Chiropractor Chandler AZ
Most people don't realize how much they use their hand and wrist in a day. Every time you reach for your phone to text a friend or your pocket, drive, or change channels with the remote, you are utilizing the muscles, tendons, and ligaments in the hand and wrist.
In the forearm the muscles start at the elbow and extend down to the wrist region. The wrist bones are made up of eight bones that allow for flexing, extending, turning, twisting, and gliding motions. The carpal bones are small but aligned in a way that provide a significant amount of support while performing a push-up, yet flexible enough to extend the hand into the proper position. The carpal bones are the scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate. These bones are often named in specific types of fractures, sprains, or strains.
The large wrist flexor muscles cross across the anterior surface of the wrist for flexion, and some muscles extend to the fingers allowing for wrist flexion without changing the angle of the carpals. On the backside of the wrist is a similar set up with strong wrist tendon extensors crossing the carpal bones, while other tendons cross to the fingers to allow for finger extension. The thumb requires multiple muscles crossing over that lateral and posterior surface, and some of these tendons are involved in injuries you may have heard of, such as De Quevein's syndrome or game thumb. Additionally, there are stabilizing ligaments connecting the carpels together and stabilizing the carpels to the radius and all of bones.
The anatomy of the wrist and hand is quite amazing between the multiple muscles, tendons, and ligaments. Injuries to this area often affect multiple types of tissues, and small injuries can produce severe pain or functional limitation. This area is often difficult to treat because of its location and the small bones, muscles, tendons, and ligaments. The shape of the hands make it difficult to apply electric pads to. We also use our hands throughout the day, so it is very difficult to immobilize and prevent a person from using their dominant hand during their workday or at home.
Specific fractures of the hand, especially to the scaphoid, capitate, or hamate bones, can be quite difficult to resolve. Damage to the ligaments that produce carpal instability often occur with falling on an outstretched hand or chronic repetitive use.
Specific treatments can be performed to decrease pain and inflammation in the hand and wrist, in addition to enhancing the recovery and functional motions and movements. Often with the hand we are addressing the muscles and tendons that cross the wrist and fingers. The large wrist flexors and extensors begin at the elbow and travel towards the fingers. Physical therapy modalities often involve heat, ice, electric, ultrasound, and stretching motions and movements.
Chronic tendinitis or tendinosis can be improved with addressing the chronic muscle spasms of the forearm muscles. Massage therapy, Graston technique, and active release technique are therapies designed to address muscle injuries and scar tissue within the fibers. These treatments are trying to break up the scar tissue that glues the muscles and tendons together, which alters the normal functional movements.
Class IV cold laser is one of the newest treatments that plays a critical role in decreasing pain and enhancing recovery in the hand and wrist. Cold lasers, or low-level lasers, utilize specific wavelengths and frequencies to stimulate cellular processes. The wavelengths help turn on the healing and repair mechanisms within the muscles, tendons, and ligaments. They enhance the overall healing and repair processes by increasing energy production, ramping up repair cells, and decreasing scar tissue formation. Low-level laser therapy is an excellent treatment for decreasing pain and inflammation that occurs with many of the soft tissue injuries. The lasers shut off inflammatory pathways to help reduce swelling, edema, and inflammatory molecules associated with the injuries.
Older class III lasers have been utilized for many years for many of the same purposes. The newer class IV cold laser is able to produce significantly more power than its class III counterpart. Increased power allows for greater depth of penetration as it produces more joules of energy per minute, which is what accounts for the greater success in treatment between class III and class IV lasers.
There are multiple treatment modalities associated with improving hand and wrist pain. Class IV cold lasers are an excellent treatment for enhancing the cellular repair and regeneration mechanisms, in addition to decreasing the pain and inflammation associated with the injury.