Entries by Tobias Hall

Gait Speed & Ageing: Is There a Connection?

Gait Speed & Aging: Is There a Connection? 

Person track running

Age is just a number. At least, that is what we would love to believe. However, as time goes on the body faces inevitable wear and tear. At the same time, this doesn’t mean you don’t have some control when it comes to aging gracefully and maintaining your independence, mobility, and function.

Recent research indicates that a reduced gait speed is associated with adverse health outcomes, including an increased risk of disease, falling, disability, and hospitalization. Overall, gait speed assesses a person’s functional mobility. Studies further show that decreased functional mobility may be associated with an increased mortality risk. So, let’s dive into this topic a little further. What is the connection between gait speed and mortality? And what can you do to gain back control and improve your life at any age?


The Impact of Gait on Mortality and Aging

A 2011 study demonstrated how predicted survival rates in older adults based on age, sex, and gait speed were just as accurate as those based on age, sex, chronic conditions, the use of mobility aids, smoking history, body mass index, hospitalization, and blood pressure. This indicates that gait speed plays a major role in longevity and health as we age.

 

In other words, gait speed offers an accurate assessment of overall health. It provides a window into muscular strength, balance, knee and hip joint function, and more. And when moving is tough, we likely feel more inclined to move less. In turn, this can create a downward spiral where your physical health quickly detoriates. 

As you may already know, regular movement is an essential factor in maintaining good overall health, including mental and physical components. Various research even proves this to be true. This means if you’re struggling to walk or move, it’s of the utmost importance that you actively find ways to improve this and increase your strength and mobility.

The Impact of Gait on Mortality and Aging

A 2011 study demonstrated how predicted survival rates in older adults based on age, sex, and gait speed were just as accurate as those based on age, sex, chronic conditions, the use of mobility aids, smoking history, body mass index, hospitalization, and blood pressure. This indicates that gait speed plays a major role in longevity and health as we age.

 

In other words, gait speed offers an accurate assessment of overall health. It provides a window into muscular strength, balance, knee and hip joint function, and more. And when moving is tough, we likely feel more inclined to move less. In turn, this can create a downward spiral where your physical health quickly detoriates. 

As you may already know, regular movement is an essential factor in maintaining good overall health, including mental and physical components. Various research even proves this to be true. This means if you’re struggling to walk or move, it’s of the utmost importance that you actively find ways to improve this and increase your strength and mobility.


How to Maintain Your Physical Function At Any Age

Aging gracefully and maintaining walking function isn’t as complicated as you might think. Overall, it comes down to doing the basics when it comes to taking care of your physical health. This means:

The human body thrives with moderate movement. Daily walks, strength training, and stretching routines are crucial pieces of a healthy routine, especially with age. In particular, walking is a fundamental part of many daily activities. As with most things, practice makes perfect. Walking further improves muscular strength and cardiovascular and respiratory function.

Additionally, strength training increases muscle mass, which begins to decline after the age of 30. Stretching a few times a week can also help maintain flexibility of your joints and muscles.

The saying, “You are what you eat,” isn’t that far from the truth. Your body can only do so much with what you give it. Obtaining a variety of nutrients, vitamins, and minerals through your diet contributes to optimal functioning and cellular repair. Focus on consuming whole foods and making meals at home as opposed to eating or ordering out. This way, you know exactly what goes into the food you eat.

If you’re a smoker, one of the best things you can do for your health is quit. On top of this, limiting your alcohol consumption to a few drinks a week or not drinking at all can substantially improve your physical health. After all, your liver isn’t just in charge of detoxification. It also contributes to enzyme activation, the storage of vitamins and minerals, the production of certain proteins, and more. Ensuring your liver can do its job right is a major factor in overall good physical health.

Sleep deprivation is associated with obesity, type 2 diabetes, impaired immunity, mood disorders, neurodegeneration, high blood pressure, and more. Sleep is essential for repair and restoration of the body and its systems. This is why it’s so important to ensure you go to bed and wake up at the same time, as well as practice proper sleep hygiene, such as sleeping in a dark, quiet, and cool room. Most adults should get about 7-9 hours of quality sleep a night. If you’re getting less than this, it’s time to make a change!

Effectively treating any pain that is limiting your movement is an important first step towards better long term mobility. At Featherston St Pain Clinic we use cutting edge technology to identify gait weaknesses and asymmetries – this data enables us to prescribe specific exercises that target your legs stabilising muscles. We monitor and measure patient progress carefully using the same software over time. Many people who suffer with poor health outcomes due to gait degradation have high arches or flat feet, for these people we prescribe custom insoles which can have a profound impact on the preservation of mobility in the long term.

Not Sure Where to Start?

At the Featherston Street Pain Clinic, our expert team can perform a biomechanical analysis of your gait and help you make a plan to restore your health and improve your life. That way, you won’t let life pass you by. Instead, you can spend more quality time with the people you love and participate in the activities you enjoy. Book your appointment today.

Not Sure Where to Start?

At the Featherston Street Pain Clinic, our expert team can perform a biomechanical analysis of your gait and help you make a plan to restore your health and improve your life. That way, you won’t let life pass you by. Instead, you can spend more quality time with the people you love and participate in the activities you enjoy. Book your appointment today.


Recent Articles

Could Stress Be Aggravating Your Hand Pain Or Wrist Pain?

Could Stress Be Aggravating Your Sore Hand Or Wrist? Research Says It might

Wrist : Hand Pain And Stress

Our hands and wrists are beautiful pieces of natural engineering. And they may be the secret to our success as a species even more so than our brains. Our ability to grip objects easily allows us to perform tasks other beasts simply cannot consider. The extreme utility of our hands and wrists means however that they’re used for nearly everything we do.

Because our hands and wrists are so vital, they’re prone to wear and tear, which can of course result in pain. Things that we once loved to do can all become unnecessarily tricky.

Wrist and hand pains have a physical basis. The tendency towards heavy use means they are prone to developing scar tissue, fascial adhesions and other wear and tear that all require treatment. However, you might also be surprised to learn that psychological stress can aggravate your hand and wrist pain greatly.

Modern pain research suggests that psychological and emotional components can play a major role in developing chronic pain. These non-physical elements help to create new neural circuits, rewiring our brain’s circuitry to perpetuate this sensation we call “pain”. Put simply, we all get pain, but stress can modulate our pain perception and make us more susceptible to it. 

In this blog, we’ll break down how stress might be modifying the intensity of your hand and wrist pain. 


The Link Between Stress And Pain

Stress is a normal part of life – you become stressed when you face hard situations or have a lot to deal with. 

That’s because stress has a vital function. If we’re under threat, stress gets us ready to take action. Similar to how acute pain lets us know when something is wrong in the body. 

When they function as they should, stress and pain are positive additions to your life, helping to keep you safe. However, if you’re constantly stressed, stress can become chronic. 

A chronically stressed person has an overactive nervous system – one that’s on edge for the next email from our boss, the next phone call from a friend, or even the next lockdown. This overactive nervous system can be the tipping point and begin the cycle of chronic pain.

There might be an event, such as a gym injury, that brings on your pain, or it might creep on over time. However, when the pain does start, it’s likely to feel more painful than if you weren’t stressed. A 2015 meta-study published in the Malaysian Journal of Medical Sciences found that we feel pain more intensely when we’re stressed. In particular, negative emotions heighten the impact of stress on pain. 

A study that illustrates this fantastically is one carried out by Boeing. In the study, Boeing teamed up with researchers to identify risk factors for reporting acute back pain at work. 3,020 aircraft employees took part in the study, so this wasn’t a small sample! The researchers found that heavy lifting or repetitive work didn’t predict back pain, but feeling underappreciated did. That’s right, the workers who experienced the worst back pain were the ones who felt chronically underappreciated. 

So, if you’re stressed, you’re more likely to get pain in the first place. That pain might be bad too, which is in itself stressful. 

Once you’re in pain, stress can keep the cycle of pain going. Research indicates that stress influences people’s labelling and attribution of pain. If you’re stressed, you might be more likely to fixate on your pain or label it as something that’s “really bad” instead of “a bit annoying”. 

The crux of developing pain and then fixating on it is that our brain and nervous system are plastic, meaning they’re really good at forming habits. Research suggests our brains can undergo a sensitivity adjustment if we’ve been experiencing pain for a while. Essentially, our brain becomes very good at detecting danger and sending pain as a warning signal. So, although you’re desperately trying to avoid pain, your brain becomes better at creating it.

