Posterior wrist pain

Hello,

I'm a new PT, and will be starting my first job soon. However, for the past two years, throughout my clinical rotations, I have had a problem with recurrent wrist pain, and despite trying a number of things have not found a good solution. I'm 30, female, and have significantly greater than normal range of motion in all my joints, due to a connective tissue disorder. So right there, that's likely the problem, but since I can't change my tissues, I'm still hoping to find some symptom relief, as I anticipate wrist pain being very problematic at work.

The details: R wrist pain (dominant hand), sharp pain in posterior wrist in roughly the area of the lunate with passive or active extension past ~80 degrees. Sharp pain with weightbearing on palm when wrist is in extension. No pain if weightbearing on hand with fingers fisted and wrist in neutral. No strength limitations in hand or forearm, no sensory changes. In addition to the sharp pain with extension, I have constant aching pain (~2/10) in the posterior wrist. No visible inflammation.

As mentioned above, I do have significant hypermobility (115 flexion, 104 extension) and laxity of the TFCC complex and just really the whole wrist joint in general. I am very conscious of trying to stay out of that excessive range. I'd really appreciate any advice, as I've not had great improvement with ice, NSAIDs, splinting, rest, heat.

Thank you!

Hi,
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Hi,

is the pain relieved with use of a splint? This may very well be a long term, albeit temporary solution (especially in your line of work!)

Have you completed any form of exercise for your wrist?

Thanks

TRY TAPING, I hope it will help You. GOOD LUCK.

Thank you all for the advice. I have a few splints that I wear occasionally. I have one that was made by a hand therapist for me, and it's just a plastic sleeve style splint, you wear stockinette inside it. This one fits well, but it's kind of a pain to deal with stockinette all the time. The other one is a more typical standard wrist splint, but I don't love it because I have big hands and small wrists, so it doesn't fit super well. I do wear it to sleep in a lot, but I certainly won't be able to wear it at work (inpatient). I have tried taping a bit- I'm allergic to leukotape, so that's a no-go. I believe kinesiotape is latex-free- do you think that would provide enough support?

Oh, and exercise. No, I haven't really done anything for exercise. I feel like whenever I exercise I flare it up, though I'm sure that's not entirely true. I also have some problems with my elbows, so i generally don't have great success with UE resistance exercises. I've done yoga in the past, and most of the time that is fine, but when my wrist is irritated something like the downward dog position, with weight on the palm, REALLY hurts. I would love to hear any recommendations. I know that in theory exercise might strengthen this joint, but it seems to me that the majority of wrist stability comes from ligamentous structures rather than muscle, and my very high degree of ligamentous laxity, I have to say I'm a little skeptical. I'd LOVE to hear otherwise!

why dont u try a under wrap with tape? it is made up of hypo allergic material, especially made for people who have allergy from tape. As u must be knowing advantages of tape are that, it shift the line of force, so the painful/injured/inflamed area gets rest. and it keeps ur hand functional, unless like most of the splints which interfere with the range of motion.

You're right, it absolutely seems that an underwrap should help, but I've used the white hypo-allergenic tape under leukotape, and sill got a rash in the exact shape of the taping technique used.

Extensor carpi radialis brevis, extensor indicis, subscapularis, scalene minimus all refer pain to the back of the wrist. Check them out at Forearm & Hand Pain
As near graduating PT student myself, I have the same pain issue from all the typing and bad study posture. If this is what’s causing the pain, rather than issues with hypermobility, you can address it by finding the offending points, working them out, and if they are causing the pain the pain should go away. Good also to figure out the source of the trigger points, to prevent future issues. Posture? Neck Tension? Repetitive typing?