East Toronto Orthopaedic & Sports Injury Clinic and Trilogy Physiotherapy have partnered in order to provide you with the experienced and skilled care you deserve.
If you have pain in your wrist when carrying a bag, turning a doorknob, or experience numbness in your fingers, you may require treatment. Wrist pain can be caused by a sprain, traumatic or overuse injury, or due to a medical condition (ex: arthritis).
Some injuries are minor and heal quickly on their own, but other injuries can cause chronic pain and require ongoing medical care.
Common causes of wrist pain include:
Carpal Tunnel Syndrome
The carpal tunnel is a small boney tunnel in the wrist that has multiple tendons and a nerve called the median nerve passing through it.
When the muscles in the hand become overused, these tendons can become inflamed and compress the median nerve as it passes through the carpal tunnel. This can cause numbness into the middle and index fingers, as well as the thumb and weakness in the hand. Night-time symptoms are common among people who sleep with their wrists bent and symptoms can wake you up. Other causes include hormonal changes during pregnancy, and health conditions such as diabetes, rheumatoid arthritis, and thyroid gland imbalance. Women and seniors are the most likely to develop carpal tunnel syndrome.
De Quervain’s tenosynovitis
This condition is an inflammation of the tendons on the side of the wrist at the base of the thumb.
Symptoms include pain and swelling at the base of the thumb, a sticking sensation in your thumb when you move it, and pain during activity that requires repetitive thumb or wrist movement such as working in the garden, and playing golf or tennis.
Arthritis of the wrist joint or base of thumb (CMC joint)
Wear and tear, an injury or aging can all contribute to the development of arthritic symptoms, such as swelling, redness and pain,
as well as chronic symptoms such as joint enlargement, deformity or chronic loss of movement, and being unable to grip.
Wrist sprain and a subluxed bone
This is caused by falling on an outstretched hand, or when punching something with force.
The ligaments in the wrist can become over-stretched and/or a small bone in the wrist may shift or sublux.
Triangular Fibrocartilage Complex Tear (TFCC)
The TFCC is a cartilage structure located on the small finger side of the wrist that cushions and supports the small wrist bones in the wrist.
The TFCC keeps the forearm bones (radius and ulna) stable when grasping with the hand or when the forearm rotates. An injury or tear to the TFCC can be traumatic when falling on an outstretched hand or degenerative, occurring over time.
Symptoms of TFCC include:
Pain at the base of the small finger side of the wrist
Pain worsens when pushing off with the wrist or side-to-side movement
Painful clicking of the wrist
Swelling of the wrist
Loose grip
Physiotherapy treatment
Management of the above conditions has been proven to be helpful in relieving pain, speeding up recovery, and rehabilitating chronic issues.
Treatment involves education, self-care management, exercise therapy, manual therapy, other treatments such as acupuncture, soft tissue release and laser therapy can also help. Splinting of the wrist can be helpful for carpal tunnel syndrome and other acute injuries, as well as a TFCC strain.
A registered physiotherapist can conduct a skilled assessment and examination of your condition and recommend the appropriate treatment.
To book an appointment, Call Us today at 416-691-3943 or contact us here.
Frequently Asked Questions About Wrist Pain & Carpal Tunnel Syndrome
What are some techniques used for carpal tunnel syndrome?
Techniques used to treat CTS depend on the cause, which a registered physiotherapist can help you determine. Patient education on ergonomics, postural awareness, and activity modification lays the foundation. Manual therapy techniques such as joint or nerve mobilization, and soft tissue release are often used on the wrist and forearm muscles, as well as the neck and upper back. These secondary sites can often be a source of neuromuscular tension contributing to the main nerve irritation or compression at the wrist. Modalities such as acupuncture, ultrasound or laser are used for pain control and to stimulate circulation to aid healing.
What are some techniques used for wrist therapy?
Common wrist conditions include carpal tunnel syndrome, DeQuirvan’s tenosynovitis, thumb joint (CMC) arthritis, strains and sprains or subluxations. Treatment can vary depending on the condition and it’s cause, but will typically involve patient education, activity modification, and bracing or therapeutic taping to offload the irritated tissue. In some cases, custom wrist braces are made with an occupational therapist to ensure proper fitting and comfort for one’s daily activities. Exercise therapy focuses on regaining functional mobility and strength of the hand and wrist, particularly grip strength which can often be compromised with a wrist condition. Manual therapy techniques such as joint mobilization and soft tissue release, as well modalities like acupuncture, ultrasound and laser are also utilized.
Are wrist braces good for carpal tunnel syndrome?