Does this mean you’re not in pain? Not at all. Your pain is genuine. Could you have reacted differently? No, your brain and body were doing what has helped humans survive for millions of years. It’s essential to make the distinction that just because your mood impacts your perception of pain, it doesn’t mean that pain is your “fault” because you’re stressed. Instead, your constant stress reflects how our wiring doesn’t match our modern way of life.

However, what’s important to take away is that our perception of pain can be changed by how we’re feeling. Stress and pain are two parts of the same underlying neurobiological system and are interconnected. We still don’t understand the relationship entirely. However, if you’re experiencing chronic stress, it may very well be aggravating your wrist pain or hand pain.


How Stress Might Aggravate Your Hand And Wrist Pain

So, we understand how stress might impact our perception of pain, but how does it impact hand and wrist pain specifically.

A 2003 review of pain in the forearm, wrist and hand listed the below as some ways in which ‘stress’ may promote musculoskeletal illness: 

– Alter how we work to increase the mechanical load.

– Reset the tone in muscles, causing them to fatigue more readily.

– Extend the duration of muscle tension and reduce the rest period (delay unwinding).

Research has also looked at specific stressors linked to hand and wrist pain. According to the same 2003 review, some of the stressors related to hand and wrist pain include: 

– Occupational factors (e.g. time-pressure, overtime, work overload)

– Emotional job demands (e.g. heavy responsibilities).

– Monotonous work and low job control (e.g. lack of autonomy and flexibility).

– Low social support from peers or supervisors, 

– Low job satisfaction

– Perceived job stress 

So, it could be that you’re stressed because you have a deadline or KPI in your repetitive job, or you could be dealing with lots of responsibilities at home. Because you’re stressed, you’re more likely to move in a way that promotes pain and take fewer breaks, leading to overuse/injury and pain. Once you’re in pain, your brain is more likely to amplify that pain, causing you more stress. In short, a perfect pain recipe!


What Can You Do To Reduce Stress When Managing Hand And Wrist Pain

Taken together, the idea that stress might be aggravating your hand and wrist pain isn’t something that you should dismiss. There’s a clear link between how we feel on the inside and what we experience physically. So what can you do about it?

Although stress can aggravate your hand and wrist pain, remember, you will have embodied this stress physically too. Tight muscles, scar tissue and tendinopathy, can all arise when we’re doing a task in a repetitive, stressed manner. To be pain-free, you’ll need treatment for your physical symptoms while you work on reducing your stress. Often, actively treating your pain also helps you feel as if you’re in control of it, reducing the control pain has on your life. 

Exercising regularly, getting proper nutrition and sleeping eight hours a night can all do wonders to help manage stress. Be mindful of assuming that the answers to your pain are found within treatment interventions alone. Imagine we believed that fillings were the only care needed for our re-occuring tooth decay and weren’t willing to look at our sugar intake!

Recent research has shown that cognitive behavioural therapy (CBT) effectively treats hand and arm pain conditions. However, it’s important to note that this research also suggests that cognitive-behavioural therapy is only helpful in conjunction with evidence-based physical treatments. There are other treatments that can be incredibly beneficial for stress too; at our clinic we use brain wave entrainment which utilises LED lights that can switch off stress and pain pathways in the brain.

How much is your pain impacting your life? Is it worth working a job that’s affecting your health and overall life satisfaction? Sometimes, if our bodies are telling us that we’re not happy, it’s helpful to take the hint and reassess what’s important to us. Of course, this is a very different process for everyone. However, it shouldn’t be overlooked if you think there may be a link between your hand and wrist pain and stress.

How We Approach Wrist & Hand Pain

We know that stress can aggravate wrist and hand pain. However, it’s important to remember that if you’re experiencing pain, there will also be an underlying physical basis for your pain. Because we use your hands and wrists often, they’re prone to developing scar tissue, fascial adhesions and other evidence of wear and tear that all require treatment. So, if you’re currently experiencing pain, we certainly can help.

We aim to provide legitimately transformative healthcare in a welcoming & uplifting environment. For us, genuine care, real rapport, and clear communication are not bonus features – they are healthcare fundamentals! That’s why we not only look at the physical symptoms of your pain, but also consider how factors like stress can also play a role. 

Our process could be described as a ‘very hands-on’ style of pain management. Twenty-five years spent treating pain ‘on the front line’ has taught us the value of this treatment style. 

We have a wide range of technologies, including shockwave therapy, laser therapy, Graston and trigger point release. Which are scientifically backed to help improve hand and wrist pain.

Contact our team today to book in for an initial consultation if you think you might be suffering from wrist and hand pain so we can get started to help you live a pain-free day. 

Recent Articles

7 tools we use to treat hand and wrist pain (and one we recommend against!)

7 Tools We Use To Treat Hand And Wrist Pain (And One We Recommend Against!)

Our hands and wrists are some of the hardest working joints in the body. As long as we’re awake, it’s likely we’re using our hands and wrists in some way.

Because we use our hands and our wrists so much, developing pain in them can feel somewhat debilitating. Tasks that were once simple “no-brainers”, such as going to the gym, cooking a meal, or picking up our child, become painful and difficult.

So, how can you treat wrist pain and hand pain? If you’re considering treatment for hand pain and wrist pain, it’s worth understanding what treatment options are available to you. While some treatments are safe and non-invasive, some come with nasty side effects.

At Featherston Pain Clinic, we’ve treated countless cases of hand pain and wrist pain. We specialise in providing flexible multidisciplinary pain relief using a wide range of tools and techniques. To give you insight into what treatment options are available for you, here’s a list of seven treatments we commonly use for hand pain and wrist pain – and one we recommend against.


1. Extracorporeal Shockwave Therapy

Shockwave therapy is a gold standard treatment for hand and wrist pain. It’s non-invasive, effective and backed by heaps of research.

If you’ve never heard of shockwave therapy before, it’s sort of like laser therapy. However, instead of using focussed light, shockwave therapy uses sound waves. 

A handheld device fires sound waves through the body’s bone and soft tissues at up to a depth of up to 12 cm.

The effect that these soundwaves have on the body is complex. However, put simply, shockwave therapy treats wrist and hand pain by breaking down scar like  tissue and promoting the regeneration of soft tissue.

If you’ve injured or overused your hand or wrist, you’ve likely got built up scar tissue. This scar tissue causes pain by impairing how your hand or wrist functions. Shockwave can break that scar tissue down. Not only that, but it also increases blood flow and vascular regeneration, reducing inflammation. 

If you’re the kind of person that likes to do their research on a treatment before diving in, there’s no shortage of research into shockwave therapy as a treatment for hand and wrist pain. Research has shown that shockwave therapy helps treat hand and wrist pain, including the below conditions: 

– Osteoarthritis (see research here

– De Quervain diseases (see research here)

– Trigger finger (see research here)

– Dupuytren disease (see research here)

– Carpal tunnel (see research here

– Tendonitis (see research here)

1. Extracorporeal Shockwave Therapy

Shockwave therapy is a gold standard treatment for hand and wrist pain. It’s non-invasive, effective and backed by heaps of research.

If you’ve never heard of shockwave therapy before, it’s sort of like laser therapy. However, instead of using focused light, shockwave therapy uses sound waves. 

The effect that these soundwaves have on the body is complex. However, put simply, shockwave therapy treats wrist and hand pain by breaking down scar like  tissue and promoting the regeneration of soft tissue.

If you’ve injured or overused your hand or wrist, you’ve likely got built up scar tissue. This scar tissue causes pain by impairing how your hand or wrist functions. Shockwave can break that scar tissue down. Not only that, but it also increases blood flow and vascular regeneration, reducing inflammation. 

If you’re the kind of person that likes to do their research on a treatment before diving in, there’s no shortage of research into shockwave therapy as a treatment for hand and wrist pain. Research has shown that shockwave therapy helps treat hand and wrist pain, including the below conditions: 

– Osteoarthritis (see research here

– De Quervain diseases (see research here)

– Trigger finger (see research here)

– Dupuytren disease (see research here)

– Carpal tunnel (see research here

– Tendonitis (see research here)


A person getting laser treatment

2. Laser Therapy

Laser therapy is another non-invasive and research-backed treatment that helps treat hand and wrist pain effectively. 

An infra-red laser works at a low frequency to penetrate invisible wavelengths deeply into the tissues below the skin. In our experience, people with wrist and hand pain often experience immediate improvements in their pain after laser therapy, and research backs this observation.

