Chiropractor Chandler AZ
Everyday activities can cause wrist pain if done over and over again. Arthritis, which is often thought of as the primary reason for wrist pain, is not always the source of pain. The two most common arthritis' to occur in the wrist are rheumatoid arthritis and degenerative osteoarthritis of the carpal bones. Rheumatoid arthritis is the most common arthritis in wrists. It is the chronic inflammation of the joints in the wrist. Degenerative osteoarthritis in the carpal bones is when the flexible tissues at the end of the carpal bones in the wrist wears down and degenerates. Arthritis in the wrist is common, and a wrist with arthritis should be able to extend and do pushups. If extension is painful and the wrist can't bear weight, arthritis may not be the only condition causing the pain.
Movement of the hand and wrist will worsen the pain, especially during weight-bearing activities like push-ups. The wrist's function is to stabilize the hand and fingers during movement and to provide strength when gripping and grabbing things. Pain will often increase when gripping or lifting an item if the wrist is indeed injured. Wrist pain, like most other pain, can range from a sudden burst of pain, to intermittent pain, to a dull ache that gradually increases. If you have a wrist sprain or an injury to the joints or ligaments, swelling of the wrist will occur and is often associated with tenderness. Depending on the injury to your wrist, you may experience bumps and bruising. These symptoms are most common with a fracture or sprain to the wrist, but can also occur with arthritis in the joint.Acute and Traumatic Falls
Falls are the most common causes of elbow, hand, and wrist pain. Our hands are used to catch ourselves from the fall, but the force from falling jams into the wrist and can cause severe damage. The most common damage caused by a fall is a fracture or sprain. If the force of the fall isn't severe enough to cause a fracture, an acute fall injury will be the result. Acute fall injuries include bruising from the force of the fall, tenderness on the palm and around the wrist where you caught yourself, and some swelling.
Traumatic fall fractures are accompanied with swelling and sharp pain. A fracture to the radius or ulna, the two bones in the forearm, will cause immediate pain. The most common fractures to the wrist are colles' fractures, smith's fractures, and scaphoid fractures. Colles' fractures are common fractures to the distal radius as a direct result from a fall onto an outstretched hand. A bone fragment is displaced dorsally and the fracture is accompanied by swelling and bruising. Smith's fractures are often referred to as the "reverse Colles' fracture." It is the fracture of the distal radius caused by falling onto a flexed wrist, whereas the Colles' fracture is caused by a fall onto a wrist during extension. The Smith's fracture is also accompanied by swelling and bruising, but the bone fragment is displaced ventrally. A scaphoid fracture occurs in the small scaphoid bone in the wrist caused by a hard blow to the wrist, most often as a result from a fall on the outstretched hand. A scaphoid fracture include pain and tenderness around the base of the thumb and the wrist.
Sometimes a fall can cause compression to the radial nerve. The radial nerve is located along the back of your arm and controls the movements of the tricep muscles. It is responsible for extending the wrist. Compression of the radial nerve may cause a tingling sensation in the arm and make it difficult for wrist rotation. Compression of the median nerve can also happen during a fall. The median nerve runs the length of the whole arm and is the only nerve to run through the carpal tunnel. When the median nerve is compressed it causes carpal tunnel syndrome which causes pain and a tingling sensation in the hand and fingers. Joint capsule sprains within the wrist are also common injuries sustained during a fall. Joint capsules are a thin covering over the joints in the wrist. They help keep the joint together and in place. If force from a fall is hard enough, it can sprain the joint capsule, moving the joint out of place, causing swelling and pain around the joint and in the wrist.Overuse Injuries
Chronic repetitive stress injuries is the number one reason for wrist pain. Repetitive activities can include sitting at a computer all day long. We often sit with poor posture which affects more than we think. The muscles, tendons, and joints in our hands and wrists have to compensate for the poor posture to be able to type on the computer comfortably. Our wrists rotate to allow our finger to swiftly move across the keyboard, but we don't think too much about what that rotation and abnormal wrist positioning does to our wrists in the long run. If we all had proper posture, our hands would be in the correct place at the computer and wrist rotation would decrease, reducing the pain.
Just like typing, other repetitive movements can cause sudden or intermittent wrist pain. These movements can be done anywhere: at work, home, or during sports. Repetitive movements at work are often from typing on a computer, scanning at a register, or lifting supplies. Movements at home that can cause wrist pain include washing dishes, walking the dog, and even something as simple as holding a book open to read. Wrist injuries caused by sports are often caused by contact injuries. Sports such as football and soccer where players run into each other, have a higher probability of wrist fractures. These high-impact sports often involve falls which bend the wrist at an awkward ankle, causing pain.
Over time, the symptoms and pain increase and become less sudden and intermittent. The more you do the motion, the more your wrist has a chance for increased pain. As you continue with these activities, you may notice hand stiffness, tightness, clumsiness, fatigue, and dull or sharp pain. Risk of overuse injuries increase with: repetition, time, vibration, force, and position. Even doing something simple over and over can lead to tendinopathy or tendinitis in finger flexor or extensor muscles tendinitis.
Evaluation of the pain and swelling is the first step to figuring out the root problem of your finger. Noticing the range of motion, the strength of your fingers and wrist for flexion and extension can tell you if you are suffering from a fracture or a sprain. Can you move all your fingers properly? If you can, you're most likely not suffering from a fracture or sprain.
MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries, but severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. The use of an x-ray machine is an easy way to evaluate what's going on under the skin. X-rays of the bones in the wrist can show any breaks or fractures. The wrist bones looked at for fractures include bones such as carpal bones scaphoid, lunate, triquetral, pisiform, trapezium, capitate, and hamate.Home Treatments
At home the first step is always PRICE: protect, rest, ice, compress, and elevate. Reduce the stress and strain to the finger. Over the counter nonsteroidal anti inflammatory drugs (NSAIDs) as recommended by your doctor can help reduce pain and inflammation. Ice helps block the finger pain and reduce swelling. Reducing arm and hand activity is also recommended to diminish finger pain. Depending on the injury, a possible brace may be needed to keep the finger stationary.
If following the home wrist treatments doesn't improve your pain after two weeks, then seek a more rigorous treatment. Conservative treatment should always be the first stop because it can help immensely and lessen the possibility for surgery. It's also best to seek conservative treatment early in the pain because the longer the pain persists the longer and more difficult treatment becomes.Medical Treatments
NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options, as well. Pain management is not usually required unless stronger medications or joint injections are involved in treatment.
Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, cold laser therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair. They eliminate nerve compression and entrapments while massaging the hand and forearm muscles relax all the tight muscles that cross the wrist, thumb, and hand.
The Graston Technique is a very effective and popular treatment for muscle, tendon, ligament, and soft tissue injuries. This treatment uses specifically designed stainless steel instruments and therapeutic exercises to detect and treat areas of swelling and inflammation. The instruments are also designed to find and treat the cause of the symptom, as well as the area of the wrist pain. Adding the Graston Technique to any treatment plan decreases recovery time and reduces the need for anti-inflammatory medication.
Cold Laser therapy is a non-surgical treatment. This treatment uses specific wavelengths of light to interact with the tissues of the wrist. The non-thermal photons of light are emitted from the laser and pass through the skin layers to the damaged tissue where it interacts with the light-sensitive elements within the tissue. Cold laser therapy is often compared to photosynthesis because the tissue absorbs the light and converts it to useable energy, which aids the healing process and provides relief for wrist pain.
Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.