Within NTIMS, we provide specialist assessment and management of a variety of wrist and hand problems.
These problems can be secondary to injury, ageing, doing too much or too little. At times, there will not be an obvious direct cause.
Symptoms may include pain, swelling, stiffness, pins and needles and/or numbness. Often it is not necessary to seek input from a health professional. Symptoms usually start to feel better within six weeks.
- Wrist and hand pain is common without any damage to joints.
- Even if you have had wrist and hand pain for a long time, it can often improve with the right management – consistency is key!
- Your wrist, hand and fingers can become healthier and stronger with regular movement and exercise.
- X-ray and scans are not usually needed to diagnose wrist and hand pain.
- X-ray and scans are not able to tell us how much pain you are experiencing.
- X-rays and scans often will identify normal age related changes which are common finding, even in those that do not have wrist and hand pain and this will often not change the management of the condition.
- X-rays and scans are best used when there is suspicion of serious injury, ie, broken bone, or conditions such as cancer or infections.
- Keeping moving is the best thing to do to help recovery and return to usual function.
- Within the first 48 hours, it may be necessary to ease back a little on usual activities and ‘relatively rest’ the painful areas.
- Try not to stop using the area and try to carry out a few movements every hour to prevent stiffness.
- After 48 hours, you may wish to increase the use of your hand gradually.
- Most people will find keeping mobile ‘little and often’ is beneficial, as our muscles, nerve, and joints respond well to movement. This is needed to keep them healthy.
- Keeping time off work to a minimum has been shown to have better outcomes for recovery. It is not always necessary to be pain-free before returning to work.
- You may wish to avoid recreational activities or sports which involve heavy lifting or contact until your pain has reduced and your movement has returned.
- Usually, keeping time off work to a minimum has been shown to have better outcomes for recovery and it is not always necessary to be painfree before returning to work.
- You may wish to avoid recreational activities or sports which involve heavy lifting or contact until your pain is lessened and your movement has returned.
- Seek advice from a health professional if you have had an injury and the wrist or finger looks out of shape
- If you are unable to move the wrist, fingers or thumb at all
- If you develop pain, redness, swelling and stiffness to the small joints of the hand, taking 30 minutes or more to settle
Osteoarthritis
Information on what osteoarthritis is, how it can be diagnosed and management strategies that we can utilise to help you manage your symptoms from self-care to surgery - https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-of-the-hand-and-wrist/
Basal thumb arthritis
Carpal tunnel syndrome
This is a helpful decision aid to help you with decisions about your carpal tunnel syndrome. It includes information about the condition and possible treatments - https://www.england.nhs.uk/wp-content/uploads/2022/07/Making-a-decision-about-carpal-tunnel-syndrome.pdf
NHS carpal tunnel advice - https://www.nhs.uk/conditions/carpal-tunnel-syndrome/
Carpal tunnel advice and exercise (CSP) - https://www.csp.org.uk/system/files/2_carpal_tunnel.pdf
Carpal tunnel exercises (American Orthopaedic Society) - https://orthoinfo.aaos.org/globalassets/pdfs/a00789_therapeutic-exercise-program-for-carpal-tunnel_final.pdf
De Quervain's tenosynovitis
Duputyren's disease
This is a helpful decision-making tool to help you with decisions about your Dupuytrens disease. It includes information about the condition and possible treatments - https://www.england.nhs.uk/wp-content/uploads/2022/07/Making-a-decision-about-Dupuytrens-contracture.pdf
Ganglion cysts
Wrist ganglion advice (NHS Scotland) - https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/ganglion-cyst
Terminal joint arthritis
Trigger finger and trigger thumb
Advice on trigger finger (BSSH) - https://www.bssh.ac.uk/_userfiles/pages/files/Patients/Conditions/Elective/trigger_digit_leaflet_2016.pdf
Trigger finger advice and exercise (Durham NHS) - https://www.cddft.nhs.uk/media/795788/trigger%20finger.pdf
Wrist active exercises
Chelsea and Westminster Hospital NHS Foundation Trust (chelwest.nhs.uk)
Thumb active exercises
Chelsea and Westminster Hospital NHS Foundation Trust (chelwest.nhs.uk)
Active finger exercises
Chelsea and Westminster Hospital NHS Foundation Trust (chelwest.nhs.uk)
Help and support
- If after six weeks you have tried the advice and exercise suggested and your symptoms haven’t improved, a self-referral to NTIMS may be beneficial.
- Click here for self-referral