Wrist & Hand Pain

Wrist & Hand Pain

The hand is one of the marvels of human nature.  The precision movements it can make allow us to do a huge number of activities that our nearest primate cousins cannot.

The complexity and dexterity of the hand are wonderful, and they also get us into trouble.  Many activities we do daily – typing on a keyboard, using our thumbs on our cell phones, using scissors or tying our shoelaces – can also lead us to develop painful hand problems, like arthritis, carpal tunnel, tendinitis.

The most powerful acupuncture points are those in the hands and feet.  These acupoints have strong pain-stopping abilities.  By determining the location and quality of the pain, I use related points to stop the pain you’re experiencing on your hand and wrist.

What are the different types of hand and wrist pain treated by acupuncture?

Carpal tunnel syndrome
Carpal tunnel syndrome is a condition in which the median nerve becomes pinched as it passes through the wrist into the hand.  The pain associated with carpal tunnel is said to increase over time, have an electric zinging nature, and is sometimes accompanied by weakness and numbness in the hand.  Carpal tunnel syndrome is caused by anatomical abnormalities in the structure of the wrist, pregnancy, and certain patterns of hand movement (ergonomics).  The carpal tunnel is a small passageway through the wrist, and a large nerve and nine tendons need to squeeze through that space.  When space is compressed, pain is felt, as well as numbness, tingling, and weakness.  Acupuncture can help relax and open that space, and reduce inflammation.

Arthritis is a leading cause of disability in the United States.  Osteoarthritis is a “wear and tear” disease in which the cartilage that protects our joints is worn down and eventually disappears.  In rheumatoid arthritis, the immune system causes degeneration of the joints.  In both cases, the smooth pain-free motion is lost.  Thumb arthritis is a very common form of arthritis in the hand.  Depending on the type of arthritis a person has, different joints (knuckles) in the hand will be affected.  Psoriatic arthritis, while less common than the other types of arthritis mentioned above, may affect the hands as well as the fingernails.

There are many tendons in the hand and wrist.  Tendinitis is inflammation of a tendon.  De Quervain’s is a type of tendinitis.  Most commonly, tendinitis in the hand affects the tendons of the wrist.  Tendinitis pain is usually described as tightness, aching and burning pain.  The pain is often worse during gripping or holding objects. Repetitive motion is likely to aggravate tendonitis.

De Quervain’s tenosynovitis
De Quervain’s tenosynovitis is one of the causes of thumb pain.  It is a condition affecting the tendons on the thumb side, which attach to the wrist.  De Quervain’s is also known as Blackberry Thumb because it is usually worsened by typing with your thumbs.  If you have de Quervain’s tenosynovitis, turning the wrist and grasping will usually elicit pain.  De Quervain’s is caused by repetitive motions.

A sprain is a name for damage to the ligaments within a joint.  There are many ligaments in the wrist and fingers, making this part of the body particularly susceptible to sprain.  This contrasts strains, which refer to the muscle and tendon injuries rather than ligaments.  The symptoms of a sprain are a pain, swelling, tenderness, bruising, stiffness, loss of strength and decreased the range of motion.  During injury, you may have the sensation of tearing or popping of the ligaments.

Trigger finger (AKA stenosing tenosynovitis)
Trigger finger, also known as stenosing tenosynovitis, causes the finger joint to lock or catch in a curled position due to restricted motion of the tendons responsible for flexing and extending (bending) the finger.  Symptoms range from difficulty extending the finger to becoming locked in a bent position.  Other symptoms include stiffness, catching, or popping when the finger is extended.  Some people notice a small lump and swelling by the base of the finger and pain in the palm and base of the finger.  Typically, only one finger is affected, though it is possible for trigger finger to affect more than one finger.  Symptoms are generally worse with rest and improve with activity.

How does a doctor treat hand and wrist pain?

Your doctor will perform a physical exam of your hand and conduct a medical history. Electromyography, X-rays and MRIs may also be ordered. Your doctor will likely prescribe physical therapy, rest, icing, and anti-inflammatory or painkiller medications for treatment.

How does acupuncture treat hand and wrist pain?

In addition to acupuncture, I always prescribe herbal soaks for hand and wrist pain problems. It’s so easy to put the hand and wrist into a bowl of warm herbal medicine soaks – how could I not prescribe that?  Herbal soaks allow delivery of medicine directly to the affected tissues to improve circulation, stop pain and encourage the healing of ligaments, tendons, muscle, and bone.

Acupuncture treats hand pain and wrist pain by similar actions. Acupuncture improves circulation and relaxes spasms.  The improved circulation caused by acupuncture brings fresh blood and oxygen to the area, which promotes healing.  Certain acupuncture points help stop the pain, too.

As with any acupuncture treatment, it is important to determine a pattern of disharmony before treating.  To this end, I always conduct a full medical history to better understand a patient’s overall wellness in addition to gathering information about the hand pain or wrist pain.  I will also conduct a physical exam and perform orthopedic and/or neurological tests to help better understand the cause of the pain in the hand or wrist.  Coming to the proper diagnosis will inform both the acupuncture treatment and any internal herbal medicine I might prescribe.