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Self help resources - Wrist and Hand

Please self-refer to be assessed by a Physiotherapist if you:

  • Have had recent trauma to your wrist or hand and have a significant pain or loss of movement/strength
  • Constant day & night pain that you cannot settle
  • Persistent pins and needles or numbness in the hand and fingers
  • Your symptoms are worsening and are not improving despite following advice below over the course of six weeks.

What can I do to help?

The hand and wrist is a very complex area comprising of many structures.  Pain is common but can be self-managed really effectively following some simple advice and exercises.  If you are struggling with your pain, the following initial advice should help you to get started:

Pain relief:  Basic painkillers (like paracetamol) or non-steroidal anti-inflammatory drugs or gels, (such as ibuprofen) are cheap and easily available over the counter without the need for prescription.  These can be very effective as they lessen your discomfort and importantly allow you to keep your wrist/hand moving.  However, do not use them for more than 2 weeks without seeking medical advice and check for possible contraindications.  If you are currently taking any form of medication it is advisable to consult your GP or pharmacist before taking additional pain relief.

Heat or Ice: Heat is often useful for easing pain using a wheat pack or soak in warm water.  Use a heat pack for 15-20 minutes at a time and repeat several times a day as necessary.  However, if you have had a recent injury or flare up you may find it more therapeutic to use an ice pack to reduce your pain/irritation.  A packet of frozen peas wrapped in a tea-towel works well.  Leave in place for up to 15 minutes at a time.  Again, this can be repeated several times a day if found helpful.  It is advisable not to use ice if you have numbness/reduced sensation of the area you are treating.

Rest vs. activity: It is usually best to carry out your normal activities, but try not to overdo it.   Let pain be your guide; short-lasting/temporary discomfort is fine but worsening or constant 24/7 pain indicates you are likely doing too much and need to take things a little easier.  You need to pace yourself to start with and try to do a bit more each few days.

Balls Squeezes:  People are often told to squeeze a ball a lot of gripping can irritate hand problems so only do if you can do the following exercises comfortably.

Exercise

Exercise can be an extremely beneficial treatment for your wrist/hand pain as it can gradually build the tolerance and load-capacity of your tissues and help ease stiffness and soreness.  

Please try this exercise programme 2-3 times a day.  A small increase in pain is OK if it goes away within 30-60 minutes and not worse the next day.  If this happens, don’t worry, do fewer repetitions the next time and then gradually build up again.  It may take 5-6 weeks before you start to see improvement.  

If your wrist/hand does not start to improve over next 6 weeks, or gets worse despite the exercises, then you can self-refer yourself to see a Physiotherapist for an assessment.

Exercise 1 - Wrist Movements

Move your wrist upwards/downwards and side to side as far as you can with minimal pain.

Gradually try to move your wrist further as tolerated 5-10 times each direction (no holds necessary).  If easily tolerated, perform with a light weight instead (can of beans etc.)

Exercise 2 - Finger Tendon Glides

Copy the movements in the following pictures in order.  You may not be able to achieve the exact position try to copy the pictures as close as possible.  

Repeat the whole sequence 5 times.

Exercises 3 – Thumb Reaches

Try and touch your thumb to the tips of all your fingers then slide it down your little finger towards the palm as far as it will go

Repeat 5 times

Exercise 4 - Gentle wrist press

Make a loose fist then press your wrist against the fingers of you other hand creating tension in forwards/backwards/upwards and then downwards directions.  Your wrist does not move.  You can adjust the amount as it is tolerable.

Aim to hold the position 30 seconds.  Rest for 30 seconds then repeat again 2-3 more times

This can help ease the pain and can be repeated if helpful throughout the day to give pain relief and start gentle/early strengthening work.



If the above exercises are easy then you could try the following exercise:

Exercise 1 - Wall presses:

Stand facing a wall at arm’s length distance with your arms outstretched for a push-up

Slowly bend both elbows bringing your chest towards the wall then return

Repeat as able; aiming for 10-15 repetitions or for slight discomfort/fatigue

To make harder bring your feet further away from the wall then progress to a secure table top

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