Don’t take wrist pain lightly! Our lives have become increasingly technology-centric, and this puts the vulnerable wrist joint at great risk for repetitive strain injury (RSI). Even nontech activities like riding a bike, playing a musical instrument, knitting or gardening and other hobbies can make your wrist hurt all the time—and many people don’t realize just how debilitating wrist pain can be. They don’t take their symptoms seriously early on, when they could do something about them—and then the condition could become permanent.
Another mistake: Assuming that any chronic wrist pain is carpal tunnel syndrome and treating it that way. It’s often not—and in that case, treatment for carpal tunnel won’t help you and can make matters worse. Here’s how to know what’s going on with your wrist…
UNDERSTANDING WRIST PAIN
Carpal tunnel syndrome is only one type of issue that can affect the wrist. It is (or should be) a very specific diagnosis involving compression of the median nerve at the wrist (the nerve itself starts in the neck and travels all the way down the arm to the fingers—its branches feed through the thumb, index and middle fingers and half of the ring finger). If you have carpal tunnel syndrome, you might experience not only pain in the thumb and index, middle and ring fingers as well as the hand but also numbness and tingling in your fingers, and symptoms might persist all day and even wake you up at night.
But other ailments could be causing your wrist pain. For instance, pain on the thumb side of the wrist, especially when you make a fist, twist or grasp an object forcefully, could mean de Quervain’s tenosynovitis, an inflammation of the tendons that straighten the thumb and move the thumb away from the palm. Another possibility is ulnar tunnel syndrome, sometimes called Guyon’s canal syndrome, which happens when the ulnar nerve (running from the neck down into the hand) is compressed at the wrist. This syndrome affects half the ring finger and the pinky, can make them numb and tingly, and can result in weakness in your hand grip or finger pinch.
WHEN TO SEE A DOCTOR
If you have numbness, tingling, swelling, weakness and/or pain in your hand or wrist that either persists for longer than a month or that repeatedly comes and goes, don’t assume it’s carpal tunnel syndrome…don’t assume you can treat it with a drugstore splint or other device marketed for carpal tunnel syndrome…but instead, get yourself to a doctor for a real diagnosis. If you don’t, you may miss the opportunity for a full recovery.
See a hand surgeon, a physician who has specialized training in the evaluation and treatment of hand, wrist and arm conditions. But don’t be afraid that he or she will automatically recommend surgery. Hand surgeons are hand doctors first, and they don’t perform surgery on everyone they see—far from it. Occupational medicine doctors or physiatrists can also diagnose RSI.
When surgery isn’t necessary, healing will most likely involve working with an occupational or physical therapist, such as a certified hand therapist (CHT). You want a health-care professional with intricate knowledge of hand anatomy and hand conditions and your type of injury in particular. (These therapists can also help you postoperatively.) To determine the exact hand-therapy program you need, the therapist will do a thorough examination and perform tests appropriate for your situation.
What about the original cause of the injury? Your doctor and hand-therapy specialist will discuss with you which kind of movements provoke symptoms, how to limit these motions, how to reduce the pain…and then stay as symptom-free as possible. (You can find a certified hand therapist through the American Society of Hand Therapists.)
BE YOUR OWN BEST HEALER
What you do on your own, not just in therapy sessions, is also an important part of your recovery, and nutrition, including supplementation, can play a big role in success. Robert E. Markison, MD, a hand surgeon and clinical professor of surgery at the University of California, San Francisco, often recommends these nutrients to his patients…
- Liquid vitamin D3, which is more easily absorbed by the body than D3 in capsule form, to maintain musculoskeletal health. A periodic blood test can help you maintain your blood vitamin-D level between 50 and 80 ng/mL.
- Vitamins B6 and B12, preferably from food. These vitamins actively support central and peripheral nerve system function. Supplemental vitamin B6 can cause neuropathy (nerve pain) if you take amounts over the safe upper limit of 100 mg per day (the recommended daily allowance is only 1.3 mg), but high intake of this vitamin from food has not been shown to have adverse effects. Foods with generous amounts of B6 include chickpeas, chicken breast, yellowfin tuna and bananas. The recommended daily allowance of vitamin B12 is 2.4 µg. Foods high in B12 include beef liver, fish, meat, poultry, eggs and milk. Your doctor can monitor your levels of both vitamins with a blood test. For B6, the healthy range is between 5 and 50 µg/L, and for B-12, it’s between 200 and 900 ng/mL. Dr. Markinson suggests aiming for at least the middle of the ranges.
- Stay well-hydrated. Microcirculation carries nutrients and oxygen to the cells and takes away waste. Regularly drinking water also ensures that you get up periodically to use the bathroom—sometimes that’s the only break from computing that people get.
These ergonomic pointers can help, too…
- As much as possible, use a voice-recognition program, not a keyboard or touch screen, for computer work. For texting, use voice-to-text, not your thumbs.
- When you must type at your computer, use a split-and-tilt keyboard. It allows you to adjust the keyboard to fit your body, rather than having to contort yourself to a molded plastic keyboard. Also, use a light touch—don’t pound on the keyboard.
- If you use a mouse, alternate it between your left and right hands to balance out the workload.
- Sit tall and avoid a forward-head posture. Relax your shoulders and keep your arms near your torso.
- Keep your hands warm to improve circulation, important for avoiding RSI.
A note about pain relief medication: Discuss options with your care providers before taking anything so that you don’t mask symptoms and jump back into activities before you’ve truly healed.