Hand and wrist pain originate from two primary sources: overuse and injury. Carpal Tunnel Syndrome is the best known condition that causes hand and wrist pain from overuse and repetitive motion. It’s been estimated that 3-6% of the adult population – as many as 18 million people – suffer from this condition.
Five common treatment options for hand and wrist conditions include:
- Splinting and casting: The focus of splinting and casting is to immobilize an injured ligament, bone, or joint in order to allow it to heal.
- Physiotherapy: The goal of therapy is to help the patient get back to normal function and activity with the minimum degree of ongoing discomfort. This is generally achieved through a series of home exercises following treatment that stabilizes and strengthens the affected area. An equally important part of the overall PT treatment plan is to educate the patient on how changes in habits and activities can reduce symptoms.
- Cortisone injections and anti-inflammatory medications:
Frequently providing temporary relief, anti-inflammatory medications and injections do not always work as intended, and sometimes require repeated doses and treatments to have any effect. More importantly, anti-inflammatories don’t address the underlying cause of the condition and are not considered a sufficient option for long-term pain relief. Also, side effects limit frequent and long-term use.
- Fusion (arthrodesis): A last resort, when options 1-3 prove to be ineffective at reducing pain to the point where it can be managed by the patient. Fusion involves removing the arthritic joints, fusing the bones in question, and stabilizing the connection with a pin. The bones heal and grow together.Fusion patients lose joint movement, but maintain the ability to grip. An entire wrist fusion is more complex and results in considerably reduced mobility and flexibility. In both cases, fusion is used to restore some degree of hand and wrist function that would ortherwise be lost.
- Artificial joint replacement (arthroplasty): This surgery is required when pain does not respond to options 1-3 and the condition has destroyed surfaces, removing fusion as an option. Arthroplasty involves replacing arthritic joints with prosthetic implants. The wrist, finger and thumb joints can all be replaced with artificial implants. It is important to note, however, that prostheses function over a given period of time and that subsequent surgery may be required.