Wrist and Hand Pain


hand pain1We use our hands constantly.  Wrist and hand pain can be a great burden whether acute or chronic.  

Several common causes of wrist and hand pain include:

  • Osteoarthrtis and Rheumatoid Arthritis
  • Inflammation due to overuse
  • Carpal Tunnel Syndrome
  • Ulnar Nerve Neuralgia
  • Median Nerve Neuralgia
  • Radial Nerve Neuralgia
  • Active trigger points in skeletal muscles

Osteoarthritis is a degenerative joint disease where the cartilage slowing degrades. Rheumatoid Arthritis is an autoimmune disorder that causes chronic inflammation of the joints.  With both disorders there can be joint stiffness, pain and swelling around the joints. When the hands are inflamed from overuse, the pain may have a pulsating character to it. Resting from activities can help.

Nerve irritation can cause tingling, numbness and pain in the wrist or hand

Nerve irritation caused by tension in soft tissue is often overlooked as a source of wrist and hand pain, yet we see if often in our clinic.

 

 

 

 

 

There are 3 nerves that innervate the hand:

  1. Ulnar nerve
  2. Median nerve
  3. Radial nerve

Each of these nerves is a branch of the brachial plexus of nerves that originates at the spine, courses through the anterior neck and chest muscles and into the arm. These nerves supply sensory and motor function to the shoulder, arm and hand.

There are many places in which these nerves can be irritated or compressed by tensed muscles.  When a nerve is just slightly irritated, it will produce mild symptoms, such as tingling.  As the nerve is under pressure for a longer period of time or the pressure increases, tingling will turn to numbness and numbness will eventually turn to pain.

Tingling is not usually taken seriously, as it is easy to live with.  However, once tingling turns to numbness, and certainly once pain is present, is when most people start looking for help.  It is important that any sensory symptom, regardless how mild, be addressed immediately as early treatment can prevent the progression of symptoms.

Places of nerve irritation or compression of the nerves that innervate the hand:

  • At the level of the spine by a bulging or herniated disc (all 3 nerves)
  • On the back of the neck by posterior cervical muscles (all 3 nerves)
  • On the front of the neck by the anterior scalene muscle (all 3 nerves)
  • On the front of the chest by the pectoralis minor muscle (all 3 nerves)
  • In the cubital tunnel of the elbow (the ulnar nerve)
  • By the triceps muscles (the radial nerve)
  • In the forearm by tensed flexor or extensor muscles (all 3 nerves)
  • In the carpal tunnel of the wrist (the median nerve)
  • In Guyon’s Canal of the wrist (the ulnar nerve)

Medical Massage is EXTREMELY helpful in relieving pressure from the affected nerve.

 

Active trigger point in skeletal muscles can also cause wrist and hand pain.  Some of these trigger points and there referral patterns are below.

subscap tp

Subscapularis

scalene-triggers

Anterior Scalene

 

 

 

 

 

 

 

 

Extensor Digitorum and Indicis

 

brachialis-trigger-points (1)

Brachialis