In last month’s article we spoke about carpal tunnel syndrome, but not every-one’s wrist pain is down to this. The wrist is one of the most complicated joints in the body as it consists of eight small bones, known as the carpal bones. These bones bridge the gap between the end of your forearm bones (the radius and ulna) and the bones of your hand. They are lined up in two rows, and their movement is controlled by over 30 ligaments1.
The wrist can undertake a high number of movements because it contains so many small bones, however if these bones are not moving well this can lead to problems. Pain can be experienced anywhere in the wrist but is more common in certain areas, for example many people who repeatedly extend their wrist in work, report pain on the back of the wrist2.
There are lots of different things that can be the cause of wrist pain including osteoarthritis, gout, fracture, repetitive movements of the wrist, a lack of good quality movement of the carpal bones, and injury to the ligaments of the wrist. Pain may even be referred to the wrist from another area of the body.
Although there are many reasons for wrist pain, one carpal bone in particular is more often the guilty party; the lunate bone. It is central to most wrist movements and is thought to be responsible for up to 10% of all wrist injuries3. Its important position in wrist movements leaves it more vulnerable than the other bones for subluxation or dislocation. This is particularly common amongst gymnasts and weightlifters2.
What can be done about it?
A lot can be done to help alleviate wrist pain, and in this instance prevention is better than cure. This is because wrist osteoarthritis is associated with previous injury to the ligaments of the wrist which then affects the carpal bones1.
Injured ligaments mean that the first row of carpal bones do not move properly and this in turn causes wear and tear in the joint. Even once osteoarthritis has established itself in the wrist joint, it can still be relieved through gentle mobilisation and stretching carried out by an osteopath.
A lot can be done to help support the wrist in day to day life too, and if you spend a lot of time carrying heavy loads or putting a lot of stress through your wrist it may be well worth investing in a good wrist support.
Pain and injury to the wrist can be both subtle and complex as there can be a lot of things going on, and as a result, working out what is behind the problem requires a detailed examination and case history. In the clinic I find that a lot of people coming in with wrist pain are in occupations that involve a lot of repetitive wrist movement, such as answering the phone or typing. I examine and test the wrist as well as joints and muscles further afield in order to work out where the pain is coming from, and I can then treat the problematic muscles and joints. Often when the pain is as a result of unhappy carpal bones I gently mobilise and stretch the joint which encourages good quality movement, better blood flow and therefore encourages healing. I also work in conjunction with a number of movement therapists in order to help you keep the problem at bay with exercises that you can do at home.
For further information or to book an appointment call Rosie on 07540 453280 or visit www.swanseabodykinetics.co.uk
- Laulan, J., Marteau, E., Bacle, G. (2015) Wrist osteoarthritis Orthopaedics & Traumatology: Surgery & Research 101 S1–S9
- Sung-Dae Choung, A., Oh-Yun Kwon, B., Kyue-Nam Park, A., Si-Hyun Kim, A., Heon-Seock Cynn, A. (2013) Short-term effects of self-mobilization with a strap on pain and range of motion of the wrist joint in patients with dorsal wrist pain when weight bearing through the hand: A case series Manual Therapy 18 568-572
- Meldon, SW., Hargarten, SW. (1995) Ligamentous injuries of the wrist. J Emerg Med 13 217-225