Indent in wrist: Dorsal Wrist Syndrome Diagnosis and Treatment

25.09.202329.06.2023 by alexxlab

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Dorsal Wrist Syndrome Diagnosis and Treatment

What is Dorsal Wrist Syndrome?

Dorsal wrist syndrome is actually the most common cause of wrist pain on the thumb side of the wrist.

It is worse or made worse:

When the wrist is bent backwards.
The pain is worse with heavy-lifting.
Patients sometimes have pain with heavy gripping or after releasing after heavy gripping.
It’s often made worse or irritated by typing or keyboard work.
Patients will very often have a lump on the top of the wrist or a dorsal ganglion, as seen in this picture here. The dorsal ganglion itself is usually a bit of joint fluid that escapes from the damaged joint surface in dorsal wrist syndrome.
Eventually, people with dorsal wrist syndrome will develop arthritis if it’s no managed properly.
They will eventually develop constant pain and stiffness, so it’s a very important thing to understand.
Patients will usually have pain with the thumb side of the wrist.
There is usually pain when bending the wrist backwards.
There is often tenderness in the snuff box – this area here of the wrist. When pushing hard here, patients will often feel pain.
There may be laxity or looseness in one of the bones in the wrist called the scaphoid bone, which is located approximately here in the wrist.

What Causes Dorsal Wrist Syndrome?

The cause of dorsal wrist syndrome is when the wrist bends backwards, generally past 35-degrees as seen in this gymnast, the cartilage and the ligaments in the proximal row or the very initial part of the wrist in this area here are damaged.

The reason they’re damaged is because the contact surface area of the joint goes from a large one-centimeter contact surface with a straight wrist into this very tiny one-millimeter contact surface when the wrist is bent and that creates damage to the cartilage along the wrist surface here and it creates damage to the ligaments along the wrist surface here, eventually leading to cracked cartilage, loose ligaments, and arthritis.

Who is at Risk for Dorsal Impaction Syndrome?

Individuals with more flexible wrists.
Younger people, women, often people with very slim builds.
Individuals who regularly put heavy weight against an extended wrist are at higher risk.
Gymnasts, people who are doing pushups such as this woman here with her wrist bent. People who weight lift and allow their wrist to bend backwards. People who do yoga with a downward dog and the wrist bent in this position. Often people who work with their wrists after force and bent back, such as carpenters, can develop this if they don’t have good wrist positioning while working.

How is it Treated?

There is no way to repair the damage once it has occurred.
Prevention is the main treatment.
Avoidance of activities that bend the wrist past 35-degrees.
If you’re doing an activity where your wrist may be forced back, consider a splint that holds your wrist in a neutral position, such as this one here.
There is also specialized Dorsal Impaction Hand Therapy. I am aware of one therapist who can provide this.

What about the Pain?

If one has chronic pain, there is a stepwise approach to treatment.

Initially, we start with splints.
Specialized Dorsal Impaction Hand Therapy Programs. Currently, I am aware of one.
Anti-inflammatory creams and medications
Cortisone injections
Surgery, however, this is a last resort used for salvage or desperate situations. Surgery includes:
- Resection of the nerves that provide pain to the wrist.
- Partial or complete wrist fusion.

Watch Dr. Anzarut’s Video on Dorsal Wrist Syndrome

All You Need to Know About Scaphoid Fracture

Do you often end up putting your weight on your wrist? If there is too much stress on your wrists, it might impact your elbows, shoulders, and neck. It means you are putting yourself at a higher risk of an injury. Sprains and fractures from sudden injuries often cause wrist pain. It can be caused by long-term stress on the wrist, such as arthritis and carpal tunnel syndrome. Remember, many things can cause pain, and diagnosing the exact cause is the most difficult. The next time you have wrist pain, you might mistake it as a sprain, whereas you may have a scaphoid fracture.

What is Scaphoid Fracture?

The scaphoid bone is one of the wrist’s eight smaller carpal bones. It is on the thumb side of your wrist below the radius (one of the two larger bones in your forearm). If you hold thumb up and look at the back of the hand, there’s an indentation, and at the end lies scaphoid bone. Due to the bone’s large size and position, it is most likely to injure or fracture. It is the most likely damaged carpal bone in the wrist. Scaphoid has three parts

· Proximal pole: End closest to your thumb

· Waist: Curved middle of the bone that lies under the triangular indentation.