Research suggests that low laser therapy can effectively treat hand and wrist pain, including the below conditions:

– General wrist and hand pain (see research here

– Osteoarthritis (see research here) 

– De Quervain diseases (see research here)

– Trigger finger (see research here)

– Dupuytren disease (see research here)

– Carpal tunnel (see research here

– Tendonitis (see research here)

2. Laser Therapy

Laser therapy is another non-invasive and research-backed treatment that helps treat hand and wrist pain effectively. 

An infra-red laser works at a low frequency to penetrate invisible wavelengths deeply into the tissues below the skin. In our experience, people with wrist and hand pain often experience immediate improvements in their pain after laser therapy, and research backs this observation.

Research suggests that low laser therapy can effectively treat hand and wrist pain, including the below conditions:

– General wrist and hand pain (see research here

– Osteoarthritis (see research here) 

– De Quervain diseases (see research here)

– Trigger finger (see research here)

– Dupuytren disease (see research here)

– Carpal tunnel (see research here

– Tendonitis (see research here)


3. Graston Technique

Graston Technique is a specialised massage that uses ‘scraping’ tools to release connective and soft tissue adhesions. 

Soft tissue adhesions are often the root cause of hand or wrist pain. These types of adhesions can come from almost any history of physical injury, trauma or overuse and are a bit like a tiny spider web that creates tissue tension and irritation. 

We’ve found that using Graston Technique to release adhesions can bring shockingly fast relief for many wrist pain and hand pain sufferers, even for those patients who have struggled for years.

Again, research backs up what we’ve witnessed at the clinic and suggests Graston Technique is an effective treatment for hand and wrist pain.

– De Quervain diseases (see research here)

– Trigger finger (see research here)

– Dupuytren disease (see research here)

– Carpal tunnel (see research here)

– Tendonitis (see research here)


4. Acupuncture/Dry Needling

Acupuncture can be beneficial in the management of many cases of wrist pain and hand pain. Needling aims to promote blood flow, ease painful pressure points in soft tissues and reduce pain signals.

Traditionally, acupuncture places needles in a broad set of related locations. However, we tend to use a method often referred to as dry needling, where needles are placed directly on your hand or wrist at appropriate trigger points. Once we’ve placed the needles on your hand or wrist, we’ll generally leave them in for around 10 minutes, depending on your body’s tolerance to them.

Again, research backs the effectiveness of dry needling. A 2017 systematic review of 15 studies published in the Journal of Complementary Therapies in Medicine found dry needling offers short-term benefits of reduced pain, increased ROM, and better quality of life in patients with myofascial pain. 

Dry needling can also effectively treat: 

– De Quervain diseases (see research here)

– Trigger finger (see research here)

– Carpal tunnel (see research here)

– Tendonitis (see research here)


5. Trigger Point Release

Myofascial pain syndrome (MPS) is a chronic condition that causes muscle pain. In people with myofascial pain syndrome, sensitive spots are known as trigger points.

It’s thought that injury and overuse can cause muscle fibers to contract and shorten. The shortened muscle means that the supply of oxygen and nutrients to the trigger point is constantly compromised, and therefore it can’t relax. 

Trigger point release techniques use the hands to release those painful muscle points.
Myofascial trigger point therapy aims to improve blood circulation to the trigger zone and release the surrounding fascia.  

There’s still no complete scientific understanding of the role myofascial trigger points play in pain, although research suggests it’s an effective treatment for carpal tunnel syndrome. Over the years, we’ve seen trigger point release provide effective relief from hand and wrist pain and think it’s an effective, accessible and non-invasive tool to have in the bank for helping to get your hand or wrist pain-free again.


6. Exercise Prescription

Exercises are a vital part of long-term wrist pain and hand pain rehab. However, there is an important nuance to understand about the role exercises have in wrist pain and hand pain management. 

Most stubborn wrist and hand pain cases require hands-on treatment before they are truly responsive to exercise prescription. If you have a significant build-up of muscle knots, soft tissue adhesions, or tendinopathies, it is too much to expect that exercises alone will resolve them. Although exercises help manage wrist and hand pain, you don’t want to put the horse before the cart. Treat first, exercise later.

However, that doesn’t mean exercises are useless. Research suggests that exercises can assist in improving wrist and hand function after treatment.

So, we will prescribe them when required to strengthen weakened muscles and tendons as needed. However, if you go to a pain specialist and exercises are the only treatment they give you, we advise you to find another pain specialist!


7. Bracing & Splints

Braces and splints immobilise your hand or wrist to help it heal. Globally, pain management practices have moved away from immobilisation techniques over the last 30 years. Instead, more active types of rehab are now preferred. However, bracing for wrist pain and hand pain is still surprisingly common in New Zealand. 

Of course, there is still a place for bracing and immobilisation. Bracing is essential while bone and soft tissue heal from significant breaks. Beyond that, a modern take on pain management broadly indicates that you should be suspicious of managing your pain in a way that favours bracing over other more active treatments.

So, like exercise prescription, there’s a nuance as to when braces are the right choice for treating your hand wrist pain, and they shouldn’t act as a substitute for more hands-on treatment.

7. Bracing & Splints

Braces and splints immobilise your hand or wrist to help it heal. Globally, pain management practices have moved away from immobilisation techniques over the last 30 years. Instead, more active types of rehab are now preferred. However, bracing for wrist pain and hand pain is still surprisingly common in New Zealand. 

Of course, there is still a place for bracing and immobilisation. Bracing is essential while bone and soft tissue heal from significant breaks. Beyond that, a modern take on pain management broadly indicates that you should be suspicious of managing your pain in a way that favours bracing over other more active treatments.

So, like exercise prescription, there’s a nuance as to when braces are the right choice for treating your hand wrist pain, and they shouldn’t act as a substitute for more hands-on treatment.


8. Cortisone Shots

Finally, a treatment we don’t recommend you dive into without exploring all other avenues first – cortisone shots.

Cortisone shots are injections that can help relieve pain and inflammation in a specific area of your body. The injections usually contain a corticosteroid medication and a local anesthetic and can be injected into your joints, including your wrist and hands. 

However, cortisone shots come with a bunch of side effects. Here’s a list of the side effects we’ve taken from Mayo Clinic

– Cartilage damage.

– Death of nearby bone.

– Joint infection.

– Nerve damage.

– Temporary facial flushing.

– Temporary flare of pain and inflammation in the joint.

– Temporary increase in blood sugar.

– Tendon weakening or rupture.

– Thinning of nearby bone (osteoporosis).

– Thinning of skin and soft tissue around the injection site.

– Whitening or lightening of the skin around the injection site.

As you can see, it’s not a short list! Before you jump in and take the risk of cortisone injections, it’s worth trying less invasive treatments, such as the seven that we have listed above.


Treating wrist and hand pain

The Take Home

Wrist and hand pain can be a major inconvenience, but the good news is that there is no shortage of effective treatments for both conditions. If you’re currently experiencing pain, we can certainly help.  

We aim to provide you with a genuinely transformative healthcare experience. For us, real care and clear communication are not just bonuses – they’re fundamentals! 

Our process is a hands-on style of pain management, and we’ll work one-on-one with you as your unique needs dictate. We have spent 25 years treating on the front line and know hands-on treatment brings the best results.

Contact our team today to book in for an initial consultation if you think you might be suffering from wrist and hand pain so we can get started to help you live a pain-free day.

The Take Home

Wrist and hand pain can be a major inconvenience, but the good news is that there is no shortage of effective treatments for both conditions. If you’re currently experiencing pain, we can certainly help.  

We aim to provide you with a genuinely transformative healthcare experience. For us, real care and clear communication are not just bonuses – they’re fundamentals! 

Our process is a hands-on style of pain management, and we’ll work one-on-one with you as your unique needs dictate. We have spent 25 years treating on the front line and know hands-on treatment brings the best results.

Contact our team today to book in for an initial consultation if you think you might be suffering from wrist and hand pain so we can get started to help you live a pain-free day.

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9 Causes Of Wrist And Hand Pain And How To Treat Them

9 Causes Of Wrist And Hand Pain And How To Treat Them

Research suggests that wrist pain and hand pain impact about 10% of the population. It’s highly prevalent in people who perform physically demanding, repetitive activities daily, like manual labourers and sportspeople. It’s less common for office workers, but a life of scrolling, typing and sitting means that it’s becoming more common.

Finding that you can’t perform normal day-to-day activities without wrist pain or hand pain is as annoying as it gets. It can impact your work, family life and hobbies. So, what might be causing your pain? Sometimes we might have an inkling of what’s behind our pain, and other times, it crops up for reasons that seem like a complete mystery. 

