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Pain Treatment-Wrist Pain

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Anatomy of the Wrist

The wrist is a critical joint of the upper limb. Wrist pain is significantly debilitating as it restricts fine movements of the hands, such as washing dishes, cooking and even writing or typing! The chances of injuring your wrist during a fall are very high, as we use our palms and wrists to support ourselves during a fall. Aside from that, wrist pain can also be caused by compression of underlying nerves, due to injury or diseases of nerves. Therefore it is important to protect the wrist joint to perform routine tasks.

The wrist joint is a compound joint as it is made up of 8 bones, each of which is connected to each other with ligaments. The bones of the wrist joint are also termed carpal bones and are set in a proximal and distal row. The proximal row is made up of Scaphoid, Lunate, Triquetrum and Pisiform bones, while the distal row is made up of Trapezium, Trapezoid, Capitate, Hamate. The bones of the wrist joint are also attached to the radius and ulna bones in the forearm proximally, and the bony framework of metacarpals of the palm distally. The attachments are reinforced by ligaments and the joint capsule. Trauma can cause damage to any of these ligaments, or cause a fracture of the underlying bones in the wrist.

A cavity is formed between the Hamate, Capitate, Trapezium and Trapezoid bones and overlying muscle tendons, termed the carpal tunnel. The Carpal Tunnel is a space through which structures deep to the palm pass, primarily the median nerve and tendons of muscles supplying the palm. Superficial to the carpal tunnel lies the ulnar nerve, which supplies the medial one and a half of the hand and digits. Any injury to the wrist can result in compression of the carpal tunnel and underlying structures, resulting in numbness and contractures.

What causes wrist pain?

Wrist pain can be caused by multiple reasons, such as injuries, arthritis and other medical conditions associated with nerve compression and joint pain.

Injuries:

  • Sudden impact on the wrist, such as falling on your outstretched hand. This can cause a sprain, torn ligaments, and even fractures. Since the bones of the wrist are small, fractures may not show up on X-rays immediately.
  • Repetitive movement of the wrist, such as playing tennis, playing the cello or even prolonged driving can cause stress fractures, and inflammation of the joint capsule.

Arthritis:

Rheumatoid Arthritis is an autoimmune disease, in which cells from the immune system are deposited in the joints, destroying the bone and joint capsule. More common in women, Rheumatoid Arthritis affects joints of the fingers but can affect the wrist as well, causing deformity and pain.

Other Diseases:

  • Carpal Tunnel Syndrome is due to increased compression on the wrist, due to edema or thyroid disease, causing compression of the median nerve and muscles. This can also present with pain and functional loss.
  • Ganglion Cysts are soft tissue cysts which appear on the dorsum of the hand. Smaller ganglion cysts cause more pain than larger ones.

How do I know my wrist is injured?

If a joint is injured due to fracture or torn ligament, you will probably experience mild to moderate pain on routine activity, such as cooking or typing. You will also experience a restricted range of movement, as well as note swelling or redness around the joint. If the underlying nerves are being compressed, you will experience numbness (loss of sensation) and a tingling feeling in your palm. Carpal Tunnel Syndrome has an individual pins and needles sensation in your palm, particularly at night. All these symptoms require consultation with a physician, who will prescribe investigations such as x-rays to confirm the cause of wrist pain.

 

What can I do to help relieve the pain?

Not all wrist pain requires medical intervention. Minor sprains and swellings can be treated with ice packs, or over the counter relaxants and pain relievers.

Try giving the joint some rest, and reduce activities with maximal joint involvement. If the pain persists after 3 to 5 days, you may have to wear a splint or cast, allowing the wrist joint to heal.

Physiotherapy is also a non-invasive method of pain reliever and common repair, allowing the joint to heal with repetitive movement of muscles. Your first consultation for pain relief may not necessarily involve a physician or surgeon - a physiotherapist can also guide you regarding pain relief for acute joint pain.

Severe pain in a joint which is compromising its blood supply or nerve function has to be treated with surgical management. Fracture of multiple bones of the wrist and carpal tunnel syndrome have shown no efficacy with conventional medical therapies, and are thoroughly treated by surgery only.

What can I do to help relieve the pain with a TENS unit?

A significant number of patients now opt for electrode therapy for pain relief. Termed electroanalgesia, it uses a small current applied to the pressure point, which is transmitted along the nerve fibers to the surrounding area. The current is delivered by electrodes placed on the field of pain and connected to a Transcutaneous electrical nerve stimulation (TENS) device. The current relieves pain by multiple mechanisms, such as:

  • A release of biological pain modulators such as endorphins, enkephalins, and dynorphins,
  • Direct inhibition of pain nerve fibers,
  • Presynaptic inhibition of spinal tracts which transmit pain sensations to the brain.

 The advantages of TENS electrode analgesia is that it is non-invasive and easy to administer, does not need adjunctive drug therapy and is a safe and economical treatment. It is used for relief of chronic back pain, post-surgical pain and is now being administered to women during labor for pain relief.

Healthmate Forever provides high-quality TENS and PMS units for commercial and home use. Available in a variety of prices, sizes and even wireless devices, TENS devices deliver a small charge to the muscle and nerves, stimulating an impulse. These generated pulses can block the pain nerve fibers, providing relief from pain. The current is delivered with electrode pads, provided with the devices, which have to be placed over the painful joint. These pads do not require any gel or cream to stick and can be used for a prolonged period.

If you are considering buying a TENS device for pain relief at home, you can check our products at healthmateforever.com and find a device suited to your needs and budget.

Wrist pain electrode placement

TENS pain relief works by stimulating the muscles and nerves surrounding the area of pain, so electrode pads have to be placed in the field of pain. You will need a consultation with a physician to locate the correct area of placement of electrodes, after which you can apply these at your home. For wrist pain, the electrodes have to be placed on the dorsum of the hand and the forearm, just below the wrist joint.

Healthmate Forever is dedicated to providing quality pain management products. Catering to multiple medical problems, our products are affordable and easy to operate. So allow yourself pain relief from chronic ailments with TENS and PMS units by Healthmate Forever.

References:


http://wristtryst.weebly.com/bones.html


http://nhi.edu/event/advanced-neuromuscular-therapy-program-sampler-carpal-tunnel-syndrome-2


http://www.hoanmy.com/danang/hoi-chung-ong-co-tay


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