As this syndrome often comes on due to repetitive activity, it is most important to stop or change the activities that are causing your symptoms. Taking frequent breaks when doing repeated hand and thumb movements is also important. If possible, we will encourage you to avoid repetitive hand motions such as heavy grasping, wringing, or turning and twisting movements of the wrist.
Downhill skiers may get relief by avoiding heavy planting and dragging of their ski poles and by getting a shorter pole with a smaller basket diameter which reduces the drag and force transmitted to the wrist. In addition to giving the wrist as much rest as possible, keeping your wrist in a neutral alignment will also assist in the healing process. In other words, keep it in a straight line with your arm, without bending it down and in. This position avoids the stress caused by stretching the tendons in this area.
Your Physical Therapist may even suggest the use of a splint for the area, which keeps the thumb and wrist from moving excessively and helps to keep the wrist in the neutral position. Resting for the wrist extensor tendons and the thumb muscles allows the area to begin healing. As part of your treatment your Physical Therapist may check your workstation set-up and observe the way you do your daily tasks.
We will also educate you about healthy body alignment and proper wrist positions. It is our belief at Peak Performance Physical Therapy that preventing future problems is as much a part of our treatment as getting rid of your existing pain. Once the initial pain and inflammation has calmed down, your Physical Therapist will focus on improving the mobility and strength of your wrist and thumb. Simple regular wrist stretching exercises will be prescribed and should be done within the limits of pain.
Strengthening exercises will also be prescribed. These exercises will focus on improving both the strength of the wrist and thumb muscles, but also the ability of the hand to grip and exert force when twisting or grabbing. Exercises to improve strength will include eccentric exercises for the area. Eccentric contractions occur as the muscle lengthens and the tendon is put under stretch while resisting a force.
Your Physical Therapist will advise you when it is the appropriate time to start these exercises. Eccentric exercises for the wrist are done by dropping the wrist down slowly at first and then, as able, progressing to a quick motion. These exercises will put the enough stress through the injured area to start building up the tensile strength in the tissues and associated muscles. In addition to eccentric exercises, therapeutic putty might be used which adds some resistance to finger and hand motions, or simple ball gripping or handle twisting exercises may be prescribed.
As you become stronger, weights or resistance bands will be used to further build up strength. Fine motor control and dexterity exercises for your thumb and hand may also be added into your rehabilitation routine depending on your occupation or the cause of your injury. If possible, we will tailor the exercises we give you to simulate the functional activities used in daily living or in your occupation.
Being that intersection syndrome is most often caused by repetitive stress in the first place, close monitoring of your rehabilitation program by your Physical Therapist at Peak Performance Physical Therapy is necessary to ensure excessive stress is avoided and that you do not re-injure the area during your rehabilitation. The use of anti-inflammatory medications may be helpful to control the swelling of thetenosynovium and ease symptoms.
These medications include common over-the-counter medications such as ibuprofen and aspirin or stronger prescribed medications. Your Physical Therapist may suggest you see your doctor to discuss the use of anti-inflammatories or pain-relieving medications in conjunction with your Physical Therapy treatment. If rehabilitation, rest, and oral medications fail to control your symptoms, we may liaise directly with your doctor regarding their opinion on an injection of cortisone.
Cortisone is a very effective anti-inflammatory medication. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health. Who is at Risk? Causes of a Sprained Wrist The most common cause of sprained wrists is using your wrists to break a fall. Common Signs and Symptoms of a Sprained Wrist Swelling around the wrist area Bruising and discoloration Intense pain in the affected area Tearing sensation Home Management for a Sprained Wrist For minor sprain injuries, you can manage your injury using the following methods: Refrain from doing any activity with your sprained wrist.
Put ice on the affected area to reduce the pain and swelling. Wrap a bandage around your sprained wrist. This will help immobilize the affected part and prevent swelling. Elevate your sprained wrist above the level of your heart. Take over-the-counter pain-relief medications. When to Seek Medical Help If you observe the following signs and symptoms, consult a wrist doctor in Cary immediately: Hand deformity.
The injured hand may appear crooked or deformed. The best way to find out is to compare it with the other hand. Together, these tendons are responsible for the complex and subtle movements we use in the wrist, hands, and fingers. It is easy to tell if you have wrist tendonitis because you will experience pain and stiffness in the wrist, especially after you wake up in the morning.
The area will also feel tender and sore when you put pressure on it. Mild swelling may be visible. In addition, the inflamed tendon may make a creaking noise when you move it. The pain of wrist tendonitis is not particularly severe.
Wrist tendonitis can decrease the range of motion in your hand, and you may experience weakness when performing routine motions, such as:.
When the tendons of the wrist are working properly, they slide in a sheath lined with synovial fluid to create frictionless movement.
Injury or inflammation of the tendon can cause the sheath to thicken, enlarging it and restricting the fluidity of movement. The most common cause of this inflammation is usually simple, repetitive motion that puts stress on the tendon over time. While repetitive daily motions are the most common culprit for wrist tendonitis, this condition can also be caused by injuries and lifestyle habits.
Some of these causes include:. Your therapist may give you suggestions about healthy body alignment and wrist positions, helpful exercises, and tips on how to prevent future problems. Surgery is rarely necessary to treat intersection syndrome. In extremely difficult cases, a surgeon may remove some of the thickened tenosynovium around the tendons. The operation is called a tendon release.
It can be done using a general anesthetic , which puts you to sleep, or a regional anesthetic. A regional anesthetic blocks the nerves going to only a certain part of the body. Injection of medications similar to lidocaine can block the nerves for several hours. You may get an axillary block, which puts the arm to sleep, or a wrist block , which puts only the hand to sleep. It is even possible to perform the surgery by simply injecting lidocaine around the area of the incision.
The first step is to make a small incision over the spot where the two muscles cross over the two wrist tendons. The surgeon identifies the irritated tendons, and then separates and removes the inflamed tenosynovium from the tendons.
If nonsurgical treatment is successful, you may see improvement in four to six weeks. You may need to continue wearing your thumb splint to control symptoms. Try to do your activities using healthy body and wrist alignment.
Limit activities that require repeated motions of the wrist and thumb. A period of rehabilitation is needed after surgery. Pain and symptoms generally begin to improve after surgery, but you may have tenderness in the area of the incision for several months. At first, take time during the day to support your arm with your hand elevated above the level of your heart.
You should gently move your fingers and thumb from time to time during the day. Keep the dressing on your hand until you return to the doctor. Avoid getting the stitches wet.
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