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Wrist and Hand Pain

The anatomy of the wrist and hand is complex. There are 8 small carpal bones in the wrist, 5 meta-carpal bones in the hand joining to the phalanges in the fingers. The wrist and hand has an intricate network of ligaments, tendons and muscles, with multiple axes of movement to provide mobility for hand function.
Acute injuries to the hand and wrist occur mainly from falls on an outstretched hand (e.g. fracture or dislocation of the distal radius or scaphoid, ligament sprains or triangular fibrocartilage tears).
Chronic wrist/hand pain can be caused by an overuse condition (e.g. tenosynovitis); or following an acute injury that went untreated or was misdiagnosed.
Determining the onset and location of wrist/hand pain, mechanism of injury and identifying activities/movements that aggravate wrist/hand pain is essential in the correct diagnosis and subsequent treatment of the injury.

Some Common Causes of Wrist & Hand Pain:

Signs & Symptoms
• Swelling and local tenderness over the tendon +/- crepitis
• Pain after repeated movements or excessive activity
• Reduced wrist mobility
• Pain with passive stretching
• Stiffness after a period of rest

Wrist/Carpal Instability
Signs & Symptoms
• Pain and tenderness
• Reduced grip strength
• History of joint clicking can be associated with carpal instability, triangular fibrocartilage tears or subluxation of a tendon

Carpal Tunnel Syndrome
Signs & Symptoms
• Pain in the front of the wrist, with paraesthesia (pins and needles) or numbness radiating into the thumb, index finger, middle finger and part of the ring finger
• Occasionally pain radiates to the elbow or shoulder
• Night pain +/- paraesthesia
• Difficulty holding things (often due to numbness)

Metacarpal/Phalange Injuries
• Fractures/dislocations – pain, swelling, obvious deformity
• Ligament/tendon/joint – pain, swelling, weakness, instability, deformity