Hand & Wrist Pain

Carpal Tunnel Syndrome
There are many different types of wrist and hand pain. The most common wrist pain is either sprain of the wrist or the carpal tunnel syndrome (CTS). The most common pain in the hand include sprained fingers due to trauma or arthritic pain, both of which can occur on any finger or thumb joints. There are also two types of common pain in the hand: trigger fingers and De Quervain’s disease.

Hand and Wrist Nerve Pain
Another type of common problem with hand and wrist involve nerve pain, numbness and tingling, in any fingers, thumb, or other areas of the hand. This frequently has to do with nerve problems that stem from the neck and shoulder area ( read the neck pain article)..

Fall onto Palm of Hand
Among the pain that can be lumped under wrist pain, there is one type of injury that deserves special attention because of possible grave consequences.

Anatomical Snuff BoxIf after a fall on an outstretched hand with palm side down (how we typically support our body with our hands during a fall), there is pain on the thumb side of the wrist, particularly in the so-called “anatomical snuff box” area as indicated in the picture, it is very important to be examined by doctors with X-rays and/or other radiological imaging.

This is because there is a potential risk of fracture of a wrist bone called scaphoid, and due to the unusual blood supply to this bone, a fracture may render part of this bone to undergo necrosis (die off).

Trigger FingerTrigger Finger
The diagnosis for Trigger fingers is called stenosing tenosynovitis, which means inflammation of the tendon sheath that encloses the tendon where it passes through a finger or thumb joint.

The inflammation causes thickening or narrowing of the corresponding tendon sheath that wraps around the tendon. The result is a much narrowed tunnel for the tendon to pass through each time your flex or extend your finger or thumb, causing the tendon to get caught and the finger to be stuck at the bent position, which releases with a pop.

Trigger fingers usually starts with stiffness of the finger, which is followed by clicking, nodule formation at the affected joint. It can be painful or painless, but left untreated, the condition usually get worse, resulting in contractures that prevent the finger or thumb from straightening out completely, and eventually the finger may get stuck at bent position.

Trigger fingers usually occurs on people who frequently use their hands for gripping, and conventional treatment usually comprises of anti-inflammatory medication, resting, avoid gripping, soaking in hot water. For more severe cases, steroid injection to the joint, or even surgical release of the tendon sheath is used.

De Quervain’s Disease
Besides trigger finger, De Quervain’s disease is another variation of the same type of disease: stenosing tenosynovitis.

The only difference is that it is exclusively with the thumb. The annoying pain is usually at the base of the thumb, and is provoked by most hand movements that involve the thumb, including opening jars, gripping with thumb, or even bending the wrist toward that pinky fingers.

The conventional treatment also comprises anti-inflammatory medications, rest, heat, or steroid injection.

Taking a bio-mechanical view locally at the hand, the frequent use of hand for gripping causes overuse of a particular group of muscles in the thumb and palm. These repeated uses result in significant imbalances in forces loaded on the problematic joint and surrounding soft tissues.

The overuse of these muscles also causes the corresponding tendon to be inflamed and enlarged, making it harder to pass through the tendon sheath and results in the popping or being stuck that marks beginning of the diseases.

Eventually the chronic inflammation leads to thickened scarring and narrowing of the tendon sheath, marking a full blown condition of Trigger finger or De Quervain’s disease that only gets worse over time.

Therefore the corresponding treatment at Action Chiropractic and Wellness Center first aims at direct release on the narrowed tendon sheath to allow more room for the tendon to pass through. Second, releasing the muscular imbalances at the hand that resulted in the problem in the first place will take care of the problem at a deeper level and prevents future occurrence. Our expertise of the Active Release Technique therapy and acupuncture are excellent tools for that purpose.

Bio-mechanical Approach
However, we do not stop here either. It goes beyond the local hand structure to have a complete Bio-mechanical approach that takes the full body into account. The hand is the end of the entire upper limb, and most of our movements that involve the hand, thumb and wrist should be appropriately initiated at a higher point, either from elbow, shoulder, or center of the body. It may also be initiated from hip, knee and feet.

Biomechanical approachUnfortunately, when the movement is initiated farther and farther distal (away) from these appropriate points (such as center of the body) due to faulty bio-mechanics, more and more forces are needed at the local and distal joints at the wrist, thumb or fingers to accomplish the same goal.

This forced abuse is the key underlying reason for the problems at hands and wrists. Therefore overuse of the wrist, hand or thumb are almost always linked to problems at elbow, shoulder, neck, trunk of the body, or even your hips and knees.

Without addressing these issues, any symptomatic treatment of the thumb, hand or wrist alone are most likely temporary fixes.

The full experience at the Action Chiropractic & Wellness Center includes a thorough examination and treatment of the problem from the root up, aiming at a true relief from the heart of the problem, including relieving pain at the problem site and releasing of overused musculatures.

To achieve long-term results with the short-term care we provide, you will also be taught to use your body with sound bio-mechanics to permanently be rid of the pain.

Call us today to get rid of your hand and wrist pain!
(858) 481-1438

Dr. Dawn Liu, Ph.D., D.C., L.Ac
Dr. Anna Phillips, D.C., M.S.
David Snyder, L.Ac., C.Ht
Action Chiropractic & Wellness
312 S. Cedros Ave, Ste 326
Solana Beach, CA 92075

Call: (858) 481-1438