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Elbow, Wrist, Hand & Finger Pain Physiotherapy
Strained or Inflamed Causes, Symptoms and Relief Treatment

Do you know someone who has pains or aches in their elbow, wrist, hand or finger? 

Frankly, anyone who

  • works in jobs that require repetitive arm or hand movements
  • engages in hobbies
  • plays sports

has higher chances of getting injury or developing painful conditions from their fingers all the way to their elbows.

My nam

who to see for your elbow, wrist, hand and finger pain:
hand therapist or physio or chiropractor vs osteopath

My name is Nigel Chua, and I am a hand occupational therapist (often shortened to hand therapist) and all I do professionally, clinically, is hand therapy, where I assess, diagnose and treat painful conditions or injuries to the

  1. elbow
  2. forearm
  3. wrist
  4. hand
  5. fingers (including the thumbs)

I've often found it unusual that NON-hand/upper limb trained physiotherapists, chiropractors and osteopaths communicate that they "can" and do treat pains in the elbows to the fingers, because our fingers, hand, wrist all the way to the elbow is so complex and intricate that cannot and should not be treated like injuries to the other parts.

The problem when getting advice or treatment who dont know or dont have the expertise to treat is 

  1. WRONG treatment means that the painful injury or condition either wont get better or get more inflamed
  2. DELAYED RIGHT treatment and this is the more problematic issue. Most conditions heal better the earlier it is treated with the right diagnosis and treatment, and delaying it can mean something mild that can be resolved in 6 weeks can become either severe or chronic that may take 6-12 months to recover.

That is why I ONLY treat elbows, forearms, wrists, hands and fingers and I dont communicate that I can treat anything outside of my scope. Shoulder pain? See our shoulder physio. Knee pain? See the knee pain physio. 

I specialize and go deep for best and fastest recovery.

If I'm not the right therapist to treat you, I will also tell you and refer you to the right one for you.

If you do need surgical intervention, I will tell you that as well, and refer you to the right and trustworthy doctors I know (hand or other orthopedic doctors) in Singapore.

This is my commitment to you and my profession.

reasons for elbow, forearm, wrist, hand and finger pains in singapore

So generally, there are two (2) reasons for pains in the elbows, forearms, wrists, hands and fingers:

  1. Acute injuries including trauma / force or infections
  2. Overuse and overstrain issues over time

Let's talk about these 2.

Acute injuries including trauma / force or infections

Acute injuries to the fingers, hands, wrists, forearms and elbows include

  1. Falling

    a) on outstretched hand (FOOSH)
    b) falling to side / back
    c) from height such as from ladder or stairs
    d) during exercise such as slipping on yoga mat but in half-standing

  2. Motor vehicle accident (car / motorbike) as driver or passenger or pedestrian

  3. Bicycle / e-scooter accidents

    a) crashing into things
    b) hard braking causing one to be thrown off the bicycle 

  4. Sports

    a) direct blow such as in MMA or boxing
    b) finger or hand getting caught in clothing
    c) falls

  5. Infections arising from bites or scratches

Injuries that are acute tend to be more painful and quick, such as fractured bones, partial/full tear of tendons, muscle tear etc, and also tend to be more than one structure at a time eg in the case of a fall leading to wrist fracture (distal radial fracture), patients may also have multiple soft tissue injuries such as ligament sprains, cartilage tears of multiple nearby joints and structures, making recovery more slow and complex if left untreated.

Overuse and overstrain issues over time

Overuse and overstrain is as the name implies - structures in the elbows, forearms, wrists, hands and fingers that are overused, leading to wear-and-tear breakdown, and the recovery rate is slower than the overuse rate.

Examples of these are:

  1. Elbow

    a) Golfer's Elbow
    b) Tennis Elbow

  2. Wrist

    a) TFCC
    b) Carpal Tunnel Syndrome
    c) De Quervain's tenosynovitis

  3. Hand & Fingers

    a) Trigger finger / Thumb


Hand therapists are trained and experienced in treating both acute injuries and overuse conditions of the fingers, wrists and elbows, providing pain relief, as well as restoring strength, movement and function.

What is hand therapy for Elbow, Wrist and finger Pain?

Some people also call us hand physiotherapists, and we're trained and experienced in matters of the muscles, bones, tendons, cartilages, ligaments and nerves from the fingers to the elbows.

