Wrist pain can occur due to several reasons and can be acute or chronic. A pain is categorized as chronic when it lasts for more than 3 to 6 months, gradually worsens or reoccurs even after medical treatments. Chronic wrist pain can be due to work-related musculoskeletal disorders, overuse injury to muscles, ligaments, etc. It can also be a side effect of prolonged use of medications or being in wrong postures for extended periods. As per the CDC, arthritis and wrong ergonomics are some of the main factors leading to chronic wrist pain.
Ways to manage Chronic Wrist Pain
There are several ways to manage chronic pain. Medication is, of course, one of the major pain management options, but, it comes to side effects. When a pain is chronic in nature, you want to find some conservative measures that will give you relief with no side effects. So, Let’s discuss some non-medication/NSAID based treatment options.
Heating Modalities to Reduce Wrist Pain:
Heat is effective in helping to reduce pain and soreness. Applying heat helps to relax the affected area and improves blood circulation. In turn, the increased blood supply washes out the waste metabolites and pain-causing substances (substance P ), resulting in a reduction of pain and stiffness. Relaxation of muscles caused by heat also causes “feeling good” which is an added positive effect. It can be done by traditional hot packs or electric heat packs.
The effects of heat modality are superficial and temporary. So really changing the root cause of a problem like positioning or muscle weakness is a long-term answer.
Paraffin Wax Bath:
acts under similar mechanism of action as heat therapy. It creates a layer on your body part (wrist here) and holds that heat for few minutes.
Wax bath treatment is proven to be significantly effective in chronic pain, inflammation, and stiffness caused by arthritis mainly Rheumatoid kind of arthritis. Performing a range of motion after the treatment is proven to improve range of motion.
Paraffin wax bath is also a treatment of choice when a mobilization begins after a long period of immobilization. When a wrist is in a POP cast for several weeks, introducing wax bath to reduce pain and inflammation before starting a range of motion exercises helps relaxing muscles.
Exercise is crucial to reduce the pain and prevent it from reoccurring. If the muscles around the joints are strong enough then they will less likely to cause any discomfort or pain. Strong muscles also help with arthritic pain in the joints. There are several wrist exercises that one can perform. Below are some exercises that can be done to strengthen the muscles, reduce pain and improve flexibility.
Pain Reduction with Isometrics:
Wrist Flexion & Extension:
As shown in this figure on left, you can place your forearm on a table. Place your other hand on top of the hand. Try to lift your hand up (wrist extension), at the same time, with the other hand, press gently against the hand – as if you are resisting or opposing the motion.
Another option to perform wrist isometrics are with using a tennis ball as shown in the second figure.
Wrist Isometrics: Deviation
The figure below explains how to perform isometrics of wrist radial deviation. Your forearm in a neutral position as shown in the picture below. In this position, you are trying to lift your wrist upwards, in the direction of the chest. At the same, your other hand is preventing/resisting that movement by applying force exactly opposite to that movement. The red arrow demonstrates the direction of force applied by the other hand to prevent the wrist from performing the actual movement.
Wrist Strengthening Exercises:
Few figures below demonstrate some wrist and fingers strengthening exercises. you can use dumbbells, wristbands, therapy puddies etc to strengthen the muscles.
These few pictures demonstrate some wrist strengthening exercises.
Finger Strengthening Exercises:
finger strengthening can be done with external weights as shown in the figure below or with manual resistance.
Here is some exercise equipment that you can use to perform wrist strengthening exercises.
Gently stretching the muscles reduces pain and soreness. Always remember to stretch the muscles in pain free range.
Braces are good to maintain a proper position and avoid any sudden movement at the wrist. It can also help in cases like carpal tunnel syndrome, or wrist sprain or strain. There are several braces available depending on need and injury.
Here are a few braces that I recommend in case of chronic wrist pain.
Proper ergonomics is very important in cases with chronic pain. You need to make sure you are using correct positioning to avoid overuse and fatigue. Correct position of wrist starts from using a computer or desk, to gold play or tennis play. Here are some correct wrist positions and the adaptive devices that help you achieve that position.
Hope this article helps you to find some relief with chronic wrist pain.