Wrist and Hand
Carpal Tunnel Syndrome
Carpal Tunnel is a common condition where the median nerve gets compressed in the tunnel within the wrist and causes symptoms of pain, numbness and tingling in the hand and fingers. The carpal tunnel is formed by the carpal bones and the transverse carpal ligament at the top. The median nerve as well as the tendons that move the wrist and fingers pass through this tunnel. The bones and ligaments that form the tunnel have very little give and so any swelling of the tendon structures within the tunnel then causes compression on the median nerve. This condition if left untreated can lead to progression of the condition with worsening symptoms and ultimately nerve damage.
Carpal tunnel syndrome is caused by a combination of factors including genetic factors (women are more susceptible, the shape/size of the tunnel can predispose), repetitive hand and wrist use, prolonged end of range wrist positions, pregnancy, health conditions (such as diabetes, inflammatory arthritis’).
Distal Radius Fractures
The distal radius fracture of the wrist is the most common diagnosed fracture, often the result of a fall onto the hand. This can be treated in a cast, however in more severe cases is treated surgically with an ORIF (open reduction internal fixation). In both cases, once the immobilisation cast/brace is allowed to be removed, the wrist movements are stiff and there is a loss of strength of the forearm and gripping muscles.
Ultimately prevention is better than the cure, and our physiotherapists will assess your balance, generalised muscle strength (sarcopenia assessment) and provide a program to improve your bone strength (prevention/treatment of osteopenia and osteoporosis), muscle strength and balance. The ultimate aim is to keep you on your feet and prevent falls.
If you have had a fracture, treatment afterwards will include techniques and exercises to increase your wrist movement, improve your strength and regain your hand and wrist function. We will also test your balance and falls risk at this point and address any problems to keep you on your feet.
Dupuytren’s contracture is a condition of the hand where the palmar fascia becomes tight and forms nodules affecting the flexor tendons and resulting in abnormal flexion of the finger(s) and preventing the finger from being able to straighten. The ring finger is the most common finger affected, followed by the 5th finger and the 3rd finger. The condition has a genetic predisposition with 30% of men over the age of 60 in Norway affected, 20% of men over 65 are affected in the UK and 5% of American’s are affected. It is more prevalent in males than females of Anglo-Saxon origin.
The condition can be treated in the early stages with physiotherapy. Later stages of the condition can be treated with cortisone injection, collagenase injections or surgery.
Our expert physiotherapists are trained to assess your wrist or hand problem and determine the cause. We will then provide you with an evidence based treatment and rehabilitation plan to get you moving and functioning your best. The services and types of treatment that may help are:
Taping and bracing
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