Hand, Wrist, and Elbow Pain

Signs and Symptoms

Pain in the hands, wrists, and elbows can result from many different conditions. One common condition of the wrist and hand that can affect the use of the whole arm is carpal tunnel syndrome (CTS). It is caused by pressure on the nerve at the base of the palm (median nerve). Because of the demands that people place on their hands and wrists, CTS is a common condition affecting 1 out of 20 Americans. Surgery for this condition is commonly performed on the wrist and hand. Fortunately for most people who develop CTS, physical therapy treatment can often relieve pain and numbness and restore normal use of the hand, wrist, and arm without the need for surgery.

Another condition we see treat is wrist tendinitis, which most commonly occurs in individuals who perform repetitive activities using the hand and arm. These include computer users, factory workers, and athletes who throw and catch balls and play racquet sports. Overuse tendinitis is responsible for 25% to 50% of all sports injuries in the United States. Older individuals are often more at risk for wrist tendinitis due to a loss of elasticity in the wrist tendons. Our physical therapists help people with wrist tendinitis reduce their pain, increase their wrist flexibility and strength, and return to their previous functional activities and sports.

A third condition we see is elbow (olecranon) bursitis, commonly known as "baker's elbow," "student's elbow," or "Popeye elbow." It involves swelling at the tip of the elbow, on the back of the arm. The condition can be painless, or it can be painful at rest and when leaned on, as when writing with the arm pressing on a table. Elbow bursitis can have many causes, but the most common is trauma, whether a direct hit, or smaller bumps or pressure applied over time. Elbow bursitis is commonly seen in students or office workers who lean their elbows on hard desks or armrests for long periods of time; however, its occurrence is not related to any particular age or ethnic group. 


How We Evaluate

At Advance Physical Therapy, we will perform a thorough evaluation that includes:

  • A review of your health history.
  • Questions about your specific symptoms.
  • A thorough examination that includes assessing the quality and quantity of your movements, and any movement behaviors that might put you at risk for delayed recovery.  
  • Tests to identify signs or symptoms that could indicate a serious health problem, such as broken bones in your wrist or arm.
  • Assessment of how you use your body at work, at home, during sports, and at leisure.


How We Can Help With Hand, Wrist, and Elbow Pain

Pain Management - We will help you identify and avoid painful movements, and show you how to correct abnormal postures to reduce stress on the wrist and hands. We may recommend resting the wrist short-term, and applying ice to the area to help alleviate pain. Your physical therapist also may apply braces to restrict movement, allowing the tendons to heal.

Manual Therapy -  We also may use manual techniques, such as gentle joint movements, soft-tissue massage, and stretches to get your hands and arms moving properly.

Range-of-Motion Exercises -  You will learn exercises and stretches to reduce stiffness and help your wrist, hand, and forearm begin to move properly.

Strengthening Exercises -  We will determine which strengthening exercises are right for you, depending on your specific areas of weakness. The entire arm, including the shoulder, elbow, and wrist, can potentially be weakened and contribute to movement dysfunction. We will design an individualized home-exercise program to meet your specific needs and goals, which you can continue long after you have completed your formal physical therapy.

Patient Education -  Depending on the specific activities you plan on resuming, we will teach you ways to perform actions, while protecting your wrist and hand. For example, keeping the wrist in a neutral position to reduce excessive force while performing repetitive tasks, and taking frequent breaks are ways to decrease your chances of re-injury.

Functional Training -  As your symptoms improve, we will teach you how to correctly perform functional movement patterns using proper wrist mechanics, such as typing on a computer or swinging a racquet. This training will help you return to pain-free function on the job, at home, and when playing sports.


Information provided by the American Physical Therapy Association and their partner MoveForwardPT.com.