Understanding the root cause of your wrist pain and hand pain is the first step to creating an effective treatment plan that works – one that won’t see your symptoms returning again and again.  At Featherston Pain Clinic, we’ve treated hundreds of hand and wrist pain cases and have a solid understanding of the common root causes. To give you some insight into what might be causing your hand and wrist pain, we’ve compiled a list of common causes, with some insight into how to treat them.


Woman lifting weights

1. Repetitive Strain

Our hands and wrists are always busy, so it makes sense that some of the hardest working parts of the body are the most prone to injury from being overused. Research suggests that repetitive stress is the leading cause of hand pain and wrist pain. 

Put simply, repetitive stress injuries happen when our body can’t keep up with all the damage caused by high levels of activity. To grasp this, you need to understand that your body is constantly repairing itself. If it were to go head-to-head in a competition with a machine, it would most definitely lose, simply because it needs to repair itself, whereas a machine doesn’t. 

We see two common types of overuse injuries frequently at the clinic – overuse injuries due to work and overuse injuries due to overtraining. Repetitive work tasks, tasks requiring strength, and tasks that place our wrists and hands in awkward angles can all lead to pain. The same goes for overtraining. You might be incredibly strong and have perfect lifting technique, but if you do the same intense lifting every day for three years, you’ll exceed your body’s ability to carry out repair processes.

1. Repetitive Strain

Our hands and wrists are always busy, so it makes sense that some of the hardest working parts of the body are the most prone to injury from being overused. Research suggests that repetitive stress is the leading cause of hand pain and wrist pain. 

Put simply, repetitive stress injuries happen when our body can’t keep up with all the damage caused by high levels of activity. To fully understand this, you need to understand that your body is constantly repairing itself. If it were to go head-to-head in a competition with a machine, it would most definitely lose, simply because it needs to repair itself, whereas a machine doesn’t. 

We see two common types of overuse injuries frequently at the clinic – overuse injuries due to work and overuse injuries due to overtraining. Repetitive work tasks, tasks requiring strength, and tasks that place our wrists and hands in awkward angles can all lead to pain. The same goes for overtraining. You might be incredibly strong and have perfect lifting technique, but if you do the same intense lifting every day for three years, you’ll exceed your body’s ability to carry out repair processes.


Person on their phone

2. Inflexibility

On the other side of the coin, our hands and wrists are busy, in fact they’re not actually doing as much as they used to. 

We were designed to roam vast fields, hunt prey, and construct shelters out of branches or leaves – not typing emails, scrolling news-feeds and reaching for the remote control.

Our modern-day activities limit our tendons and muscles to a minimal range of motion. Scrolling your newsfeed requires a great deal of repetition, but it doesn’t strengthen or mobilise your tissues in any meaningful way. 

If our soft tissues don’t get the varied work they need to stay strong and elastic, they’re simply more prone to being strained from overuse (already you might be thinking that your hand and wrist pain is multifaceted!). As you’ve likely guessed, this can predispose you to develop hand pain and wrist pain.

2. Inflexibility

On the other side of the coin, however, although our hands and wrists are busy, they’re not actually doing as much as they used to. 

We were designed to roam vast fields, hunt prey, and construct shelters out of branches or leaves – not typing emails, scrolling news-feeds and reaching for the remote control.

Our modern-day activities limit our tendons and muscles to a minimal range of motion. Scrolling your newsfeed requires a great deal of repetition, but it doesn’t strengthen or mobilise your tissues in any meaningful way. 

If our soft tissues don’t get the varied work they need to stay strong and elastic, they’re simply more prone to being strained from overuse (already you might be thinking that your hand and wrist pain is multifaceted!). As you’ve likely guessed, this can predispose you to develop hand pain and wrist pain.


3. Postural Tension

A wise woman once said, “it’s not what you do, it’s how you do it” – and she was right! Funnily enough, this also makes a great analogy for explaining hand and wrist pain.

How we do a task matters. When you perform a task in a smooth, relaxed and efficient way, it puts far less stress on the body than if you do it in a way that’s tense and awkward. How you grapes a steering wheel, a barbell, or even your pen can all contribute to your hand pain and wrist pain. These habits don’t seem bad in isolation, but hand and wrist pain can come knocking if you do them for days, months, and even years.

If you suffer from wrist and hand pain, adjusting how you do something can improve your pain immensely. Happily, any pain clinician who knows their stuff should be able to tell you just what you need to do to eliminate your pain.


4. Scar Tissue

Scar tissue is a major cause of wrist pain and hand pain. Either significant injury or repetitive strain usually causes it.

Significant injuries can leave deep tracts of scar tissue behind. Sometimes, old scar tissues are a vital factor in wrist and hand pain because they disrupt the function of your joints or muscles. It’s not a cause of the problem per se, but a factor of it nonetheless. The role that old injuries play in wrist pain and hand pain can be complex. For example, old shoulder injuries can easily contribute to pain in the wrist and hand. 

By now, you’ll be familiar with the idea that repetitive strain from daily activities plays out over weeks, years and even decades. If we dive into how this actually leads to pain even further, scar tissue is a large component. Repetitive strain can lead to scar tissue forming within the areas of maximum tissue stress since your body is constantly trying to repair the situation.


5. Surgery

Surgery is great; we’re truly blessed to live in an age of modern surgical procedures and technologies, which can save lives or relieve the pain we feel every day from nasties, such as nerve compression.

As wonderful as surgery is, it’s inevitably very invasive for our body – you are being cut open after all! And like all injuries, surgery can leave long term issues that may predispose us to pain, which in some cases can become chronic. 

Many of us are not given sufficient rehab after surgery due to the pressure on our healthcare systems. Hospitals need to discharge patients in a timely fashion, which can stunt your recovery process. 

As we mentioned above, scar tissue is a significant component of hand and wrist pain. If you’ve had arm surgery in the past and are dealing with persistent wrist or hand pain, there may be some residual scar tissue because you haven’t had the rehab you need to recover from surgery.

Luckily, wrist pain and hand pain related to poor surgical recovery are easily treatable as long as you’re willing to put in the necessary work.


6. Muscle Wasting

Muscle weakness is almost certainly part of the issue if you have chronic pain of any kind, including in your hands and wrists. Strong body parts seldom hurt, no matter what other complex factors are involved.

It’s no secret that we’re far less active than we used to be, and this means that our bodies are incredibly prone to muscle wasting. Our sedentary lifestyle patterns are causing specific muscle wasting compared to a few hundred years ago.

Movement makes muscle – or at least helps it from wasting away. The role muscles play in injury prevention is, however,  just as important as their role in maintaining movement.

If there is a threat of injury, muscles assume their role as protective armour. They prevent our joints from reaching extreme ranges of motion and protect soft tissues.

Strong, healthy muscles play a major role in preventing wrist pain and hand pain, in much the same way as they prevent traumatic injuries. The likelihood of developing hand pain is influenced by the amount of work you do – it is also influenced by how strong your hand is.


7. Tendinopathy

Tendinopathy is an integral part of almost all persistent wrist and hand pain and is an inseparable part of the underlying problem. It is valuable to understand what tendinopathy is and what we can do about it.

Tendinopathy used to be called tendonitis, but it turns out tendonitis is an unscientific term that doesn’t accurately capture what happens to painful tendons. 

More recent research has revealed that when you look down the microscope at chronically painful tendons, you see that they’ve degenerated – similar to what you’d see in bones with osteoarthritis. So, put simply, tendinopathy is your tendons degenerating from wear and tear. 

Fortunately, unlike bones, tendons have a rich blood supply. This is crucial because it means that if you’re able to get everything moving again as it should, you can rejuvenate the tendons and reduce the pain associated with it.


Fascia Diagram

8. Fascial Adhesions

Have you ever eaten a lamb roast? If you have, we’re going to assume two things. First, you’re likely not vegan, and secondly, you’ve probably seen the silvery membrane of a lamb shoulder. That’s fascia. It’s a thin, tough layer of white fibrous tissue that wraps all the internal organs. 

Fascia used to be thought of as boring connective tissues, but recently we’ve begun to understand it as an organ system in itself.

Put simply, fascia is important stuff. It’s the tissue holding everything together in your body. It helps us move our muscles and bones smoothly so that they can work for you more effectively. 

However, anything that causes physical strain, such as repetitive movements, surgery, and an inactive lifestyle, can lead to fascial adhesions. This is when your fascia becomes catchy and crinkled up. When it dries up and tightens around muscles, it can limit mobility and cause painful knots to develop. If you have had limited success with exercise and braces, it’s likely that you have fascial adhesions that need to be broken up, along with residual scar tissue. 