· Distal pole: End closest to your forearm

Most scaphoid fractures happen at the wrist, 20 percent at the proximal pole, and 10
percent at the distal pole. Usually, the site of the injury affects how it heals. Most proximal poles have a poor blood supply and are cut off in a fracture.

Causes of Scaphoid Fracture

It is a common perception that when you are about to fall, your body has reflex action
to protect yourself from falling and extend your hand. You might save your face or head, but your arm and wrist may bear that force on themselves. That causes your wrist to bend back in an extreme position, causing a fracture. The further your wrist is bent, the more likely your scaphoid bone is broken. You may get hurt while participating in sports or other activities, which causes repeated stress on your wrist.

Diagnoses

Remember, it is not always apparent that your wrist pain would be a sprain it may be a
scaphoid fracture. It is accompanied by pain and tenderness and might be mild initially. However, as you pinch or grip, it may become worse. The tricky thing is it doesn’t swell, so it can be hard to find if there’s an issue or fracture with the wrist or not. These are the reasons which often confuse people if it is a fracture or a sprain and delay their treatment. And if you don’t treat your fracture, it can cause profound long-term implications. X-rays are common to identify a fracture. If the fracture isn’t determined and still the doctor feels the need, they will immobilize your wrist with a thumb splint for 10-14 days. Then again, you will undergo the examination. However, they might do MRIs
or scans for proper treatment if the bone isn’t visible.

If any of your activities have caused you wrist pain and given you a hard time, then don’t delay your treatment; schedule an appointment with FORM Hand Therapy at (510) 350-3030 today.

Pain in the wrists – causes of the disease, prevention

In just 24-36 sessions, depending on the intensity of treatment and the stages of the development of the disease, you will get rid of pain and discomfort in the wrist joint, increase mobility and amplitude in the joint, normalize sleep and be able to live full life

It is important to understand

In case of pain in the wrists, it is necessary to choose an individual set of therapeutic exercises, study the technique of their implementation and exclude exercises due to contraindications.

With this diagnosis, it is important to regularly attend treatment sessions, undergo a full course of treatment in a specialized Center, and in the future you need to maintain your health in a prophylactic regime on your own.

Urgent help

All videos of therapeutic exercises

This article will help you understand the causes of pain and discomfort in the wrist area, as well as conduct an independent diagnosis, taking into account the existing symptoms.

Conditions that cause pain in the wrist

Inflammation of a nerve or tendon can cause pain and discomfort in the wrist.

Wrist pain may be caused by carpal tunnel syndrome or ulnar epicondylitis. These diseases are accompanied by inflammation of the tendons. Damaged cervical vertebrae provoke inflammation of the cervical-brachial nerve. As a result, pain is felt in the wrist area.

An unpleasant symptom is reflected not only in the wrist joint, but also in the whole arm.

Localized wrist pain may be accompanied by deformity, poor mobility, or swelling of the wrist. This indicates the presence of diseases such as arthrosis and arthritis. In 20% of patients with similar symptoms, osteoarthritis of the wrist is diagnosed.

Arthritis and arthrosis

Arthrosis of the wrist joints, as a rule, appears after an injury. A dislocation or fracture can give a complication in the form of arthrosis. Symptoms of this disease are a crunch and a feeling of pain when moving. They occur during sudden movements. If the arm is bent or straightened as much as possible, then a crunch is heard in the joint, which is accompanied by pain. A hand that has previously been subjected to significant stress, even at rest, can hurt.

Arthrosis reduces the mobility of the wrist joint by 30-50%. In this case, the affected joint does not change its appearance. At first glance, the hand looks quite healthy. If the disease arose as a result of a fracture or displacement of the bones, then the joint has a noticeably deformed appearance.

Rheumatoid arthritis can cause inflammation in the wrist area, so it is easy to confuse it with arthritis. In fact, it is not difficult to distinguish these diseases. Arthritis pain in most cases occurs at rest. This may be in the morning or at night. In the active state, the pain is reduced. Discomfort subsides after dinner, and in the evening it completely disappears.

Rheumatoid arthritis causes marked deformity of the affected joint. This may be swelling, swelling, or a dent that appears due to muscle atrophy.

Arthritis can affect more than just the wrist joints. Several joints can get into the affected area at once. Arthrosis affects only the wrist joints. Deviation appears after suffering injuries or fractures.

Arthritis or arthrosis can be cured with the help of kinesiology, massage, reflexology, shock wave techniques, millimeter wave therapy, magnetic laser and mud therapy.

