Understanding Wrist Tendinitis: A Hand Therapist’s Perspective
Wrist tendinitis is a condition that affects many patients, both in the clinic and at the companies where Advanced Physical Therapy & Sports Medicine/Advanced Industrial Medicine provides onsite therapy services. It involves inflammation of the tendons around the wrist joint, often resulting in pain, swelling, and decreased function. Tendinitis can significantly impact daily activities like gripping, lifting, or even typing.
Our Role & What We Do
First of all, it’s important to understand the role of a CHT, or Certified Hand Therapist, who works for Advanced. We work with companies and businesses—and have for the past 25 years—with fewer than 50 employees and others with more than 3,000. Each program we offer is fully customizable to meet the needs of the employer. At the companies where we’re onsite, it’s our job to identify obstacles to employee wellness and turn those challenges into opportunities to improve workforce health and safety.
The companies who reach out specifically for the services of a CHT often have a number of employees who engage in a good deal of repetitive handwork. By being onsite, we can meet the employees right where they are. Yes, you heard that right: our providers, whether they be CHTs, PTs, OTs or LATs, are available to employees as needed, across multiple shifts, getting workforces the care they need, when they need it most.
We call this service “Rapid Response,” where we address issues immediately, maximizing access and minimizing interruption.
Plain and simple, our job comes down to being responsive and where we need to be to get in front of issues faced by every company’s most important asset, its workforce.
Now, let’s return to that annoying, frustrating, and often painful tendinitis.
Causes & Symptoms
Did you know there are more than 10 tendons that cross the wrist into the hand and thumb? Together, they help us perform everyday tasks using multiple ranges of motion. Wrist tendinitis typically arises from repetitive strain and overuse. Common contributors include activities involving repetitive wrist motions, like typing, lifting weights, sports (e.g., tennis or golf), and even manual tasks such as gardening or cooking. With workers, it’s often people just doing their job, especially those that require long periods of using their hands. And these are the common complaints:
Pain: May be felt around the wrist, but can extend up the arm.
Swelling: Noticeable around the affected tendons.
Tenderness: Especially when pressing on or moving the wrist.
Weakness: Difficulty performing repetitive tasks.
Treatment Approach
Early intervention is key to preventing the condition from worsening when treating wrist tendinitis. After the injury is determined to be work-related or non-work-related, here are five strategies that can provide relief:
Rest and Activity Modification: It’s crucial to modify the activities or change the routine's techniques that are causing pain. That’s where looking at the job and offering ergonomic recommendations pays dividends in the long run, regardless of whether it is work-related or non-work related.
Splinting: Using a wrist splint provides stability and reduces stress on the affected tendons, allowing them to heal. Remember, soft splints are okay to use under OSHA First Aid guidelines.
Side note: If the injury is work-related and the employee is sent for x-rays, it’s important to understand that getting an x-ray and interpretation is considered diagnostic and encouraged under OSHA First Aid. However, if the doctor prescribes medication, gives work restrictions, provides a hard splint or cast or gives specific exercises, the injury escalates from a reportable to recordable injury. We encourage you to work with your medical team and referral resources to make sure that they understand best practices to set the employee up for success and protect your company from unwarranted recordable injuries.
Therapeutic Exercise: When it comes to therapeutic exercises, it’s essential to understand whether the injury is work-related. If work-related, the employee can utilize the company-wide stretching program or other company-wide resources to improve mobility and increase blood flow. We can guide the employee through tailored therapeutic exercises if the injury is non-work-related. These focus on stretching and strengthening the muscles around the wrist to improve grip strength, forearm stability, and overall wrist endurance.
Manual Therapy and Modalities: Massage is the only OSHA-approved option for work-related injuries in this category. If non-work related, hands-on techniques can expand to soft tissue mobilization, friction massage, and joint mobilization, which can help relieve pain and promote blood flow to the affected tendons. And it’s usually one of the employees’ favorite parts.
Education on Ergonomics and Prevention: A crucial part of treatment is educating patients about ergonomic adjustments at work. Small changes, such as adjusting the keyboard height, using cushioned grips, alternating hands for specific tasks, or using different tools or the same tool differently can make a real difference.
The Role of Patience in Recovery
Recovery from wrist tendinitis takes time and consistent effort. Patients often feel impatient, but it’s essential to understand that wrist tendinitis usually doesn’t disappear overnight. Using the information provided, you too can kick-start your recovery process.
Final Thoughts
Although management of wrist injuries changes depending on if the injury is work-related or non-work-related, addressing it early and thoroughly can and will enhance your quality of life, at work and at home!
About the author:
Fue Moua, CHT, OTR, MS-OT
As an occupational therapist and certified hand therapist, Fue earned his bachelor’s degree at the University of Wisconsin-Stevens Point and completed his master’s degree at the University of Wisconsin-Madison. His broad expertise includes treating hand, upper extremity, sports, and work-related injuries. Drawn to the intricacies of upper extremity conditions, Fue utilizes an evidence-based approach to reach an informed decision when diagnosing and selecting an intervention. He has a special interest in working with baseball players with overhead throwing issues and has treated numerous high school and collegiate athletes in the area. His passion for helping others overcome injury and his easygoing demeanor make Fue a favorite of patients.