8. Fascial Adhesions

Have you ever eaten a lamb roast? If you have, we’re going to assume two things. First, you’re likely not vegan, and secondly, you’ve probably seen the silvery membrane of a lamb shoulder. That’s fascia. It’s a thin, tough layer of white fibrous tissue that wraps all the internal organs. 

Fascia used to be thought of as boring connective tissues, but recently we’ve begun to understand it as an organ system in itself.

Put simply, fascia is important stuff. It’s the tissue holding everything together in your body. It helps us move our muscles and bones smoothly so that they can work for you more effectively. 

However, anything that causes physical strain, such as repetitive movements, surgery, and an inactive lifestyle, can lead to fascial adhesions. This is when your fascia becomes catchy and crinkled up. When it dries up and tightens around muscles, it can limit mobility and cause painful knots to develop. If you have had limited success with exercise and braces, it’s likely that you have fascial adhesions that need to be broken up, along with residual scar tissue. 


9. Psychological Stress

Yes, you read that right. Stress might be a key factor in your wrist pain and hand pain. Increasingly science is unpacking the profound effects our emotions have on health issues, and stress can influence pain in a big way.

Our modern understanding of “pain” hinges on one relatively simple concept: wherever you feel stubborn aches, they’re happening both within the body’s tissue and deep inside our central nervous systems’ pathway for processing them.

The pain pathway handles everything from incoming messages to various types of sensations received through neurotransmitters like serotonin or dopamine, impacting how we experience emotions.

Put another way, pain happens in the brain. Some people can have damaged tissue and never feel something, while others can’t live a day without intense pain. There’s no hard and fast rule for who does or doesn’t feel pain in any given situation, but we do know that pain can be amplified from psychological stress from sources like family issues and work problems.

A study that illustrates this fantastically is one carried out by Boeing. In the study, Boeing teamed up with researchers to identify risk factors for reporting acute back pain at work. 3,020 aircraft employees took part in the study, so this wasn’t a small sample! The researchers found heavy lifting or repetitive work didn’t predict back pain as well as one other factor – feeling underappreciated. That’s right, the workers who experienced the worst back pain were the ones who felt chronically under-appreciated. That is, experiencing negative emotions day-to-day is linked to pain. 

So, how are you feeling, really? It could be that you’re not stressed – it’s still extremely normal to feel pain without stress in our lives. But, if you are stressed, it’s worth acknowledging that this can impact pain perception.


How Do I Treat Hand Pain And Wrist Pain?

If you’re reading this blog, you likely want to know the cause of your hand pain and wrist pain so you can treat it. 

Maybe your pain has been with you for a while. You might have even tried several treatments and found no one seems to be able to help. We get it! Often people with hand pain and wrist pain come to us just wanting one thing – a pain-free day. Which, we’re happy to say we’ve been able to give them after a bunch of hard work.

Successful management and relief of stubborn wrist and hand pain can be surprisingly straightforward. Yet, in other instances, a systematic, focused, and persistent approach may be required to get your pain under control. 

We specialise in providing flexible ‘multidisciplinary’ pain relief – using a wide range of tools and techniques. This ensures we have the best possible chance to help everyone: from the easiest straightforward cases right through to the most treatment-resistant forms of wrist and hand pain.

However, as wrist pain and hand pain primarily arise from overuse/injury causing scar tissue and fascial adhesions, there are a few common techniques we like to employ:

Shockwave therapy uses soundwaves to break down the scar tissue from overuse injuries. Read more about it here.

Graston Technique is like a form of specialised massage that utilises ‘scraping’ tools to release the connective tissues and get the blood flowing to your tendons again.

Getting your hands and wrists strong again is an essential part of managing wrist and hand pain. But need to be done alongside other treatments to help deal with scar tissue and fascial adhesions.

If stress is likely a contributing cause to your pain, they’ll be factors outside of the treatment we provide directly that will need to be addressed by you. However, what you can count on is that we’ll constantly assess and treat your pain in a holistic fashion, taking into account how stress might be impacting your pain.

The Take Home

Wrist and hand pain can be a major inconvenience, but there are many ways to treat it. If you’re currently experiencing this problem, we can certainly help.  

We have a wide range of technologies, including shockwave therapy, laser therapy, Graston and trigger point release. Which, as you now know, are scientifically backed to help improve hand and wrist pain.

Contact our team today to book in for an initial consultation if you think you might be suffering from wrist and hand pain so we can get started to help you live a pain-free day.

The Take Home

Wrist and hand pain can be a major inconvenience, but there are many ways to treat it. If you’re currently experiencing this problem, we can certainly help.  

We have a wide range of technologies, including shockwave therapy, laser therapy, Graston and trigger point release. Which, as you now know, are scientifically backed to help improve hand and wrist pain.

Contact our team today to book in for an initial consultation if you think you might be suffering from wrist and hand pain so we can get started to help you live a pain-free day.

Recent Articles

Understanding And Treating Wrist And Hand Pain

Understanding And Treating Hand And Wrist Pain: What Science Tells Us

We use our hands and our wrists every day.  So when wrist pain and hand pain develop, it can interfere with many aspects of our lives. Things that we once loved to do – go to the gym, cook a meal, pick up our child, can all become much harder. At best, this can simply be annoying, but at worst, it can significantly impact our quality of life.

Understanding wrist pain and hand pain is, therefore, an important job. A solid understanding of what the science and research says about wrist pain and hand pain can inform the best ways to treat it.

At Featherston Pain Clinic, this matters to us. Why? Because our mission is simple: to help people live pain-free using treatments that science says work. We specialise in providing flexible multidisciplinary pain relief using a wide range of tools and techniques.

So, what does the science say about hand pain and wrist pain? And, more importantly, what are some research-backed treatments for hand pain and wrist pain? 

In this blog, we’ll break down what the science says about hand pain and wrist pain to help you get some insight on why your pain might have developed and how you can treat it.


How Common Is Wrist And Hand Pain?

Our hands and wrists are some of the hardest working parts of the body, so it makes sense that they’d be prone to injury from being overused.

Hand pain and wrist pain are common. However, their prevalence estimates vary greatly and depend on the length, severity, and duration of symptoms that a study includes.

One large American population survey put the prevalence of persistent hand or wrist pain anywhere between 3–7%. More recently, two British surveys found 5-10% of adults experienced some form of hand and wrist discomfort, with rates being even higher for older people. 

So, all-in-all, we can guess that roughly 10% of the population will experience some niggly hand and wrist pain in their lifetime – that’s quite a few people! We’d assume that this figure is likely a conservative estimate since many people likely experience pain and don’t report it.


Wrist Pain

How Are Our Hands And Wrists Structured?

To understand why hand and wrist pain are so common, it’s good to know how the hand and wrist are structured.

The structure of the human hand is highly complex. It is composed of skin, blood vessels, nerves, tendons, ligaments, bones and joints. When there is a problem with any of these structures, pain or impaired function may result.

Twenty-seven small bones make up each hand and wrist and more than 30 muscles that control it. Muscles are attached to bones by tendons, which are small but very tough pieces of connective tissue. Tendons pass through a bony passage in your wrist, known as the carpal tunnel. 

The important thing for you to understand about our hands and wrists is that their complex structure makes them susceptible to pain. These muscles, tendons and bones all experience wear and tear from everyday life, meaning they can become knotted, stiff and degenerate. If we have surgery, the trauma they experience can be even greater.  Together, this can lead to inflammation within the hand and wrist and, as you guessed – pain.

How Are Our Hands And Wrists Structured?

To understand why hand and wrist pain are so common, it’s good to know how the hand and wrist are structured.

The structure of the human hand is highly complex. It is composed of skin, blood vessels, nerves, tendons, ligaments, bones and joints. When there is a problem with any of these structures, pain or impaired function may result.

Twenty-seven small bones make up each hand and wrist and more than 30 muscles that control it. Muscles are attached to bones by tendons, which are small but very tough pieces of connective tissue. Tendons pass through a bony passage in your wrist, known as the carpal tunnel. 

The important thing for you to understand about our hands and wrists is that their complex structure makes them susceptible to pain. These muscles, tendons and bones all experience wear and tear from everyday life, meaning they can become knotted, stiff and degenerate. If we have surgery, the trauma they experience can be even greater.  Together, this can lead to inflammation within the hand and wrist and, as you guessed – pain.


What Types Of Hand And Wrist Pain Are There?

So, we know that the complex structure of the wrist and hand can be prone to wear and tear from everyday life, but what are some different types of hand and wrist pain?