The main causes of wrist pain

In most cases, the cause of discomfort can be a fracture, dislocation of the wrist or sprain.

The wrist can hurt for the following reasons:

1. Sprain or other injury that was received as a result of a direct blow to the wrist or a strong fall on the arm. This can cause the wrist to swell. The mobility of the hand will be limited, and the person will feel excruciating pain.

2. Frequent strenuous exercise provokes pain in the wrist. It can be a sharp grip or a strong bend of the wrist. At risk are people who practice rowing, tennis or golf. Strong loads provoke the occurrence of tendonitis. These are very common diseases. The tendons are in very narrow sheaths. Even slight irritation of the tendons can cause seals.

3. Carpal tunnel syndrome. This disease most often develops in expectant mothers in the 2-3 trimester of pregnancy. The cause of the development of the syndrome is weight gain in women and swelling, which appear in the second half of pregnancy.

4. Monotonous work on the computer. Frequent use of the mouse and keyboard puts a huge strain on the muscles. Such work keeps the brush in a long tension. As a result, the tendons, which are located close to the nerves, swell. In some cases, the nerve swells. A right-hander has pain in his right wrist. A person feels regular discomfort. The ability to grasp something weakens, the hands of the palms go numb. This disease is called carpal tunnel syndrome.

Wrist injury

Injury may be caused by a fall or a strong blow. The consequence of an injury can be a fracture of the smallest bones of the wrist. Sometimes it is difficult to recognize an injury due to vaguely expressed symptoms. The main symptoms of injury are pain, swelling, and deformity of the wrist. Late treatment can adversely affect the motor abilities of the hand.

Sprain occurs from a sharp bending of the arm. The ligamentous apparatus consists of the radius, ulna and wrist. This damage provokes terrible pain. The hand loses its mobility.

Inflammation of the tendons and ligaments

Inflammation occurs in the walls of the tendons. They are responsible for the mobility of the muscles of the entire arm. The disease is called tendovaginitis. Regular, monotonous hand movements cause pain in the wrist. People of certain professions fall into the risk zone. The tendons are in narrow sheaths. With regular movement of the brush, irritation and inflammation appear. Seals may form. The main symptoms of tendovaginitis are aching pain, crunching and crackling. The process of development of the disease is quite long. The wrist hurts a lot when bent, it is difficult to grab an object with the hand.

Carpal tunnel syndrome

This disease is accompanied by pain in the right wrist. The main cause of carpal tunnel syndrome is monotonous, monotonous, long-term work. This pathology is typical for people of certain professions. For example: surgeons, musicians, tailors. This disease also affects people working on a computer. Such activity provokes infringement of the nerve, which is located in the narrow canal of the wrist. Symptoms of the disease: pain from the wrist to the elbow, burning, weakened fingers, tingling. It is difficult for a person to carry out daily work.

Rheumatoid diseases

The most common disease is rheumatoid arthritis. This is a systemic disease in which the immune system is weakened. It can affect not only the wrist, but also other joints.

The body begins to produce antibodies that attack its own tissues. This causes inflammation and damage to the joint. Pathology has a chronic protracted character. Women from 30 to 50 years old are at risk.

Dystrophic changes in the joint

In arthrosis, the cartilage that covers the surface of the joint is damaged and worn out. There is a deformation of the wrist, and pain appears. Joint dystrophy is diagnosed much more often than arthrosis of the wrist joint. The elderly are at risk. In exceptional cases, the disease occurs in adolescents and even children.

Preventive measures

It is possible to reduce the chances of developing diseases. To do this, follow these tips:

1. Perform special exercises that will strengthen the muscles of the hand.

2. If any symptoms occur, reduce the load on the wrist immediately.

3. Grab the object with your whole hand, not just your fingers.

4. People who work with vibrating machines must wear special gloves. They will support the hand. You also need to use gaskets that absorb vibration waves.

5. Before starting sports activities, it is necessary to put on special guards for the wrist. They will help prevent stretching.

6. You need to work at the computer intermittently. A five-minute rest can be spent doing squats. For the hands, it will be useful to stretch the fingers or shake the hands. Comfortable and stable shoes will help to avoid falls and injuries.

7. Do not lift objects that are too heavy. It is better to carry the load in parts. A strong load on the wrists can cause sprains.

