Common Repetitive Strain Wrist Injuries and What You can do About Them
You use your hands almost constantly. So it's no surprise that your wrists are highly susceptible to Repetitive Stress Injury (RSI). RSIs are nothing new, as they have actually been documented as far back as the 18th Century. However, the use of modern technological devices such as computers and gaming equipment have made them all the more common. Below are some of the most common Repetitive Stress Injuries affecting the wrist, along with the recommended treatments for them.
Carpal Tunnel Syndrome
Your wrist contains a narrow passageway known as the carpal tunnel. This passageway houses the median nerve, which begins in the upper arm and extends to the palm of your hand. The tendons that allow your fingers to bend are also found inside the carpal tunnel, and are surrounded by tissue known as synovium.
Overuse can cause the synovium to swell, causing pressure on the median nerve. The tunnel itself might also narrow due to arthritis or a wrist fracture. Either way, moving your wrist can become difficult, and could lead to a numbness and tingling in your fingers.
Carpal Tunnel Symptoms
Some symptoms that might indicate you have carpal tunnel syndrome are:
- An itchy feeling in the palm of your hand
- Numbness and tingling, particularly in the thumb and fingers
- Feeling as though your hand or wrist is asleep
- Decreased grip strength
- An inability to form a fist
Carpal tunnel can leave you unable to feel pain or distinguish hot from cold. Accordingly, it could be potentially dangerous, meaning that you should not put off treatment.
Treatment for Carpal Tunnel Syndrome
Doctors normally advise wearing a wrist splint or brace, and limiting the number of repetitive movements you make. Alternate hot and cold therapy to eliminate pain and reduce swelling. Surgery is often needed to reduce pressure on the median nerve. Following surgery, you could require physical therapy to fully regain the use of your hand again.
Cubital Tunnel Syndrome
Your ulnar nerve is also known as the "funny bone", and sits along a groove inside your elbow. When this nerve becomes damaged, it can lead to pain and tingling in the wrist, hands, or fingers. This can lead to cubital tunnel syndrome, which is sometimes referred to as ulnar neuropathy.
Any activity that requires constant use of the elbow can lead to cubital tunnel syndrome. As such, it's a very common sports injury among tennis and baseball players. With ulnar neuropathy, you may:
- Be unable to bring the little finger and thumb together
- Have difficulty picking up or holding objects
- Notice tingling in the ring and little fingers
- Have persistent numbness and pain in your elbow
Tests and Treatment for Cubital Tunnel Syndrome
To detect cubital tunnel syndrome, your physician may order an electromyography. An electromyography is performed to check your nerves' responses. Electrodes placed near precise nerves can measure how well they are working, as well as determine the extent of damage.
If cubital tunnel syndrome is confirmed, you should not put undue pressure on your elbows. Do not lean on them, and wear elbow pads when performing activities that might cause stress to your funny bone. Avoid overworking your elbow, even if that means taking a break from sports for the time being.
More serious cases could require surgery to decompress the ulnar nerve or move it to a location where it is better protected. Surgery is often followed by physical therapy to help you learn to fully use your elbow again.
Radial Tunnel Syndrome
Tendons and muscle create the radial tunnel, which sits at the outside of your elbow. The radial nerve-one of the three main ones in your arm-runs directly through the radial tunnel. When that nerve becomes damaged or inflamed, the result can be radial tunnel syndrome.
Radial tunnel syndrome is common among factory and construction workers, particularly those who repeatedly do heavy lifting. Regularly pushing, pulling, or twisting the arm can lead to this condition as well.
Signs and Symptoms of Radial Tunnel Syndrome
With radial tunnel syndrome, the bony part of your elbow may feel tender or sore. This pain may become worse whenever you twist or otherwise move your wrist. You might also have:
- A loss of grip strength
- Trouble fully extending your wrist
- Dull, aching pain in your wrist or forearm
- Stabbing or piercing pain when flexing or extending your fingers
- Muscle weakness in the wrist
Difficult to Diagnose
There are no specific tests designed to help doctors diagnose radial tunnel syndrome. Instead, they must rely on your answers to specific questions concerning the location of pain and the presence of other symptoms. Occasionally, other tests might be performed in order to rule out other conditions. This can include x-rays, ultrasounds, or Magnetic Resonance Imaging (MRI).