– Diffuse non-specific pain in the forearm or wrist: Experiencing pain in the absence of there being anything wrong with your hand/wrist.

– Dupuytren disease: Pain caused by a gradual thickening and tightening of tissue under the skin in hand.

– Trigger finger: A condition in which a finger gets stuck in a bent position and then snaps straight.

– Tendinopathy: Pain caused by inflammation or degeneration of one or more tendons in the wrist/hand.

– De Quervain’s disease: Pain caused by the two tendons around the base of your digits becoming swollen.

– Carpal tunnel syndrome: Pain caused by irritation to the median nerve in the carpal tunnel.

– Osteoarthritis: Pain caused when the protective cartilage that cushions the ends of the bones wears down over time.


What Are The Causes Of Hand And Wrist Pain?

Ultimately, the research into hand and wrist pain risk factors focuses on two factors – physical and psychosocial.

Much of the research into hand pain and wrist pain looks at how physical activities at work may lead to it.

The main takeaway from this research is that exposure to certain risk factors inevitably leads to a much higher chance of developing hand or wrist pain. In fact, research tells us that you’re 29 times more likely to develop tendinopathy in your wrist and hands if you do a job that’s repetitive and forceful. It also tells us that approximately 25% of all sports-related injuries involve the hand or wrist.

One research paper that reviewed several studies on hand and wrist pain lists the below as common risk factors: 

– Repetitive activities of short cycle time.

– Static loading (e.g. standing, lifting, and carrying).

– Awkward postures with asymmetrical joint loading. 

– Workstations, tools and tasks that impose unnecessary load on muscles and undesirable torques on joints. 

So, if you have a hobby or work task that constantly exposes you to any of the above, you’re significantly more likely to develop hand and wrist pain. 

To illustrate this point even further, we’ve summarised a couple of studies that have looked into the extent to which the above risk factors lead to hand and wrist pain.

One study assessed hand and wrist pain in 90 meat cutters and 77 referents construction foremen. Both are physical jobs, but meat cutting often involves repetitive tasks, leading to hand and wrist pain. All the participants filled out a questionnaire about their pain. They were then assessed by the researchers – who had no idea if the people they were assessing were meat cutters or construction foremen. The results suggested that meat cutters were 20% more likely to get hand and wrist pain symptoms. The older the meat cutters were, and the longer they’d been doing the job, the more likely they were to have hand and wrist pain.

A study on 107 women who were either sewing machine operators, nurses and home helpers also reported similar findings. Again, these are all physical jobs, but sewing machine operators complete niggly repetitive tasks. Because of their constant exposure to niggly tasks, the researchers found that sewing machine operators were more likely to experience myofascial pain syndrome.

Interestingly, all the research on hand and wrist pain has defined pain differently but found similar results. This suggests that the risk factors studied in the research to date are predictive of hand and wrist pain.

So, if you’re experiencing hand and wrist pain, consider what you do day-to-day. Could your work, an activity or a hobby be contributing to your hand or wrist pain? 

Physical risk factors are only part of the puzzle when it comes to hand and wrist pain. 

Modern pain research suggests that psychological and emotional components can play a major role in developing chronic pain. These non-physical elements help to create new neural circuits, rewiring our brain’s circuitry to perpetuate this sensation we call “pain.”

To date, research has looked at how the below psychosocial factors influence hand and wrist pain:

– Occupational factors (e.g. time-pressure, overtime, work overload)

– Emotional job demands (e.g. heavy responsibilities).

– Monotonous work and low job control (e.g. lack of autonomy and flexibility).

– Low social support from peers or supervisors, 

– Low job satisfaction

– Perceived job stress 

One review of 28 studies found that psychosocial factors consistently influenced hand and wrist pain. Many studies have reported a strong association with high perceived job stress and pain. 

Stress can impact our bodies in several ways. A large review of hand and wrist pain research suggested it can encourage pain by:

– Resetting the tone in muscles causing them to fatigue quicker.

– Extending the duration of muscle tension because people are less likely to take breaks. 

– Intensifying the perception of pain.

– Influencing people’s opinion on the labelling and attribution of pain. 

– Undermining the mechanisms people use to cope with pain. 

– Modifying the physical and behavioural responses to pain (e.g. to promote disability and chronicity).

So, if you’re experiencing hand and wrist pain, it’s also worth considering if stress may be contributing to it and looking to reduce stress levels in your life.

How To Treat Hand And Wrist Pain: What The Science Says

However, if you have had wrist pain, you may already have a good idea about what led to it. What you really want to know is the all-important question – how can you treat it? Depending on what has led to your pain, there are a few options.

If physical factors have brought on your hand and wrist pain, research suggests that improving your ergonomics can have a significant impact on the hand and wrist pain you’re experiencing.  

According to one review, some of the actions you can take include:

– Minimising work effort by adopting ’good’ postures 

– Avoiding prolonged static loading (which interrupts the blood supply and causes anaerobic metabolism)

– Minimising the forces that have to be applied (e.g. by improving tool design) 

– Ensuring that the tool fits the worker (e.g. handle of the correct size) 

– Avoiding application of forces at the extremes of joint movement

– Avoiding repetition of the same movements over and over again – by mixing up the pattern of work and slowing down the cycle time

– Allowing enough rest breaks

– Avoiding forceful twisting or rotation of the wrist, movement of the wrist from side to side, highly flexed fingers and wrist, and upper limb motions beyond the range of comfort

– Minimising adverse cofactors (e.g. reducing the vibration of tools by damping; improving lighting and layout to avoid awkward posturing)

However, improving ergonomics will only improve pain getting worse. If you’re still in pain, you’ll likely have muscle knots, degeneration and scar tissue that needs to be dealt with. 

Shockwave is widely considered the treatment of choice for chronic soft tissue pains in the wrist and hand. Your pain will likely be caused in part due to muscle knots, degeneration and scar tissue, and shockwave can help treat these.

If you’ve never heard of shockwave therapy before, it’s sort of like laser therapy. However, instead of using focussed light, shockwave therapy uses sound waves to treat pain. 
A handheld device fires sound waves through the body’s bone and soft tissues at up to a depth of up to 12 cm.

Research has shown that shockwave therapy is effective at treating the below types of hand and wrist pain:

– Osteoarthritis (see research here

– De Quervain diseases (see research here)

– Trigger finger (see research here)

– Dupuytren disease (see research here)

– Carpal tunnel (see research here

– Tendinopathy (see research here)

Low Energy Laser Therapy is the application of specific, deeply penetrating light waves to a painful area. Like shockwave therapy, it will also help treat muscle knots, degeneration and scar tissue.

Many clinical trials have shown this type of treatment has a meaningful effect on inflammation and tissue repair. In one study, low-level lasers reduced the pain associated with carpal tunnel syndrome. 

In our experience, people with wrist and hand pain often experience immediate improvements in their pain after laser sessions.

Many people suffer from stubborn wrist pain and hand pain caused in part by soft tissue adhesions. If you don’t know what soft tissue adhesions are, they’re a bit like a tiny spider web that creates tissue tension and irritation. These types of adhesions can come from almost any history of physical injury, trauma or overuse. 

Graston Technique is a specialised massage that utilises ‘scraping’ tools to release the connective tissues. 

Using Graston Technique to release adhesions can bring shockingly fast relief for many wrist pain and hand pain sufferers, even for those patients who have struggled for years.

In one study, patients with carpal tunnel syndrome showed improvements to nerve conduction latencies, wrist strength, and wrist motion. These improvements were maintained three months after receiving the Graston technique to relieve pain.

Trigger point release techniques use the hands to release painful muscle points that are all too easy to find in and around literally all chronically painful body parts. 

The same study that looked at the Graston technique also used Trigger Point Release. Patients responded similarly to how they’d responded to the Graston technique and showed the same improvements.

If you have a significant build-up of muscle knots, soft tissue adhesions, or tendinopathies, it is too much to expect that exercises alone will resolve them. 

Most stubborn wrist and hand pain cases require hands-on treatment before they are truly responsive to exercise prescription. However, research does suggest that exercises can assist in improving wrist and hand function after treatment.

If there’s one thing we know about pain management, it’s that a flexible multidisciplinary treatment approach to hand and wrist pain is best, and in many cases, if stress is likely a contributing cause to your pain.

Recent research has shown that cognitive behavioural therapy (CBT) effectively treats hand and arm pain, including discrete wrist pain and idiopathic hand and arm pain. However, it’s important to note that research also suggests that cognitive–behavioural therapy is only helpful in conjunction with evidence-based physical treatments.

