Working from home and wrist pain
We see a lot of wrist pain at Movement Centre in Randwick. The advent of work from home has meant a lot of us are working from sub-optimal workstations. Laptops at coffee tables just don’t allow for the movement that our bodies crave. For the purposes of this blog we will address pain in the wrist, and not acute wrist injuries.
There can be many different causes for, and structures involved in wrist pain. In the absence of an acute injury, many of the wrist pains that we see result from the wrist being placed in prolonged postures and repetitive movements. While these positions and movements tend not to cause damage to the tissue, they can be very irritating, and become more irritated over time.
The wrist has many articulations, and has many tendons and nerves that run from the arm down into the hand.
Carpal tunnel as a contributor to pain in the wrist
For a long time, the carpal tunnel has been identified as a contributor to wrist pain. The carpal tunnel is a small passage at the base of the palm, through which tendons and our median nerve pass into the hand. In rare cases there can be a true compression happening through the carpal tunnel. This can be due to narrowing of the surrounding structures, or thickening of the tendons. More commonly, the nerve tissue there can become irritated and sensitised due to prolonged, repetitive movements.
Pain at the base of the thumb
A common pain we see in the wrist is a
pain around the base of the thumb. This is common in parents holding and feeding newborn babies, as well as with prolonged phone use. Pain through this region can arise from several different tissues. Like the carpal tunnel, the base of the thumb has several nerves and tendons crossing the joint line. At the base of the thumb, a condition known as
DeQuervain’s Tenosynovitis can result from inflammation of tendons where they cross the joint line. There can also be sensitivity and irritation to the radial nerve which runs through and innervates this area.
Structural issues, arthritis and injuries
Injuries to the wrist can create lingering pain. Prolonged pain can result from instability after falls or contact injuries. This can result from instability between bones in the wrist and hand – such as the scapho-lunate joint; or from injury to the cartilage in the base of the wrist. Conversely, lingering stiffness post-injury can also cause ongoing pain. This is most commonly seen in the back of the wrist with end of range extension movements. This is often seen in push-ups and bench pressing. This is usually a result of some kind of posterior impingement, where soft-tissue surrounding the wrist prevents full extension.
Management of wrist pain
We focus on identifying the cause of the wrist pain – whether it is a structural issue, stiffness, weakness, or an irritation with repetitive loading. Treatment will often focus on rectifying the underlying cause. In the case of stiffness, we will encourage more movement through the affected joint; for issues with weakness we will work to strengthen and stabilise the area. In the case of irritation from prolonged postures – such as work related wrist pain – we will often encourage both strength and stretching. As well as this, we often encourage regular movement breaks and neural mobilisations. Relative rest from irritation (decreasing overall time spent at the computer or holding the phone can help) as well as a graded exposure to increased loading can be helpful.
In some cases we will look further up the kinetic chain to the arm, shoulder and neck. Strengthening and moving the whole arm is a lovely way to promote movement without focusing on the irritated area. Getting the neck moving is often an integral part of settling nerve related wrist pain. The nerves that run through the wrist (the median, ulnar and radial nerve) all originate from the neck, and run down the arm. Restrictions in the neck, or irritations “up-river” can all have an impact on how mobile and happy the nerve tissue is at the wrist. Because of this, we will often include some neck mobility exercises and upper limb neural tension stretches in our management of overuse and repetitive wrist pain.
Wrist and hand pain physio in Randwick
If you are experiencing wrist pain, thumb pain, or carpal tunnel symptoms – whether it be from work, sport or daily life – come and see
our physios at the Movement Centre. We are experienced in managing wrist pain and injuries, and getting our patients back to the activities that they love. We have a full gym to be able to progress your rehab all the way back to sport. And we are also happy to work with work cover claims and CTP insurance claims. Come and see our team and get back to the activities you love.
