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.
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.
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.
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.
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.
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.
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.
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.
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.
Pain is a symptom. Symptoms are the feedback that the body generates when it faces problems with its delicate internal balance (homeostasis). Without symptoms like pain, thirst, nausea and fevers, it would be very difficult for us to maintain a healthy body in the same way that it would be hard to drive a car safely with no dashboard display.
John is one of those rare gentlemen who has continued to play competitive soccer well into his late 50s. He is in really good shape, which you need to be to play football at that age—good shape except for his left leg. His left leg is not in good condition at all. In fact, once you get to know his left leg a bit better, it becomes apparent that it’s miraculous that he’s able to run at all, Let alone the type of running required to play competitive soccer against younger men.
9 Causes Of Wrist And Hand Pain And How To Treat Them
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