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Self help resources - Wrist and Hand

  • The following information has been written to help you fully self-manage your wrist or hand pain. 

    However, please self-refer straight away to be assessed by a Physiotherapist if you:

    • have had recent trauma to your wrist/hand and have a significant loss of movement/strength
    • constant day & night pain that you cannot settle
    • constant numbness or tingling in any of your fingers or thumbs
    • you are off-sick and struggling to return to work due to your pain
    • your symptoms are worsening and are not improving despite following the advice below over the course of six weeks

    If you have a history of cancer, immunodeficiency or TB and have new, unexplained and constant pain then please speak to your GP whilst you attempt the following self-help advice.

     



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 tablets or gels (such as ibuprofen) are easily available over the counter without the need for a prescription.  These can be very effective as they lessen your discomfort and importantly allow you to keep your wrist/hand moving.  However, please check the labels for instructions/safe usage and any possible reasons why you should not use them.  If you are currently taking any form of medication it is advisable to consult your GP or pharmacist before taking additional pain relief.  It is also advisable to check with your GP if you find you need to take regular anti-inflammatory tablets for more than two consecutive weeks.

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 heat or ice if you have numbness/reduced sensation of the area you are treating; use warm or cool bathing instead.

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 every 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 help reduce achiness/stiffness.  They can also help gradually build the tolerance and load-capacity of your tissues.

Please try this exercise programme 2-3 times a day.  A small increase in pain is OK if it goes away within 30 minutes and not worse the next day.  If you feel you have done too much, don’t worry, do fewer repetitions or smaller movements next time and then gradually build up again.  It may take 4-6 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 how hard you push to make sure it is completely tolerable.

Aim to hold the position 15-20 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



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