Wrists & Hands

Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the wrist. It often results from repetitive activities like typing, assembly work, or using handheld tools. Without treatment, symptoms can progress to persistent numbness or muscle weakness. Therapy focuses on reducing nerve pressure, improving wrist mechanics, and strengthening surrounding muscles to prevent further irritation.

Symptoms may include:

• Numbness or tingling in the thumb, index, and middle fingers
• Hand weakness or clumsiness
• Pain that worsens at night
• Difficulty gripping or holding objects
• Hand fatigue with activity

De Quervain’s tenosynovitis is an inflammation of the tendons on the thumb side of the wrist. It is commonly seen in new parents, office workers, or athletes who perform repetitive thumb or wrist motions. Without early treatment, the condition can worsen and severely limit thumb function. Physical therapy helps reduce inflammation, restore motion, and strengthen the muscles supporting the thumb and wrist.

Symptoms may include:

• Pain near the base of the thumb
• Swelling along the wrist
• Difficulty gripping or pinching
• Pain with thumb or wrist movement
• Tenderness when pressing on the thumb side of the wrist

Wrist sprains occur when the ligaments in the wrist are overstretched or torn, often due to falls or sudden twisting injuries. Mild sprains may heal quickly, but more severe injuries can cause lasting instability if not properly managed. Therapy focuses on reducing pain and swelling, restoring range of motion, and rebuilding strength for better joint support.

Symptoms may include:

• Pain and swelling in the wrist
• Bruising or tenderness
• Difficulty moving the wrist
• Instability or looseness in the joint
• Weakness when gripping

The TFCC is a structure of cartilage and ligaments on the pinky side of the wrist that stabilizes the joint. Injury to the TFCC can occur from falls, sports, or repetitive stress, leading to pain, weakness, and instability. Without treatment, TFCC tears can become chronic and severely limit wrist function. Therapy aims to promote healing, improve stability, and restore full wrist movement.

Symptoms may include:

• Pain on the pinky side of the wrist
• Clicking or popping sounds with wrist motion
• Weak grip strength
• Swelling around the wrist
• Pain when turning or twisting the wrist

Arthritis of the wrist or hand occurs when the cartilage protecting the joints wears down, leading to pain, swelling, and reduced motion. Osteoarthritis and rheumatoid arthritis are the most common types affecting these areas. Without treatment, arthritis can cause joint deformities and significant loss of function. Therapy focuses on preserving joint mobility, improving strength, and managing pain to help patients maintain independence.

Symptoms may include:

• Persistent joint pain and stiffness
• Swelling or tenderness in the wrist or fingers
• Reduced grip strength
• Grinding sensations with movement
• Difficulty performing fine motor tasks

Trigger finger occurs when inflammation narrows the space around a tendon in the finger, causing it to catch or lock when bending. It often results from repetitive gripping activities or underlying conditions like diabetes. Severe cases may cause the finger to become stuck in a bent position. Physical therapy focuses on reducing tendon irritation and improving finger flexibility and strength.

Symptoms may include:

• Finger stiffness, especially in the morning
• A popping or clicking sensation with finger movement
• Tenderness at the base of the finger
• Finger locking in a bent position
• Pain when gripping objects 

Wrist tendinitis involves inflammation of the tendons around the wrist, typically from overuse or repetitive movements. It often affects athletes, office workers, and manual laborers. Without treatment, tendinitis can progress to chronic pain and weakness. Therapy emphasizes reducing tendon inflammation, restoring flexibility, and correcting any faulty mechanics contributing to the problem.

Symptoms may include:

• Pain and tenderness along the wrist
• Swelling or warmth over the tendons
• Stiffness after rest
• Pain with gripping or lifting
• Weakness in the hand or wrist

Nerve entrapments in the wrist or hand occur when nerves become compressed due to swelling, scar tissue, or anatomical variations. Aside from carpal tunnel syndrome, other areas like Guyon’s canal (affecting the ulnar nerve) can also be involved. If left untreated, nerve compression can cause permanent sensory loss or weakness. Physical therapy focuses on relieving pressure, improving nerve mobility, and correcting posture or movement patterns.

Symptoms may include:

• Numbness or tingling in specific fingers
• Weakness in hand muscles
• Pain or burning sensations
• Clumsiness or difficulty with fine motor tasks
• Worsening symptoms with repetitive hand use

Repetitive strain injuries develop from repeated movements or prolonged awkward positions, leading to microscopic tissue damage over time. RSIs can affect tendons, muscles, and nerves in the wrist and hand. Early intervention is crucial to prevent chronic pain and loss of function. Therapy focuses on relieving symptoms, correcting ergonomic issues, and strengthening the wrist and hand to withstand repetitive demands.

Symptoms may include:

• Aching or throbbing pain during or after activity
• Stiffness and weakness in the wrist or fingers
• Tingling or numbness
• Swelling or tenderness
• Decreased grip endurance