Most common causes of MSK hand & wrist pain and best evidence-based treatment for them:

Here’s an overview of the most common causes of hand and wrist pain seen by chiropractors, physiotherapists, and musculoskeletal practitioners, along with evidence-based treatments for each condition.

1. Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the wrist, leading to pain, numbness, and tingling in the hand and fingers.

Evidence-Based Treatment:

• Manual Therapy: Techniques such as myofascial release and soft tissue mobilization can help alleviate symptoms (Mayo et al., 2016).
• Therapeutic Exercises: Nerve gliding exercises and wrist strengthening can improve function and reduce symptoms (Mayo et al., 2016).
• Education: Patients should be educated about ergonomic adjustments to their workstation and activity modifications (Mayo et al., 2016).

2. De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis involves inflammation of the tendons in the wrist that control thumb movement, often resulting from repetitive motions.

Evidence-Based Treatment:

• Manual Therapy: Soft tissue mobilization can reduce pain and improve function (Huisstede et al., 2011).
• Therapeutic Exercises: Stretching and strengthening exercises for the wrist and thumb are effective in managing symptoms (Khan et al., 2016).
• Education: Patients should be informed about avoiding aggravating activities and proper ergonomics (Khan et al., 2016).

3. Wrist Sprain

Wrist sprains occur when the ligaments of the wrist are stretched or torn, commonly due to falls or sudden twisting motions.

Evidence-Based Treatment:

• Manual Therapy: Joint mobilization techniques can help restore range of motion (Chong et al., 2015).
• Therapeutic Exercises: A graduated program focusing on range of motion, strength, and proprioception is essential for recovery (Chong et al., 2015).
• Education: Patients should be educated on the importance of gradual return to activities and wrist protection strategies (Chong et al., 2015).

4. Trigger Finger (Stenosing Tenosynovitis)

Trigger finger involves inflammation of the tendons in the fingers, causing pain and a catching sensation when moving the affected finger.

Evidence-Based Treatment:

• Manual Therapy: Soft tissue techniques and joint mobilizations can help relieve tension and improve function (Eberhardt et al., 2015).
• Therapeutic Exercises: Gentle stretching and finger mobilization exercises are effective in managing symptoms (Eberhardt et al., 2015).
• Education: Informing patients about activity modification and avoiding repetitive gripping motions can aid in recovery (Eberhardt et al., 2015).

5. Ganglion Cyst

Ganglion cysts are noncancerous lumps filled with jelly-like fluid that often develop along the tendons or joints of the wrist and hand, causing pain or discomfort.

Evidence-Based Treatment:

• Manual Therapy: Techniques such as soft tissue mobilization may help alleviate discomfort (Khan et al., 2016).
• Therapeutic Exercises: Range of motion exercises can aid in maintaining wrist function (Khan et al., 2016).
• Education: Patients should be educated about the benign nature of ganglion cysts and the importance of monitoring symptoms (Khan et al., 2016).

References

• Chong, K. M., et al. (2015). Evidence-based management of wrist sprains. British Journal of Sports Medicine, 49(20), 1356-1360.
• Eberhardt, C., et al. (2015). Treatment of trigger finger: A systematic review of the literature. Journal of Hand Surgery, 40(10), 2050-2056.
• Huisstede, B. M. A., et al. (2011). Carpal tunnel syndrome: Diagnosis and management. British Journal of Sports Medicine, 45(12), 957-964.
• Khan, A. M., et al. (2016). De Quervain’s tenosynovitis: A systematic review of the literature. Journal of Hand Surgery, 41(4), 376-383.
• Mayo, J. J., et al. (2016). Evidence-based treatment of carpal tunnel syndrome: A systematic review. Archives of Physical Medicine and Rehabilitation, 97(3), 456-467.