The wrist and hand is a complex area, giving rise to many common conditions that require careful assessment and diagnosis to enable us to identify the most appropriate treatment. The most common problem we see in the wrist and the hand is osteoarthritis of the thumb.
This manifests in stiffness at the base of the thumb, giving rise to sharp pain, swelling, and a loss of function.
Other conditions include:
- Trigger finger or trigger thumb
- Dupuytren's contracture
- Carpal tunnel syndrome
- Injuries to the triangular fibrocartilage complex
- Fractures to the small bones
Treatment for these conditions range from splinting, shockwave therapy, injections, and exercise. Depending on the nature of your problem, we will be able to recommend the most appropriate treatment for your condition.
De Quervain's Tenosynovitis
De Quervain’s tenosynovitis affects the tendons on the thumb side of your wrist, causing sharp pain when gripping, pinching, or moving your thumb. This condition commonly affects new mothers (from repetitive lifting), office workers, and anyone performing repetitive thumb movements. Our physiotherapy treatment focuses on reducing inflammation through gentle mobilisation techniques, tendon gliding exercises, and ergonomic modifications to prevent aggravation. When conservative treatment isn’t sufficient, our targeted steroid injections directly into the tendon sheath provide rapid pain relief and reduce inflammation, often providing dramatic improvement within days.
Trigger Finger and Trigger Thumb
Trigger finger occurs when the flexor tendons become inflamed and catch as they pass through the tendon sheath, causing your finger to lock or “trigger” when bending. Our physiotherapy approach includes gentle tendon mobilisation, splinting when appropriate, and specific exercises to improve tendon gliding. We also provide education on activity modification to prevent aggravation. For persistent cases, our ultrasound-guided steroid injections into the tendon sheath offer excellent results, with many patients experiencing complete resolution of triggering symptoms. The precision of ultrasound guidance ensures accurate placement and maximises treatment effectiveness.
Carpal Tunnel Syndrome
Carpal tunnel syndrome results from compression of the median nerve as it passes through the narrow carpal tunnel in your wrist, causing numbness, tingling, and pain in your thumb, index, middle, and ring fingers. Our physiotherapy treatment includes nerve gliding exercises, wrist positioning techniques, ergonomic assessment, and custom splinting programs. For moderate to severe cases, our steroid injections into the carpal tunnel can provide significant symptom relief and may delay or eliminate the need for surgery. We use ultrasound guidance to ensure precise placement while avoiding damage to the compressed median nerve.
First Carpometacarpal (CMC) Osteoarthritis
CMC joint osteoarthritis affects the base of your thumb, causing deep aching pain and weakness that makes gripping, pinching, and twisting movements extremely difficult. This degenerative condition particularly impacts activities like opening jars, turning keys, or writing. Our physiotherapy approach focuses on joint protection techniques, strengthening exercises for surrounding muscles, and custom thumb splinting to support the joint during activities. When conservative treatment isn’t providing adequate relief, we offer several injection options including steroid injections for inflammation control and hyaluronic acid injections to improve joint lubrication and reduce pain. These targeted treatments can significantly improve function and delay the need for surgical intervention.
Comprehensive Treatment Approach
Our experienced team combines detailed assessment with advanced diagnostic ultrasound when needed to ensure accurate diagnosis and optimal treatment selection. We understand that hand and wrist conditions can significantly impact your work, hobbies, and daily independence, which is why we’re committed to providing both immediate pain relief and long-term functional improvement.
Using our hands-on physiotherapy techniques combined with precisely targeted injection therapies, we help patients regain pain-free hand and wrist function – because your hands are essential tools for living, working, and enjoying life to the fullest.