Conditions
Wrist & hand pain and injuries
Your hand does something no other part of your body does: fine, coordinated, constant work. When it stops, everything stops with it. Wrist and hand problems are treated by our physical therapists at every clinic, and by Certified Hand Therapists — a specialty with its own certification — at select locations.
See a doctor first
A wrist or hand with any of the following needs an urgent care or emergency department before a therapy visit:
- A fall onto the hand with pain at the base of the thumb or over the wrist — scaphoid fractures are often missed on the first X-ray and need a specific check
- Obvious deformity, or a finger that will not straighten or bend after an injury
- A cut over a tendon or joint, or any wound with loss of movement or feeling beyond it
- A hot, red, swollen joint or finger with fever, or a rapidly spreading redness
- Sudden loss of feeling or color in the fingers
What we see most
Wrist & hand conditions we treat, and what therapy does for each.
Carpal tunnel syndrome
Numbness, tingling and pain in the thumb, index and middle fingers, worst at night and first thing in the morning, from the median nerve being compressed at the wrist.
What therapy does: For mild to moderate cases, a night splint that holds the wrist straight is the single most effective conservative measure, and nerve- and tendon-gliding exercises plus activity changes help alongside it. Persistent numbness, weakness or wasting of the thumb muscles means the nerve is being damaged, and surgical release is then the right treatment — we say so rather than treating on.
Wrist fractures (distal radius)
The most common broken bone in adults, from a fall onto an outstretched hand. Treated in a cast or with a plate, and followed by a wrist that is stiff, weak and unsure of itself.
What therapy does: Rehabilitation starts as soon as your surgeon clears movement: restoring rotation of the forearm and bending of the wrist, then grip strength, then the fine control that lets you type, cook and open jars without thinking. Lost rotation is the hardest thing to recover late, so we start early.
De Quervain's tenosynovitis
Pain on the thumb side of the wrist with gripping, lifting and turning the wrist — classically in new parents lifting a baby, and in people who text and scroll heavily.
What therapy does: A thumb-spica splint to rest the tendons, activity modification, and graded loading as it settles resolve most cases over a few weeks. Where it is stubborn, a corticosteroid injection is genuinely effective for this condition, and we will say so.
Thumb base arthritis (CMC joint)
Pain at the base of the thumb with pinching, opening jars and turning keys. Very common after 50, especially in women.
What therapy does: A well-fitted splint, joint-protection strategies and specific strengthening of the small thumb muscles reduce pain and improve function, with good evidence. Custom splint fabrication is a hand therapy skill available at select clinics. Therapy cannot reverse the arthritis; it can very often keep you out of surgery.
Tendon injuries and trigger finger
Trigger finger is a catching or locking finger from a thickened tendon; flexor and extensor tendon injuries follow cuts or ruptures and are usually repaired surgically.
What therapy does: Trigger finger often settles with a splint and activity changes; persistent locking responds well to an injection or a minor release. After tendon repair, rehabilitation follows the surgeon's protocol to the day — early controlled motion protects the repair from both rupture and scarring, and it is precise, specialist work.
Physical therapy or hand therapy?
Both are available at SportsCare. Physical therapists at every clinic treat wrist and hand pain, fractures and arthritis. A Certified Hand Therapist (CHT) — a PT or OT with additional years of upper-extremity experience and a separate certification — is the right choice for post-surgical tendon and nerve repairs, complex fractures, and custom splinting, and is available at select clinics. Your first visit at any clinic will point you to the right one.
What treatment looks like
The evaluation measures movement, grip and pinch strength, sensation, and how you actually use the hand — the tasks that hurt and the ones you have stopped doing. It also checks the neck and elbow, because numbness in the hand often starts higher up.
Treatment combines splinting where it helps, hands-on work for stiffness and scar, nerve and tendon gliding, and progressive strengthening down to the small muscles of the hand. For post-surgical patients the protocol from your surgeon comes first and we follow it exactly.
Most wrist and hand problems are seen once or twice a week for four to twelve weeks; tendon repairs and complex fractures for longer.
FAQ
Common questions
- Can carpal tunnel syndrome be treated without surgery?
- Often, for mild to moderate cases. A night splint that keeps the wrist straight, nerve-gliding exercises and activity changes relieve symptoms for many people. Persistent numbness, weakness or thumb-muscle wasting are signs the nerve is being damaged, and surgical release is then recommended.
- How long after a wrist fracture can therapy start?
- As soon as your surgeon or physician clears movement — often while still in a removable splint. Starting early protects forearm rotation, which is the hardest movement to recover if it is left until late.
- What is a Certified Hand Therapist?
- A physical or occupational therapist with at least three years of experience and a minimum number of hours in upper-extremity care who has passed a separate certification examination. CHTs are available at select SportsCare clinics.
- Which SportsCare clinics have a hand therapist?
- Hand therapy with a Certified Hand Therapist is offered at select SportsCare clinics; see the Hand Therapy service page for the current list. Physical therapy for the wrist and hand is offered everywhere.
Sources
- Carpal Tunnel Syndrome — OrthoInfo, American Academy of Orthopaedic Surgeons
- Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline — American Academy of Orthopaedic Surgeons, 2016
- Distal Radius Fractures (Broken Wrist) — OrthoInfo, American Academy of Orthopaedic Surgeons
- De Quervain's Tendinosis — OrthoInfo, American Academy of Orthopaedic Surgeons
- Arthritis of the Thumb — OrthoInfo, American Academy of Orthopaedic Surgeons
- Carpal tunnel syndrome — NHS
This page is general information, not a diagnosis. A physical therapist at any SportsCare clinic can evaluate your specific situation.