Wrist and hand symptoms may start after a clear injury or develop gradually through repeated gripping, keyboard work, tools or sport. The examination considers the exact location, mechanism, movement and neurological symptoms.
Injuries after a fall or impact
A fall onto the hand can fracture one of the small wrist bones or sprain the supporting ligaments. Fractures and significant ligament injuries do not always cause dramatic swelling. Pain after trauma, especially in the hollow at the base of the thumb, should be assessed promptly and may need an X-ray or further imaging.
Tendon and overuse problems
De Quervain’s tenosynovitis
Pain is felt on the thumb side of the wrist where two thumb tendons pass through a narrow sheath. Repeated thumb or wrist movement and caring for a baby can aggravate it. Management may include changing the provoking load, temporary support and progressive exercise.
Tendinopathy and tendinitis
Tendons across the wrist can become painful after repeated loading or a sudden change in activity. Local tenderness, pain with resisted movement and swelling help identify the affected tissue. A plan should build the tendon’s capacity without repeatedly flaring symptoms.
Trigger finger
A finger may click, catch or lock when its flexor tendon no longer glides smoothly through its sheath. Mild symptoms may settle with activity changes, while persistent locking may need assessment by a hand specialist.
Nerve symptoms
Carpal tunnel syndrome affects the median nerve and commonly causes pins and needles in the thumb, index and middle fingers, often at night. Ulnar nerve irritation can affect the ring and little fingers. Nerves can be irritated at the wrist, elbow or neck, so the assessment follows the symptoms along the whole limb.
Persistent numbness, loss of hand strength or muscle wasting needs medical review. Pregnancy-related fluid changes can also contribute to carpal tunnel symptoms and should be managed in coordination with maternity care.
Arthritis and referred pain
Osteoarthritis can cause aching and stiffness in the wrist, hand or base of the thumb. Pain can also be referred from muscles in the forearm or from the neck. Treatment depends on identifying the main source rather than applying the same technique to every painful wrist.
When appropriate, care may include gentle joint or soft-tissue techniques, movement and strengthening exercises, ergonomic advice and a gradual return to the tasks that matter to you.