First of all, we need to spend dedicated time to properly assess, test and analyze the structures that are injured or strained, to find out exactly what is the core problems. This will include differential diagnosis to rule out problems that may be similar but arent (same same but different) which can be easily missed by those who are not experienced or trained in hand therapy.

Next, once we'd established whats the core problem I will create a personalized finger, wrist and elbow therapy program just for your injury and your recovery, and then we will have a series of hand therapy sessions together.

You can expect some of the treatments to include

We dont prescribe medication, injections or surgery but where necessary, I can refer you to a hand surgeon or orthopedic doctor that we trust and work with them.

uncertain what is your hand pain? let us help.

If you have aches or pains in your elbow, wrist, hand or fingers for more than 7 days, but you're unsure what you have or if it even requires treatment, message us and visit us for an assessment and we will help you figure it out. 

for the geeks or the really interested:
the complex function and ANATOMY OF THE HAND, WRIST AND ELBOW

Regardless of what your age is or work, your fingers, hands, wrist all the way to the elbows will be the MOST used parts of your body.

Our elbows, forearms, wrists, hand and fingers are very complex and intricate structures, unlike the larger structures such as say knee or shoulder.

All the bones, muscles, ligaments, tendons, cartilages and nerves work together in a very fine manner that allows smooth and easy movement as well as function.

BONES IN THE HAND, WRIST AND ELBOW

There are a total of 27 bones in the hand.

Bones of the fingers (other than thumb) have 3 parts:

  1. Distal phalanx - the part of the finger furthest away from the knuckle, which has the finger tip
  2. Middle phalanx - the middle part
  3. Proximal phalanx - the nearest finger part to the knuckle

The thumb doesnt have the middle phalanx, so it consists of

  1. Distal phalanx - the part of the finger furthest away from the knuckle, which has the finger tip
  2. Proximal phalanx - the nearest finger part to the knuckle

These phalanges (which is plural of phalanx, which simply means finger bones) connect to the metacarpal bones of the hand. The metacarpal bones are the bones within the hand itself ie your knuckle bones

metacarpal-carpal-bones-highlighted

There are 5 metacarpal bones (blue box) in the hand and each are linked to a finger: thumb, index, middle, ring and little finger. These metacarpal bones are then connected to the carpal bones (green box above)

There are a total of 8 carpal bones, which is organized into 2 rows:

  • The distal row (nearer to knuckles) contains the trapezium, trapezoid, capitate and hamate, and it connects the carpals to the metacarpals. 
  • The proximal row (nearer to wrist), made up of the scaphoid, lunate, triquetral, and pisiform, connects to the bones of the forearm.

As you go upwards, you get to the bones of the forearm, which are the radius and ulna

elbow-wrist-bones

The ulna bone extends from the pinkie finger side of the wrist to the elbow, and the radius goes from the thumb side of the wrist to the elbow. The humerus, the large bone that makes the upper arm, meets the other two at the elbow.

These three bones help form two joints which complete the anatomy of the elbow. These joints are the humeroradial joint, where the radius and humerus join to straighten and bend the arm, and the proximal radioulnar joint, where the ulna and radius meet to allow rotation of the lower arm.

Flexible and tough ligaments hold together the two joints. The ligaments of the elbow are integral in keeping the joints connected and stopping elbow injuries which may cause elbow pain. The elbow ligaments consist of the Ulnar Collateral Ligament (UCL), the Radial Collateral Ligament, and the Annular Ligament.

That's just the bones and some mentions of ligaments.

MUSCLES IN THE HAND, WRIST AND ELBOW

The muscles intertwined with the forearm and hand bones are responsible for moving the hand and fingers. The muscles of the hand include:

  1. Interossei muscles, which allow us to spread our fingers and move them together
  2. Hypothenar muscles, found on the small finger side of the hand
  3. Thenar muscles, found at the base of the thumb
  4. Lumbricals, which allow the fingers to straighten.

There are additional muscles in the hand as well, which make up the thumb.

In the upper arm, the bicep and tricep muscles help straighten and bend the arm from the joint of the elbow. These muscles are connected to the bones by the biceps and triceps tendons. The biceps tendon helps bend the joint, while the triceps tendon helps straighten the joint.

elbow-forearm-superficial-muscles

Illustration of the front and superficial (1st layer) muscles of the forearm.

hand-front-superficial-anatomy

Here's another illustration on the complexity of the hand, just the front (volar).

