Pain in the hand or wrist, regardless of its cause, brings many suffering patients to one or another of the five offices of Long Island Spine Rehabilitation Medicine where we specialize in diagnosis and treatment of spinal and musculoskeletal conditions. We are a holistic practice, focused on returning our patients to a pain-free life of restored function as quickly as possible.
Our doctors are physiatrists who, beyond being medical doctors, have gone on to study physical medicine and rehabilitation. We offer hand and wrist pain treatment, including hand pain therapy and hand pain physical therapy, as well as wrist pain therapy and wrist pain physical therapy. In other words, we help you exercise both body parts while also taking steps to reduce discomfort.
The hands and wrists are complex parts of the body that enable us to engage in some of the activities that make us most human. Having pain and restricted use of the hand or wrist can be more than inconvenient; it can interfere with work, household chores, driving, childcare, and recreational activities. This is why so many of our patients come to us for safe, noninvasive, effective treatment.
Causes of Hand/Wrist Pain
The hand and wrist are intrinsically connected, so pain in one often extends to the other. Following are some of the most common causes of hand and wrist pain:
- Sudden impacts such as falling forward with an outstretched hand (possible fractures)
- Repetitive stress on the wrist joint during sports, while playing a musical instrument, or driving for an extended period. (see De Quervain’s disease below)
- Osteoarthritis involving deterioration of cartilage during aging
- Rheumatoid arthritis, an autoimmune disorder
- Carpal tunnel syndrome (see carpal tunnel syndrome below)
- Ganglion cysts, typically on the outer wrist
- Kienbock’s disease which occurs when blood supply to bones of the wrist is restricted and one of the small wrist bones collapses
Symptoms of Hand/Wrist Pain
The symptoms of hand and wrist pain vary. While pain resulting from a fracture is usually sharp and severe; osteoarthritis pain is commonly described as a dull ache. Carpal tunnel syndrome, in contrast, causes alternating numbness, weakness, and a pins-and-needles sensation in addition to aching or sharp pain.
Diagnosing Hand/Wrist Pain
Because delaying diagnosis and appropriate treatment can lead to long term restricted range of motion, the skilled doctors at Long Island Spine are careful to:
- Check your hand and wrist for tenderness, swelling or deformity
- Check your range of motion in the region
- Assess the strength of your forearm and your grip
- Recommend imaging tests, such as X-ray, CT and MRI scan, ultrasound or bone scan
- Perform an arthroscopy in which a tiny camera is inserted into your wrist to view the area up close
- Order an electromyogram (EMG) to measure tiny electrical discharges produced in your muscles, and perhaps nerve conduction studies as well
Hand/Wrist Pain Treatment
At Long Island Spine, hand pain treatments and wrist pain treatments are customized to the type, location, and severity of your injury, as well as to your age and any pre-existing medical conditions, but usually include:
- Over-the-counter and prescribed pain relievers
- Hand pain physical therapy and/or wrist pain physical therapy, consisting of ergonomic evaluation and carefully crafted rehabilitative exercises
- Use of assistive devices, such as splints, braces, or casts, if necessary
- Ultrasound-guided corticosteroid/analgesic injections
- Platelet-rich plasma (PRP) to facilitate healing
- Pulsed electromagnetic field technology (PEMF) to decrease pain
- Acupuncture to alleviate pain and reduce inflammation (acupuncture is offered in our Great Neck and East Meadow offices)
When surgery is necessary to repair a tendon or ligament or to stabilize a bone fracture, our fine physiatrists will refer you to an equally fine orthopedic surgeon. In such a situation, we will be available after your operation to provide hand pain therapy and/or wrist pain therapy that will help relieve post-surgical pain and restore full function to the region.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common complaint, named for the “tunnel” that protects the tendons and median nerve that pass through the wrist. Excess pressure on the median nerve, usually caused by thickening or swelling of adjacent tissue, results in hand pain, tingling and numbness. Certain actions, like opening a jar, worsen symptoms. Carpal tunnel syndrome is diagnosed by taking a complete medical history and performing a careful physical exam. An EMG study is frequently performed to determine the severity of the condition. Our physicians are highly experienced and board certified in the area of electrodiagnostic testing. In our offices these studies can be performed quickly by our skilled physicians utilizing the latest technologies and in a painless fashion.
Treatments for carpal tunnel syndrome include the hand and wrist pain treatments listed above.
When patient pain is intractable, however, or the EMG study shows substantial nerve damage, Long Island Spine specialists may refer you to one of our surgical colleagues who will have to perform a surgical procedure to cut the ligament that acts as the roof of the carpal tunnel in order to relieve pressure on the nerve. After the procedure, our physiatrists will be here to assist you in rehabilitative hand and wrist therapies that will shorten and support your recovery.
Risk factors for carpal tunnel syndrome are obesity, diabetes, osteoarthritis, rheumatoid arthritis, high blood pressure, being a smoker or being pregnant. Contrary to popular belief, computer use does not increase the risk of carpal tunnel syndrome.
De Quervain’s Tendinitis
De Quervain’s tendinitis, also known as de Quervain’s tenosynovitis, is an inflammation of the synovium (sheath) that surrounds the two tendons connecting the wrist and the thumb. Commonly associated with conditions such as rheumatoid arthritis, it is usually precipitated by repetitive stress, especially actions that move the thumb away from the wrist, e.g. turning your wrist, gardening, playing golf or racket sports, making a fist, or lifting a baby.
The symptoms of de Quervain’s tendinitis also include pain and swelling near the base of the thumb, difficulty moving the thumb and wrist, and a sticking or snapping sensation during movement of the thumb. Pain is often also felt in the wrist and up the forearm. The pain is usually worse when grasping with the hands or twisting the wrist.
At Long Island Spine, we treat de Quervain’s tendinitis in much the same ways we treat carpal tunnel syndrome and hand/wrist pain of other origins. It should be noted that both carpal tunnel syndrome and de Quervain’s tendinitis are far more common in women, particularly those between the ages of 30 and 50.
Neglecting Hand/Wrist Pain Can Cause Permanent Nerve Damage
It is crucial to have hand/wrist pain diagnosed correctly so that you can be treated before permanent damage occurs. Increasing pain and decreasing mobility in the hand and wrist can be disabling, keeping you from work, household and recreational activities, and from childcare responsibilities. This is why you should contact the capable physiatrists at Long Island Spine promptly. We will make sure your hand/wrist pain is addressed promptly and treated with consummate skill and genuine compassion.