Understanding Wrist Pain And How To Fix It

Transcript

Welcome And Topic Setup

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Welcome back to the Hand-to-Shoulder Solution where pain meets its match. I'm your host, Carl Petito. I'm an occupational therapist and a board certified hand therapist. I specialize in the rehabilitation of orthopedic conditions that affect the fingertips through the shoulder. Today I want to talk about mystery pain that often occurs on the back of the hand. It often goes undiagnosed, and folks come in complaining about that, saying that it's been lasting quite a long time. Most recently, I've had a gentleman who had a hard time playing golf because of a lot of pain on the back of the wrist and on the back of the hand. I want to start by explaining that tendons connect muscles to bone. So here the red portion is the muscles, and then it turns into this white portion, the tendons. So when these muscle bellies contract, some of them they extend or open the fingers. Now you can see that they traverse across the wrist. So when a person bends their wrist, if you bend your wrist all the way, you should not be able to make a full fist because now these cords or the tendons are wrapped around the back of the wrist, or another way to say it is they're lengthened over the back of the wrist. Now, as you put them on slack a little bit here, then you're easily able to make a full fist. And in fact, that's the best mechanical advantage, the best position for the best mechanical advantage to make a really tight, real tight grip. Now, golf and other sports and even other activities where you have to reach around something and grab that really tensions those tendons, especially if you're holding a golf club and then you go through your swing and the wrist bends a little bit. If the tendons are too tight because of stiffness, where perhaps the wrist is has arthritis, and because of the arthritis, there's a lot of stiffness, and then the tendon flexibility will start to decrease. And then a person will start to have an overstretch sensation where they'll start having pain on the back of the hand, back of the wrist, even back of the fingers. So here's what I do in the clinic, and I want to make a quick note that this is not treatment or treatment advice. This is information sharing so you can understand what might be going on with your body and understand why and when you should get into your hand therapist to be sane so we can get this taken care of. Every situation is different, it really needs to be evaluated so you can get the best treatment and get well as soon as possible. So I have my folks um rest their elbows on the front part of the rib cage and then look at the some the thumb side of the wrists in hand. And what I do is have them look at the edge of that first bone and the wrist. So they look at that angle on both sides. So this is how they can self-assess and look at that. And often what happens is on the normal side where they're not having any pain, they'll get nice flexion of the wrist while they're in a fist. Then the other side, they'll start to feel it and it'll start to hurt, and it'll be moving less than the unaffected side. So, what I have people do is a light stretch, a little bit of overpressure, until they feel that stretch, and they'll hold that for 20 seconds, relax, no pain, just pulling 20 seconds and relax. So, two repetitions for 20 seconds, three or four or six times a day. Four times a day is roughly every three hours, six times a day is every couple of hours, and in the morning, or even as often as three times per day, a low electric heating pad around the wrist and hand to relax the tissues so they can get a better, more comfortable stretch and have more rapid tissue lengthening or restoration of flexibility. The general rule of thumb is that if if you use heat more than three times per day, it causes an inflammatory response. So we don't want that. But frequent light stretching, nothing aggressive. I have my people do. At the clinic, I use a what's called the goniometer, it's a measuring tool. I actually measure the range of motion in degrees. So I see how many degrees of motion do they have on one side compared to the other. And then when they read, I'll have them do that for a couple of weeks. Um, the gentleman that I saw uh most recently, I only saw him for two visits. The initial the initial visit, I showed him what to do at home, came back, measured, and you know what? His range of motion was matching the other side. And I said, Have you tried golfing? Have you tried doing anything? That he said, Yeah, you know, my pain is gone. So we were able to verify that now the symmetrical is having no pain, and that's exactly what it was. He also had some arthritis, uh, and we discussed proper optimal self-management of arthritis, keeping the inflammation and the pain down. And that's other videos on this channel that are a good resource regarding arthritis and how to how to take care of it at home. Thank you very much for watching. Check out our website, carlpetito.com. And I want to say thank you for liking and subscribing to this channel where we are the solution to your pain.