Hand and wrist

Despite the fact that there are several possible causes, hand and wrist pain will often resolve with sensible self- management advice

• Painkillers – taking painkillers like ibuprofen, paracetamol, or a combination, are often helpful. Speak to your pharmacist for further information. Alternatively, you may prefer to use ‘rub on’ (topical) versions instead. Painkillers are not helpful for carpal tunnel syndrome symptoms.
• Heat and cold – A hot bath or hot water bottle (cover the water bottle with a tea towel to prevent against burns) can ease pain, whilst cold from an ice pack or a bag of frozen peas (wrap in a damp cloth and use for short periods only to prevent against ice burns and apply to the painful area) can help relieve discomfort.
• Splint Support – Depending on the symptoms, a wrist splint may help for wrist pain and symptoms of carpal tunnel syndrome. Splints are available from larger pharmacies or may be ordered online (your Pharmacist should be able to help with this. For De Quervains, a different splint known as a thumb spica, may be effective.
• Ergonomics – If you work at a computer for most of the day make sure that you have adequate wrist support for the mouse and keyboard. This helps to stop the wrist from bending and therefore putting pressure on the nerves or tendons. The splints can be particularly beneficial if used overnight.

• If the pain is severe or the problem does not improve, especially after a fall onto the hand
• If the pain gets worse over time.
• If the small joints in your hand swell and/or pain or stiffness in your hand takes more than 30 minutes to ease in the morning.
• If you are unable to move your wrist and hand.
• If you experience tingling or numbness in your hand (usually due to carpal tunnel syndrome symptoms which persist despite using a splint for 6-8 weeks or experience loss of sensation or weakness of your grip.

• Carpal tunnel syndrome is relatively common. Compression of the median nerve supplying the hand results in tingling, numbness and sometimes pain and weakness, often worse at night and usually in the thumb, index and middle fingers.
• Trigger finger/thumb – This occurs when the tendon to a finger or thumb gets stuck and causes the movement to stick. A triggering will be felt in the palm at the base of the affected digit
• De Quervains' tenosynovitis – Repetitive activity in the thumb can cause inflammation in the tendons supplying the thumb at the wrist.
• Osteoarthritis (OA) – This can affect wrist, thumb and fingers. It is rare below the age of 45 unless there is a history of previous joint injury. Onset is normally gradual over a few years with increasing pain and discomfort.
• Ganglion – A smooth fluid filled swelling is not uncommon around the hand and wrist (foot and ankle as well!). It is best left alone initially (several months) as they will often resolve with no treatment.  If there is any clinical doubt around diagnosis please see your GP.