A wrist brace is often recommended for those with CTS, especially for acute cases or for those suffering with symptoms overnight. This can help to stabilize the wrist in a comfortable position and ease the nerve compression caused by excessive wrist bending while sleeping. In rare cases, a patient may wear the brace during the day, but movement is quite restricted. How often they choose to wear the brace in the day, therefore, depends on balancing one’s daily activities with the severity of symptoms.
What will happen if carpal tunnel syndrome is not treated?
If the median nerve is irritated for long enough and the root of the problem is not addressed, the symptoms can become more severe and lead to weakness and atrophy of the hand muscles. Functionally, this can result in loss of grip strength and clumsiness i.e. dropping objects one is carrying. The milder symptoms such as tingling or occasional numbness may turn into chronic loss of sensation. In some cases, surgical release of the carpal ligament to decompress the nerve is needed, but should be seen as a last resort. Conservative treatment is always recommended first in order to fix the root cause and to avoid possible surgical complications.
What causes carpal tunnel syndrome to flare up?
There are several causes of CTS. Some contributing factors include pregnancy, diabetes, arthritis, hypothyroidism, wrist fractures or dislocations, cysts or tumours. Most often the cause is due to repetitive strain of he wrist with activities that involve gripping, repetitive hand movements, awkward wrist or hand positions or mechanical stress on the palm or wrist. This includes desk or assembly work, sewing, hand weeding, using certain tools and playing musical instruments.
How can I prevent carpal tunnel syndrome?
"We recommend taking these steps to prevent CTS:
Ensure proper ergonomics and postural awareness
Take frequent breaks from desk or assembly work, or other repetitious activities that involve gripping, pinching or awkward wrist and hand positions
Do flexibility exercises for the muscles of the forearm, and even the neck or upper back
Do regular weight training to improve grip strength and postural stability"
What agravates carpal tunnel syndrome?
When initially triggered, CTS can be aggravated by the same type of activities that caused it to begin with. As described above, this include gripping, repetitive hand movements, awkward wrist or hand positions. Other aggravators include bending the wrist toward its limits or by exposure to pressure or vibration. If highly irritability, one’s symptoms could be brought on more easily with several daily activities, i.e. typing, writing, other fine motor activities, working with tools or carrying groceries.
Y Leung
2024-12-23
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This is a great place to take your classes or exercise therapy. I was there for the GLA:D exercise programme led by Sarah Phillips. She was clear, concise and encouraging when needed. The reception staff are friendly and professional. All in all, a very good experience and convenient location too.
Tahira Gonsalves
2024-12-09
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Trevor was great! He provided detailed information (which I asked for 😀) to understand my injury (damaged ligaments on my foot), and provided a very reasonable and doable exercise/physio regimen, which he adjusted as my recovery progressed. Staff at the clinic are also lovely! Thank you!
Cindy Tavener
2024-12-09
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Great place -Everyone from front desk to my physio Nikhil very focused on my needs.
Nikhil was also a great listener we made a care plan and both reviewed my progress as i healed he was also open to my suggestions.I will be happy to return if /when injured again.
Baran Akpınar
2024-11-29
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I had the pleasure of working with Sarah Phillips through my recovery from a torn Achilles. She kept me informed at every stage, explained what to expect, and adjusted my therapy to overcome any challenges. Thanks to her expertise, I made consistent progress and had an excellent overall recovery at the end.
Beyond her skill, Sarah’s warm and friendly personality made every session enjoyable and motivating. I highly recommend her to anyone in need of expert, compassionate physiotherapy care.
Michelle Hachey
2024-11-06
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My good friend recommended me to the Dr. was very honest and very helpful in telling me what to go going forward. Gave me exercises to do at home. How to handle stairs with less pain.
Would highly recommend him if you are in pain of any kind. Very helpful and near public transit.
Naeem Toronto
2024-11-02
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I am going to participate in program from Monday,Nov 03,2024
Elaine Gergolas
2024-10-26
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I booked a series of appointments to try and establish a good therapeutic schedule and after the first one the therapist insisted I come back to see her earlier than planned - which I did... booking a 45 minute follow-up that turned into a distracted 20 minutes of her note taking... they did adjust the billing to reflect a 30 minute session but it was not an auspicious start.
Then I received a garbled voicemail that seemed to cancel my third appointment - which I had booked a month in advance. It blamed the error on someone at the clinic who forgot to update the schedule... but both my follow-ups to confirm / reschedule were completely ignored.
Consider another company or at least another location...
VR S
2024-10-18
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the staff is just awesome, I was having pain in my shoulder which few other places were not able to figure out, Danny spotted the cause and fixed the problem. I am thankful to him and East Toronto Orthopaedic staff from the bottom of my heart