Treatment for Radial Tunnel Syndrome
Conservative treatments are recommended first to alleviate pressure on the radial nerve. This normally means fully resting the affected arm until the nerve has returned to normal. You might also perform certain stretching exercises and take an over-the-counter medication such as ibuprofen.
Surgery may be recommended if your condition does not improve within six weeks. During surgery, compressive tissues are cut and divided to make more room inside the radial tunnel. This alleviates pressure on the radial nerve, and in some cases may result in the tunnel itself growing larger.
De Quervain's Tenosynovitis
Tendons run from your wrists to your thumbs, and allow you to grab things. Repeated use of your wrists, fingers, and thumbs can lead to a condition known as De Quervain's tenosynovitis. This condition is especially common among chronic texters or those who spend hours each day playing video games.
If you have De Quervain's, you may experience symptoms such as:
- Pain when moving or flexing your thumb
- An inability to grasp things
- Feeling as though your thumb is sticking
- Swelling near the base of your thumb
Diagnosing De Quervain's Tenosynovitis
De Quervain's tenosynovitis is relatively easy to self-diagnose at home, simply by performing what is known as a Finkelstein Test. To perform this test:
- Fold the affected thumb into the palm of your hand
- Close your fingers down over top of your thumb
- Bend your wrist toward your pinkie finger
If you notice pain in your wrist while performing these motions, then you likely have De Quervain's tenosynovitis.
Treatment for De Quervain's
With De Quervain's tenosynovitis, it's imperative to limit the use of your thumb as much as possible. Corticosteroid injections are often recommended to reduce swelling in your tendon's protective sheath. Over-the-counter anti-inflammatory medication may be used as well. With conservative treatment, most symptoms should dissipate within four to six weeks.
Sometimes referred to as "trigger finger", stenosing tenosynovitis is a condition that results in one of your fingers becoming locked in a bent position. This is normally your index (or trigger) finger, which can become stuck in the same position it would be in if you were firing a gun.
Stenosing tenosynovitis is caused by an inflammation or irritation of the tendon sheaths inside your fingers. Repetitive stress can cause the tendon sheaths to thicken or form nodes that inhibit movement.
Although it is called trigger finger, it is not limited to only those who shoot. In fact, anyone who regularly performs work that requires them to grip or bend their fingers repeatedly can become affected. It is often seen in crochet enthusiasts as well as gamers.
Trigger Finger Symptoms
Those with trigger finger normally have some very distinct symptoms, including:
- Fingers that click or lock into place
- Clicking noises in the joint surrounding the finger
- Being unable to fully straighten a finger
- Bumps or nodules at the base of a finger
- Hot or inflamed joints
Splints are very useful at treating cases of stenosing tenosynovitis. You may need to wear a splint 24/7, for about six weeks, including when you sleep. During this time, you should severely limit the use of the affected hand, wrist, and finger. Do not try to forcefully straighten your finger, as this could result in further damage that would require surgery to correct.
Adhesive Capsulitis of the Wrist
The wrist joint capsule consists of an inner and outer layer. The inside layer contains a synovial membrane along with synovial fluid that lubricates the joint. On the outside are ligaments that attach to the radius, ulna, and carpal bones.
Capsulitis involves inflamed ligaments, and can actually occur anywhere on the body. When found in the wrist, it is most often due to overuse from playing video games or texting. With capsulitis, you may notice a limited range of motion, and find it difficult to perform your usual activities.
Most instances of adhesive capsulitis of the wrist can be alleviated through rest and oral anti-inflammatory medication. More invasive treatments such as surgery are rarely ever required.
Help for Repetitive Strain Injuries
Repetitive Strain Injuries of the wrist can take on numerous forms, many of which can be helped by the use of certain braces and supports. Take action now to alleviate further damage and reduce the need for surgery.