Can physiotherapy help tendonitis of the wrist?

Painful wrists affect all areas of your life; from driving and writing to cooking and cleaning. Today physiotherapist Gianluca Magagna is here to demystify the condition of wrist tendonitis. What exactly is it, how can a physiotherapist help and what can you do to avoid painful wrists?

What is tendonitis?

Wrist tendonitis is a condition where one or more tendons in the wrist become inflamed and irritated. The medical term’s suffix ‘it is’ refers to the inflammatory component of the condition. So, wrist tendonitis is simply an inflammation of the tendons in the wrist.

Where are the wrists tendons?

The wrist joint is surrounded by several tendons which connect the muscles of the forearm and hand to the wrist and hand bones. These tendons are the small rope-like cords that you can see running down the back of your hand to your fingers. They are responsible for the complex movements of our wrist, hands and fingers.

Which symptoms should I expect?

Sufferers of wrist tendonitis often experience the following symptoms:

• Pain and stiffness in the wrist, particularly after waking in the morning
•  Tenderness and soreness when pressure’s applied
• Mild swelling, sometimes accompanied by heat or redness
• Feeling a ‘grating’ or ‘crackling’ sensation when you move your wrist
• A decrease of the range of motion in your wrist joint
• Muscle weakness – especially when performing routine motions such as: gripping, using a computer mouse, pinching, typing, throwing or using a computer game controller.

Should you experience any of these symptoms, seek help from a specialised healthcare professional such as a qualified physiotherapist.

What are the causes of the condition?

The most common cause of wrist inflammation is simple, repetitive motion that puts stress on the tendon over time. Wrist tendonitis is usually described as a repetitive strain injury because it is frequently triggered by common, every-day and sustained activities. These include: playing sport, especially golf, bowling, tennis and baseball; using a computer (repetitive typing); writing or physical labour (repeatedly using tools such as jackhammers, sewing machines or electrical saws).

How can my physio help with the diagnosis?

In your first consultation your musculoskeletal (MSK) physiotherapy thoroughly assess your entire arm, including the shoulder, elbow, wrist and hand. You’ll be asked to describe the types of activities you normally perform at home, at work and for recreation, and which of these activities causes pain or stiffness in the area. You’ll also need to state how long you’ve experienced the pain for and how it is affecting your regular, daily activities.

Your therapist will then conduct a physical exam, checking for points of tenderness around the affected area. The precise location of pain can often help them determine if it’s caused by other problems. Range of motion and strength in the entire upper arm will also be checked. Your therapist will gently touch specific areas of your wrist and forearm to determine which wrist tendons are affected and check for any swelling. Finally, they may carry out tests that stretch the specific tendons of concern to locate the precise source of inflammation.

How can my physio provide an effective treatment?

Physiotherapy is a highly effective treatment for wrist tendonitis. Your physio will create an individual treatment program which may include:

• Pain relief and pain management. A general treatment starts off with a few simple steps to control inflammation and allow tendon healing. You’ll need to rest the wrist short-term and apply ice to the area to help alleviate pain. Your physio will help you to identify and avoid painful movements and show you how to correct faulty postures. This will all reduce stress on the wrist. Your therapist also may apply a custom wrist splint to restrict wrist movement, allowing the tendons to heal properly.
• Manual Therapy. Manual techniques including gentle joint passive mobilisations, deep soft tissue massage and targeted stretches to get your wrist moving properly.
• Range-of-Motion Exercises. Your therapist will teach you exercises and stretches. These will reduce stiffness and help your wrist, hand, and forearm begin to move adequately again.
• Exercises therapy. Depending on your specific areas of weakness, your therapist will determine which strengthening exercises are right for you. This will contribute to the movement dysfunction that causes tendonitis. An individualised home-exercise program will help to meet your specific needs and goals. You can continue long after you have completed your treatment cycle.
• Education. Your physio will teach you the best ways to perform normal, everyday actions. This will help you to protect your wrist and hand and avoid causing further damage. Keeping the wrist in a neutral position to reduce excessive force and taking frequent breaks from activity are simple ways to decrease your chances of relapses.
• Functional Training. When symptoms improve, you will be taught how to correctly perform functional movement patterns using proper wrist mechanics. For example, they’ll show you the correct position for typing on a computer or swinging a racquet. This training will help you return to your daily activities, your job and when playing your favourite sport pain-free.

Take home message

If you are experiencing pain due to wrist tendonitis, your MSK physiotherapist will develop a program to cure the condition and prevent it from recurring. When you’ve recovered you’ll be able to keep on with all your normal activities – for work, daily life and leisure.