Conditions and Treatments

Wrist / Hand Pain

Look below the videos for further information regarding wrist and hand pain.









Wrist and Hand Pain

  1. Anatomy of the wrist and hand
    1. The wrist is composed eight bones that are arranged in two rows. These bones lie between the radius and ulna of the forearm and the metacarpal bones of the hand. The phalanges are the bones attached to the metacarpals and form the fingers. These bones are connected by a series of ligaments and motion is created by a combination of flexor and extensor muscles and tendons; most of which originate in the forearm. Nerves and blood vessels provide movement and sensation to the hand and deliver vital nutrients responsible for its function.
  2. Common problems of the wrist and hand
    1. There are a wide range of conditions that can lead to pain in the wrist or hand. These can be grouped into tendon and ligament injuries, arthritic conditions, fractures/ dislocations, muscular strains, and nerve entrapment disorders.

Wrist injuries are often sustained from falls, sports related injuries, or work-related incidents. They can result in fractures of the radius, ulna, or any one of the bones of the wrist or hand. Fractures can often cause visible deformity and limited function. Even in the absence of fractures, ligaments may be torn producing a sharp pain in the wrist or hand with movement. In severe crush related injuries compartment syndrome can occur where there is buildup of pressure caused by swelling.  This compress blood vessels and nerves. This is an emergent condition due to rapid progression and severe functional loss if not treated early. Repetitive motion injuries can lead to irritation of tendons or ligaments resulting in pain with activity. Carpal tunnel syndrome is one more common nerve related injury that can produce weakness and altered sensation in the hand. It can make fine motor tasks difficult and grip strength is sometimes affected. Wear and tear the joints of the wrist, and more often the hand, can cause arthritic changes. This can cause stiffness and difficulty with fine motor tasks and grip strength. Other systemic conditions such as rheumatoid and psoriatic arthritis can cause destructive joint changes in the hand and wrist.

  1. Treatment of wrist and had problems
    1. In the absence of more concerning findings to suggest fracture, infection, or instability, symptoms are initially treated with conservative strategies. Physical therapy is used early in treatment to help improve mobility, decrease pain, and address any mechanical or muscular conditions that may be contributing to the symptoms. Medications such as anti-inflammatories can help alleviate symptoms in the short term and can help patients better participate in physical therapy related treatment approaches. If symptoms of nerve compression are present, special medications to target nerve related pain may be beneficial. If the combination of physical therapy and medications do not provide enough relief, injections can be helpful. Injections are used to help identify where your pain is coming from and may provide significant and long-term relief of your symptoms. Your provider will attempt to identify the most likely pain generator and deliver medication to the right area. This may require the use of image guidance including fluoroscopy (x-ray) or ultrasound. The most common types of injections in the hand and wrist are joint and tendon injections using local anesthetic and steroid. Regenerative medicine therapies, including platelet rich plasma (PRP) or stem cell can be beneficial. When conservative care such as therapy, medications, and injections fail to provide adequate relief, surgical consultation may be indicated. Prior to surgical consultation, the providers at Denver Back Pain Specialists will perform all the necessary diagnostic tests such as imaging, injections, electromyography/nerve conduction studies, and others to determine where your pain is coming from. These results will provide the surgeon valuable information to aid in his/her surgical planning.
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