Conditions We Treat
WRIST & HAND PAIN
At a glance
Wrist and hand pain commonly involves carpal tunnel syndrome, De Quervain's tenosynovitis (often called "mom thumb"), tendinopathies and joint stiffness. Causes include repetitive strain, postural overload (desk work), pregnancy-related fluid changes or sport-specific gripping. Manual therapy, ergonomic adjustments and targeted exercises typically resolve most cases without injection or surgery, particularly when addressed early.
Your hands and wrists are involved in almost everything you do, so when they hurt, the impact on daily life is immediate. Typing, cooking, picking up your child, even scrolling on your phone: all of it becomes difficult. Wrist and hand complaints account for a significant portion of upper limb problems, with carpal tunnel syndrome alone affecting around 3 to 6% of the adult population.
Carpal tunnel syndrome is the most common nerve compression condition we see. The median nerve gets squeezed as it passes through the narrow carpal tunnel at the wrist, leading to numbness, tingling and weakness in the thumb and first three fingers. De Quervain's tenosynovitis is another frequent complaint, especially among new parents. It causes sharp pain on the thumb side of the wrist and is triggered by repetitive gripping and lifting. We also treat general repetitive strain injuries from desk work, manual labour and sport.
The evidence for conservative management of wrist and hand conditions is strong. A 2019 randomised controlled trial published in JOSPT found that manual therapy for mild to moderate carpal tunnel syndrome was as effective as surgery at 12 months. For De Quervain's, a combination of manual therapy, activity modification and progressive loading exercises produces good outcomes without cortisone injections in most cases.
We always check the neck and thoracic spine as well. The nerves supplying the hand originate in the cervical spine and travel through the shoulder and arm. Compression or irritation anywhere along this path can mimic or worsen hand symptoms. A condition called double crush syndrome occurs when the nerve is compromised at two points simultaneously, for instance at the neck and the wrist. This is why treating the wrist in isolation often falls short.
Treatment typically includes mobilisation of the wrist, hand and cervical spine, nerve gliding exercises, soft tissue work to the forearm flexors and extensors and ergonomic advice. For carpal tunnel, we often recommend a wrist splint for sleeping to reduce overnight nerve compression.
COMMON SYMPTOMS OF WRIST & HAND PAIN
- Numbness or tingling in the thumb and fingers
- Pain or aching in the wrist during or after typing
- Sharp pain on the thumb side of the wrist
- Weak grip or difficulty holding objects
- Fingers going numb at night or waking you from sleep
- Pain when turning your wrist or opening jars
- Stiffness in the fingers or wrist in the morning
- Swelling around the wrist or base of the thumb
- Pain that worsens with repetitive hand movements
- Difficulty pinching or gripping small objects
Our approach combines hands-on treatment with practical rehab and ergonomic guidance. Whether you're dealing with carpal tunnel, De Quervain's or desk-related strain, we focus on resolving the root cause rather than just managing symptoms.
Located on Rivonia Road in Morningside, we serve patients from Sandton, Bryanston, Fourways, Randburg and surrounding areas.
Book an appointment at our Sandton practice and let us help you get your hands working properly again.
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Frequently Asked Questions
Yes. Chiropractors can treat mild to moderate carpal tunnel syndrome using wrist mobilisation, nerve gliding techniques and soft tissue therapy. A 2019 randomised controlled trial found that manual therapy was as effective as surgery at 12 months for mild to moderate cases, with the added benefit of being non-invasive.
Sustained wrist extension while typing, poor mouse positioning and repetitive clicking can overload the tendons and compress the median nerve at the carpal tunnel. Over time, this can lead to repetitive strain injury or carpal tunnel symptoms including pain, numbness and tingling.
De Quervain's is a painful condition affecting the tendons on the thumb side of the wrist. It typically develops from repetitive thumb and wrist movements. It is very common in new parents from lifting and holding their baby. Treatment includes thumb and wrist mobilisation, soft tissue work and activity modification.
Not necessarily. For mild to moderate carpal tunnel, conservative care is a reasonable first step. A 2019 randomised trial found that manual therapy produced comparable outcomes to surgery at one year for mild to moderate cases. Surgery is typically reserved for severe cases with muscle wasting or failed conservative care.
Night-time numbness in the fingers is a hallmark of carpal tunnel syndrome. The wrist naturally flexes during sleep, which increases pressure on the median nerve within the carpal tunnel. It can also result from nerve compression in the neck or thoracic outlet. A thorough assessment helps determine the source.
References
- Fernández-de-las-Peñas C, et al. Cost-effectiveness evaluation of manual physical therapy versus surgery for carpal tunnel syndrome: evidence from a randomized clinical trial. Journal of Orthopaedic & Sports Physical Therapy. 2019;49(2):55-63.
- Huisstede BMA, et al. Carpal tunnel syndrome: effectiveness of physical therapy and electrophysical modalities. An updated systematic review. Archives of Physical Medicine and Rehabilitation. 2018;99(8):1623-1634.