What all RMTs Need to know about Wrist Pain
As an RMT you know the wrist can be the cause of many issues for your clients and recognizing the symptoms will help you find the most effective treatment plan. Here is what every RMT should know about wrist pain.
Tendonitis
One of the most common conditions that can result from overuse is tendonitis. Tendonitis can sometimes be misleading as although the issue might lie with the elbow, the pain might occur in the wrist. This is very common in cases of lateral epicondylitis which can be caused by improper positioning when typing at the computer. Also known as tennis elbow, it can sometimes be confused with carpal tunnel syndrome, because of the transference of pain. However carpal tunnel syndrome is caused by pressure to the medial nerve. Carpal tunnel syndrome is often related to over use or improper use of a mouse.
RSI and CTD
Repetitive Stress Syndrome (RSI) and Cumulative Trauma Disorder (CTD) are both caused by low level stress on joints and muscles. Computer use is often the cause of RSI and CTD and therefore these conditions are becoming more and more common. Because of the constant use RSI and CTD can combine a number of conditions such as carpal tunnel syndrome and tendonitis of any number of tendons used. Common risks for RSI and CTD include:
- Desk work for long periods of time without rest or stretching
- Constant bending of the wrist or reaching
- Sports such as tennis, golf and baseball
- An increase in activity
- Playing musical instruments
Symptoms of RSI and CTD
The most common symptoms of RSI and CTD include:
- Aching, pain and burning in the hand, arm, shoulder and wrist
- Limited range of motion which can affect fingers, wrists and shoulders
- Stiff and sore muscles in the elbow, shoulder and hand
Assessment
Most patients will see their doctor first to ascertain what is causing the pain and difficulty moving. If an improvement is not seen within one to two weeks of rest a referral will be made to a physiotherapist, but more and more doctors are referring patients to RMT’s. You may also have patients book an appointment with you without a referral from their doctor. A thorough medical history and exam can help you ascertain the best possible treatment without a diagnosis provided. When working with clients with complaints of wrist pain a good rule of thumb to decipher the cause of pain is to place pressure on the outside of the elbow on the muscle and then on the inside. If the patient experiences pain on the outside, the pain is probably lateral epicondylitis. If the pain is on the inside, than it is likely medial epicondylitis. You can also check for ligament injury. For radial collateral ligaments if side flexing the hand medially to stretch the radial side of the wrist causes pain or discomfort the ligaments are causing issue. For distal injury you can palpate the ligament focusing on different areas until you find the right spot.
Understanding RSI and CTD will help you better identify and treat patients suffering from wrist related pain.