The Take Home

Wrist and hand pain can be an inconvenience, but there are many ways to treat it. If you’re currently experiencing this problem, we can certainly help. 

Getting to the bottom of your wrist and hand pain means finding out where exactly the pain is coming from – and precisely what is causing it.

We have a wide range of technologies, including shockwave therapy, laser therapy, Graston and trigger point release. Which, as you now know, are scientifically backed to help improve hand and wrist pain.

Contact our team today to book in for an initial consultation if you think you might be suffering from wrist and hand pain so we can get started to help you live a pain-free day.

The Take Home

Wrist and hand pain can be an inconvenience, but there are many ways to treat it. If you’re currently experiencing this problem, we can certainly help. 

Getting to the bottom of your wrist and hand pain means finding out where exactly the pain is coming from – and precisely what is causing it.

We have a wide range of technologies, including shockwave therapy, laser therapy, Graston and trigger point release. Which, as you now know, are scientifically backed to help improve hand and wrist pain.

Contact our team today to book in for an initial consultation if you think you might be suffering from wrist and hand pain so we can get started to help you live a pain-free day.

Recent Articles

Guest Blog – When Pain Persists

Guest Blog – When Pain Persists The following is a guest blog that was written by a very impressive young Vic Uni student by the name of Emily McCarthy who recently interviewed us on a health science module she is currently sitting. When pain persists                                                                                                                                     One in five New Zealanders live with chronic pain. Having […]

10 Lifestyle Factors That Impact Your Pain

10 Lifestyle Factors That Impact Your Pain

Lifestyle

Experiencing chronic pain is an ordeal, and often a multifaceted approach to pain treatment is necessary to make a significant and lasting difference.

Being aware of the lifestyle factors that influence pain may help to change how we approach our pain treatments. 

 

 

 

Sleep

Sleep

If pain interrupts our sleep, or we are too stressed to fall asleep and get enough hours of rest every night, our body is not healing and recovering like it should. If you wake up feeling like a truck hit you, addressing your sleeping problems can make a positive difference in your pain, and healing journey. 

 

 

 

 

Weight/Blood Pressure

Blood Pressure

Research suggests that people with a higher BMI are more likely to suffer chronic pain. It is unclear to why this is. Some evidence suggests that chronic pain itself leads in a maladaptive relationship to high blood pressure. On the flipside losing weight is associated with better pain outcomes. Acute pain puts the body in fight or flight response and makes us more tolerant to pain. When the pain is chronic though, higher blood pressure increases pain sensitivity

(Sacco, Meschi et al. The Relationship Between Blood Pressure and Pain). 

The role of weight gain is massively over-emphasised in clinical settings. Weight loss in and of itself is not an effective or holistic rehab plan and should only be one small part of a far more in depth, kind  and thoughtful pain management protocol. Especially if you are suffering so much pain that you can’t do the exercise needed to lose the weight. 

 

Nutrition

Nutrition

A healthy diet is an essentially part of avoiding chronic disease. Depending on the kind of pain you have, different dietary approaches are promising. Increased omega-3 intake might help with inflammatory pain. Avoiding polyamines (as found in soy and nuts) can reduce hyperalgesia; broccoli, spinach and vitamin E have a possible effect on diabetic neuropathy. Fasting shows evidence to help improve mood in pain patients who also suffer from depression. Chronic pain is associated with increased cardiovascular risk and a balanced diet helps mitigate the impact of both issues, which makes it an extremely worthwhile topic for pain sufferers. 

 

 

 

Exercise & Activity

Exercise and Activity

Certain kinds of exercise might be more useful for certain pain conditions. Personally tailored advise with relevant movements are more successful than general exercise. 

For many people with chronic pain it is important to be able to return to their preferred activities of daily living, may they be playing team sports or getting out into nature for gardening, a walk, or a multi day tramp. Many studies show improvements of mood and sleep with increased exercise, and doing what you love surrounded by friends, family and/or nature further helps with co-morbidities and perception of chronic pain. 

 

 

Smoking

Smoking

While no direct causation between smoking and pain is proven, smokers report more pain. Quitting smoking reduces the risk of cardiovascular mortality which is highly correlated with chronic pain. It’s a no-brainer. 

 

 

 

 

 

Mental Health/Stress

Mental Health and Stress

Chronic pain is closely associated with depression and anxiety – both of which effect how you perceive pain, and also make pain harder to deal with. Many chronic pain cases cannot be effectively managed without taking factors such as stress and mood, and further, depression and anxiety into consideration. 

 

 

 

 

Alcohol

Alcohol

A big lifestyle factor in pain management is the consumption of alcohol. In ancient times it has been used for its numbing effects but this is transitory and requires high doses. Nowadays it needs to be considered that it interferes with many medications for pain and creates  other co-morbitities which can worsen pain. 

 

 

 

 

 

Work/occupational factors

Work/occupational factors

Unemployed people are more likely to report chronic pain. Factors like the job market and other people’s reactions to pain are major players in the perception and persistence of pain. The fear of re-injury and needing to return to work after taking time off for injuries or pain determine the experience as well. 

 

 

 

 

Co-Morbidity

Co-Morbidity

If you suffer from other chronic conditions, such as coronary heart disease, or obstructive pulmonary disease, you are more likely to report chronic pain than the general population. One suggested mechanism is the added challenges for people with chronic pain to exercise, increasing their cardiovascular risk. Other consideration are chronic conditions turning up the volume and making pain more intense in an already challenged body, and the influence of stress and disability from other diseases. Chronic pain cannot be treated in isolation; the whole person with any other illnesses needs to be considered. 

 

 

Pain

Pain

It sounds silly but the main risk of suffering pain is pain. If you already experience pain, you are more likely to develop pain at other sites or acute pain becoming chronic. It is important to address any pains as soon as possible to avoid changes in the brain to make you more susceptible to pain. If you are willing to fight all the battles you have a far better chance of winning the war. 

Recent Articles

Achilles Tendinopathy

Achilles Tendinopathy

Achilles Tendinopathy

What is Achilles Tendinopathy?

Many people experience problems with their Achilles tendon. 24% of athletes suffer Achilles injuries at some point in their lives. As we progress in age, we are more prone to Achilles issues, and men are three times more likely to have an Achilles rupture than women. The Achilles is a common tendon, and it is one where three different muscles merge, gastrocnemius, soleus, and the lesser known plantaris. It is the strongest tendon in the body, and works a bit like a spring. When it is stretched during running as the heel hits the ground, it stores energy that is released as we push off the foot minimising the work the muscles have to do.

Causes of Achilles Tendinopathy

The most common issues that cause Achilles tendon pain are insertional tendinitis, mid-body tendinitis, and paratenonitis.

Insertional tendinitis refers to pain around the Achilles attachment to the heel bone, the calcaneus.

Mid-body tendinitis affects the Achilles tendon further up, closer towards the calf muscles.

The paratenon is a thin sheet of elastin rich cells surrounding the tendon, bundling the tendon collagen fibres into a unit that still allows movement in between.

This is where paratenonitis occurs. When it gets inflamed, excess fibrin causes adhesions. In a chronic condition, this is a form of scar tissue, less of the healthy collagen type I and too much scar-like collagen III.

How Can I Help Achilles Tendinopathy?

Traditional management of Achilles pain includes reducing activity, non-steroidal anti-inflammatory drugs, physiotherapy (eccentric stretching exercises, progressive tendon loading), change of aggravating footwear.

Extracorporeal Shockwave Treatment

Extracorporeal shockwave treatment has proven to reduce pain by 60% in persistent tendinopathies without the side effects and risks of surgery. Nevertheless, surgery does have its place in extreme circumstances and is the recommended form of treatment if the tendon is ruptured by at least half. Surgical Therapy has about 80% of success but also depending on the study, up to 40% complications.

Early treatment of Achilles tendon pain promises better outcomes.

Extracorporeal shockwave was initially used to break up kidney stones and has since shown impressive outcomes for musculoskeletal complaints, including achilles and other tendinopathies. It is also commonly used to treat tennis or golfer’s elbow, rotator cuff tendinopathy, plantar fasciitis, and Morton’s neuroma . Shockwave therapy improves blood flow to the painful area, breaks up adhesions, facilitating the natural healing process. Another affected pathway is on the pain perception through activating serotoninergic systems increasing the pain threshold on a chemical level. See Effectiveness and Safety of Shockwave Therapy in Tendinopathies here

Final Thoughts

In clinical practice, as a rule of thumb, we believe the longer you leave it and put up with your pains and niggles, the longer it will take to get rid of them. Seeing an expert early, and not giving up if the physio exercises did not get you the promised result will more than likely eventually get you over the finish line.

