DIFFERENCE in the management of many conditions including CTS!

Mechanical: Wrist “cock-up” splints can also be REALLY HELPFUL, especially for nighttime use. The reason for this is because when our wrist is bent forwards or backwards, which frequently occurs when sleeping, the pressure inside the carpal tunnel increases, and over time (minutes to hours), the increased pressure in the tunnel exerts compression on the median nerve which then creates numbness into the thumb, index, third and half of the fourth finger, which can wake you up out of a sound sleep. Keeping the wrist straight at night prevents you from curling your wrist under your jaw while sleeping.

Ergonomic Modifications: Changing your work station (computer station, line position, machine controls, pace or rate of repetitive movements, and more) is VERY effective.

NOTE: ALL of the above can be managed through the services offered at our clinic!!!

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