NERVES IN THE HAND, WRIST AND ELBOW

The three major nerves that run from the arm into the hand are the

  1. ulnar nerve
  2. radial nerve and 
  3. median nerve

The nerves are responsible for contracting and moving specific muscles and also give us sensations of touching or feeling something.

The nerves are also responsible for feeling pain, heat or cold.

As you can imagine, finger, wrist to elbow pains or injuries can and will have a large impact on function, movement and quality of life.

Be it fracture, carpal tunnel disease, infected joints, these and other painful hand conditions can impair your ability to

  • reach out
  • grip
  • type
  • hold
  • twist

All of which are parts of your daily life.

Our hand therapy #1 goal is to help restore movement, bring down pain, rebuild strength and function to get you back to normal and full living.

It is important to seek medical advice from a trained and experienced hand therapist (not any physios, chiropractors, osteopaths or google) to get an accurate diagnosis of your elbow pain, wrist pain, hand and finger pains.

Only after you get an accurate diagnosis, then you can apply the correct treatment methods to resolve the pain and injury. Instead of self-diagnosing and risking the chance of an inaccurate diagnosis, it would be better to consult with our hand therapists.

hand therapy goes beyond pain relief for elbow, forearm, wrist and finger pains

First step to getting better is pain relief.

During your first session, the hand therapist will do an indepth and thorough assessment to determine the structures that are injured in your finger, hand, wrist and elbow, followed by the exact cause of the hand pain.

Then we will provide immediate hand pain relief with a combination of manual therapy, reduction of any compressions as well as ultrasound therapy (as well as other treatments, of course, depending on the outcome of the assessment).

Next: effective elbow, wrist, hand and finger therapy and treatments

Pain management and pain relief will always be the base foundation treatment (it is hard to do treatments or for patients to function if the pain is in the way), and then we layer on with other healing techniques and treatments to bring your pain down as well as accelerate injury recovery.

It's aligned to your treatment plans and goals.

Thirdly, the elbow, wrist and hand pain relief needs to last longer and longer.

Often what happens is patients gets pain relief for a couple of hours or maybe a day, and then they need to come back for treatment. We dont like that. We want the pain relief to last for days, weeks and then ideally to recover completely (ie the pain never comes back).

That's why our sessions are always one-to-one, and we never have any assistants to help us, and that's also why we spend so much time in the assessments. We deep-dive to confirm the root cause of your elbow, hand and wrist pains, so that we can treat accurately.

Lastly, better than before.

Getting back to pre-injury is pretty good, but we dont want to stop there. Let's get you back to even better than before, especially if before the injury your range, strength or stamina is okay, we want to get you to good.

hand-therapy-and-customized-splinting

Frequently Asked Questions Regarding Elbow, Wrist, hand and finger pains or injuries

What can I do to prevent elbow, wrist, hand or finger pains?

Frankly, preventing common painful overuse conditions and injuries may include:

  1. Making sure you stretch often before and after the sports, hobbies and activities. This can hep prevent injuries and pains
  2. Pre-emptive treatments including sports massage regularly as well as sports-specific prehab strengthening and training. Strengthening can help support joints and structures well to prevent injuries.
  3. Take regular breaks during your sports, hobbies and even work. Our bodies are not machines that can work 24/7, so take a quick 5 minutes break every 45 minutes of work to walk about, stretch and drink some water.
  4. Hydrate. Our bodies are 70%+ water, and we need water for a lot of functions to work properly, so keep drinking liquids and water throughout the day.
  5. For desk-bound workers, wrist pains are pretty common. For you, we recommend to increase the ergonomics of your work space which includes ergoes, keyboards and mouse. See under our shop, Ergonomics.

When should I see a hand therapist for my elbow, wrist or finger pains?

I recommend seeing a professionally and clinically trained hand therapist as soon as possible as the earlier any pains or injuries are treated properly, the better and fuller the recovery. If the pain is sharp or severe, come to us as soon as possible.

What kinds of hand therapy treatments do you have?

We need to assess your pain and injury first to find out exactly what structures are damaged and the root causes before we move onto treatments.

Some of the treatments may include

We dont prescribe medication, injections or surgery but where necessary, I can refer you to a hand surgeon or orthopedic doctor that we trust and work with them.