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Brief Reflections On Achilles Tendon Pain

Brief Reflections On Achilles Tendon Pain

Achilles Tendonopathy

Many people experience problems with their achilles tendon. 24% of athletes suffer achilles injuries at some point in their lifes. As we progress in age, we are more prone to achilles issues, and men are three times more likely to have an achilles rupture than women.

The achilles is a common tendon, where three different muscles merge, gastrocnemius, soleus, and the lesser known plantaris. It is the strongest tendon in the body, and works a bit like a spring. When it is stretched during running as the heel hits te ground, it stores energy that is released as we push off the foot minimising the work the muscles have to do. 

The most common ailments are insertional tendinitis, mid-body tendinitis, and paratenonitis.

The first one refers to pain around the achilles attachment to the heelbone, the calcaneous. Mid-body tendinitis affects the achilles tendon further up, closer towards the calf muscles.

The paratenon affected in the latter is a thin sheet of elastin rich cells surrounding the tendon, bundling the tendon collagen fibres into a unit that still allows movement inbetween. Tenosynovitis and tenovaginitis fall in this category. When it gets inflamed, excess fibrin causes adhesions. In a chronic condition, this is simplified scar tissue, less of the healthy collagen type I and too much scar-like collagen III. 

Conservative management includes reducing activity, non-steroidal anti-inflammatory drugs, physiotherapy (eccentric stretching exercises, progressive tendon loading), change of aggravating footwear. 

Extracorporeal shockwave treatment has proven to reduce pain by 60% in persistent tendinopathies without the side effects and risks of surgery. Nevertheless, surgery has its place and is the recommended form of treatment if the tendon is ruptured by at least half. Surgical Therapy has about 80% of success but also depending on the study, up to 40% complications. 

Early treatment promises better outcomes. Extracorporeal shockwave was initially used to break up kidney stones, and has since shown impressive outcomes for musculoskeletal complaints, including achilles and other tendinopathies, and various other pains, such as but not limited to tennis or golfer’s elbow, rotator cuff tendinopathy, plantar fasciitis, and Morton’s neuroma (https://meridian.allenpress.com/japma/article-abstract/106/2/93/151426/Extracorporeal-Shockwave-Therapy-in-Patients-with?redirectedFrom=fulltext).

It is thought to improve blood flow to the area, and break up adhesions, facilitating the natural healing process. Another affected pathway is on the pain perception through activating serotoninergic systems increasing the pain threshold on a chemical level. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029898/?report=reader#!po=36.9565)

It is a safe treatment, even helping in the treatment of cancer patients. (https://link.springer.com/article/10.1007/s00520-019-05046-y) 

In clinical practise, as a rule of thumb we believe the longer you leave it and put up with your pains and niggles, the longer it will take to get rid of them. Seeing a specialist early, and not giving up if the physio exercises did not get you the promised release, will have better – and faster – outcomes.

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Foot Pain – Plantar Fasciitis –  Back Pain – The Scar Tissue Connection

Foot Pain - Plantar Fasciitis -  Back Pain - The Scar Tissue Connection

Back Pain

Gut Bacteria & Health… What?

This article is about resolving chronic mechanical pain, not about the gut. Bear with me however, because it is useful to reflect on the way our knowledge our bodies progresses. 

It seems like only a scientific moment ago we had virtually no awareness of the importance of the gut biome to our health. In fact, we have only been aware of the existence of microscopic life itself for a handful of generations, and aware of the importance of gut bacteria for a few short years. In a handful of years we have watched our general awareness of gut bacteria’s significance shift from virtually zero to common knowledge. It is now common knowledge that the health of the lifeforms in our gut do not only dictate whether we have a tummy upset but are implicated as playing a role in everything from Alzheimer’s to eczema.

The ultimate value of any development in our understanding of health is determined by whether we can actually use that information to become healthier and stronger. The dawning of our awareness of the ecosystem within our gut most definitely has value in this respect. It is early days but there are a rapidly growing number of us finding we are able to use this awareness to improve our health, mood, wellbeing and quality of life through what we choose to eat… and let’s be honest ‘what we don’t eat’. 

The basic realisation we have had about the gut ecosystem may yet prove to form somewhat of a ‘unifying theory’, tying together many of the problems we suffer within our digestive and nervous systems. Somewhat astonishingly we are learning that we rely on the gut bacteria to manufacture the neurotransmitters that are used in the brain for example. It’s a lot of understanding in a very short space of time, understanding that we can put to good use.

Weakness, Scar Tissue & Chronic Pain

Wouldn’t it be wonderful if there was some similar (to the gut bacteria discovery) unified understanding of what caused our pandemic of perpetual back pain, plantar fasciitis, osteoarthritis pain, knee pain, hip pain, bursitis etc. Some new model of understanding that we could put into action and have more of us get out of pain. It just so happens that I believe there is.

I believe that there is a binary theory that holds together the majority of our aches and pains. In the same way that the food/bacteria combination dictates so much of our health there are a  pair of interconnected factors that drive much of our physical pain. Muscle weakness & scar tissue.

It’s a combination of muscle weakness and microscopic scar tissue that drives a significant number of the stubborn aches and pains that we suffer with. 

The science is most definitely ‘in’ on the weakness topic. An absence of strong, well coordinated muscle contractions around joints in the body is known to be a major contributor in many chronic pain conditions. This is the truth we are referencing when we feel stubborn pain in our back and say to ourselves ‘I really need to work on my core’. 

The confounding fact about weakness however that you often don’t get the kind of results you might hope for when you instruct chronic pain sufferers to fix themselves with strength exercises. The fact that so many fail in this endeavor points clearly to the need for recognition and management of other factors.

When the bodies soft tissues are subjected to repetitive strain, they can over time lay down scar tissue as a means of reinforcing and protecting themselves. In the same way that inflammation can run riot and cause problems for the body, scar tissue can cause adhesions that inhibit movement and create additional pain and irritation of tissues.

The most surprising thing about this learning for most of us is the fact that scar tissue can build incrementally. Most of us have been conditioned to believe that scar tissue is only laid down at times of major trauma. The truth is however that tracts of microscopic scar tissue can build up over time and they are a major cause of pain.

For many chronic pain sufferers there is a seminal moment where they find that the back pain/shoulder pain/neck pain they have been working on has responded well to rehab work but that they are still fundamentally in pain. For these hard working and motivated individuals who have truly had enough there is a mixture of relief at having resolved a bunch of pain, mixed with frustration that the strength/gym/rehab work was not the whole job.

There are many possible reasons why rehab can fail to resolve the entirety of a chronic pain condition. Incorrect exercises and/execution of exercises can cause rehab to fail. Undue amounts of emotional stress can perpetuate pain in a way that prevents rehab from taking hold. Stiff joints that need to mobilized can cause pain to linger long after muscles have been strengthened. Muscles that are simply too stressed and irritated to respond to exercises can prevent rehab from working. I am however going on record here and saying that scar-like adhesions are the number one reason why valid rehab protocols fail. 

Bringing It All Together

The key to great pain management is flexibility. Most stubborn pain is far too complex and layered for a ridged approach to its management. A stubborn pain complaint in your knee, ankle, hip or back for example almost certainly involves the joint, the muscle, the ligament, the fascia, the tendon and the central nervous system. Pain that has set up camp for years ultimately impacts all of the tissues in the area and even neighboring areas too. A whole box of tricks is often required to make meaningful and lasting change to chronic pain.

In the instance of the scar tissue/muscle weakness combo which underpins so many stubborn pains, a 2 pronged attack is warranted. Firstly a consistent and focused clinical attack on the scar tissue needs to be undertaken. Treating scar tissue like this basically involves heaps of weekly visits to a clinician who knows how to break it up using a combination of blunt scraping tools and deep joint stretching. Over time the scar tissue breaks up and remodels usually leaving you in a lot less pain. Once this process is complete or at least well under way a careful and extremely specific strength routine must be developed to target the primary muscles that have weakened as part of the condition.

Once there is a widespread understanding of these principles (as there now is with gut flora) we will have a breakthrough in the amount of chronic pain we suffer as a culture. The combination of strength work and scar tissue remodeling is not enough to make us all pain free or save the world; but it will make a huge difference I promise you. And it is entirely possible that it will be enough to make you totally pain free.

For many pain sufferers merging strength work that targets the right muscles in the right way with deep release of scar tissue adhesions is the game changer they had been looking for. It’s a beautiful thing. There is nothing quite like the feeling you get when you realise you are finally getting better!

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