Self-treatment of pain in the hands will not give a positive result. If you experience certain symptoms, you should immediately consult a specialist!

How is the treatment going?

You are consulting with a doctor

The initial consultation is by appointment.

Doctor’s consultation: history taking, myofascial diagnostics, functional diagnostics.

How does it work?

Collection of anamnesis – analysis of the disease, limitations and contraindications, explanation of the principles of kinesitherapy, features of the recovery period.

Myofascial diagnostics is a method of manual diagnostics, in which the doctor evaluates the range of motion of the joints, determines painful seals, edema, hypo- or hypertonicity of the muscles and other changes.

Functional diagnostics (carried out in the rehabilitation room) – the doctor explains how to perform certain exercises on the equipment and observes: how the patient performs them, what amplitude of movement he can work with, which movements cause pain, what weight the patient can work with, how he reacts the cardiovascular system. Problem areas are identified. The data is entered into the map. Emphasis is placed.

Based on the results of the initial examination by a doctor and functional diagnostics, a preliminary individual treatment program is drawn up.

It is desirable to have with you:

for pain in the spine – MRI or CT (magnetic resonance or computed tomography) of the problem area;
for pain in the joints – x-rays;
in the presence of concomitant diseases – extracts from the medical history or a polyclinic card;
comfortable (sports) clothing and footwear

Starting with an instructor

At the beginning of the treatment cycle, the doctor, together with the patient, draws up a plan of treatment measures, which includes the date and time of the treatment session, control visits to the doctor (usually 2-3 times a week).

The basis of the treatment process is therapeutic sessions in the rehabilitation room on simulators and sessions in the gym.

Rehabilitation simulators allow you to accurately dose the load on individual muscle groups, providing an adequate regime of physical effects. The treatment program is compiled by the doctor individually for each patient, taking into account the characteristics of the body. Supervised by qualified instructors. At all stages of recovery, it is important to follow the technique of proper movement and breathing, to know your weight standards when working on simulators, to adhere to the prescribed treatment regimen and follow the recommendations of specialists.

Sessions of articular gymnastics help to restore visual coordination, improve joint mobility and elasticity (flexibility) of the spine and is an excellent preventive system for independent use.

Each treatment cycle – 12 sessions. Each lesson is supervised by an instructor. The duration of one treatment session is from 40 minutes to 1.5 hours. The instructor draws up a program, taking into account concomitant diseases and the patient’s condition on the day of classes. Teaches the technique of performing exercises and controls the correct execution. Every 6th lesson, a repeated consultation of the doctor is carried out, changes and additions are made to the program, depending on the dynamics.

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How many cycles will it take? – individually for everyone

Important to know:

– how long have you had this problem (stage of the disease)

– how your body is prepared for physical activity (do you do gymnastics, any kind of sport) … –

Important!

what result do you want to get.

If the disease is in the initial stage and the body is prepared, one treatment cycle is enough. (example – young people aged 20-30 years old who go in for sports. We focus their attention on the technique of doing exercises, breathing, stretching, “wrong” exercises that are harmful to problem areas are excluded. Such patients are trained, receive the skill of “caring for their body ”, receive recommendations in case of exacerbation and continue to practice themselves).

If the problem has been around for a long time, you do not do gymnastics, there are concomitant diseases, then another period of time will be needed

– to remove the exacerbation? – one or two cycles is enough,

– restore the function?

– walking non-stop (climbing stairs),

– bending over, doing certain work without effort

– being motionless for a long time on a trip (in an airplane, car …)

improve? support? not worsen?

three or more treatment cycles may be needed …

Every organism is different and the program for every patient is different.

Specialization:

What happens to my hands while I’m stuck on my phone

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Hypochondriac

Author: Yulia Lebedeva

14.04.2022

Nowadays, the phone has practically become an extension of the hand: at the beginning of 2021, there were more than eight billion active smartphones in the world. We understand how the weight of the device can affect the health of the hands and what to do so that nothing hurts.

Most people hold their smartphone in such a way that it rests on the little finger and the thumbs are in front of the screen.

On Twitter and Tiktok, worried people create threads where they share photos of their little fingers: some have changed the position of the finger, and someone has a dent on it.

The little fingers of the author of the article also lost their symmetry.

Scientists have no evidence that the smartphone somehow displaces the joints in the little finger. Most likely, a dent on the little finger is formed due to compression of soft tissues, and this is not dangerous.

On the other hand, there is information that too long use of a smartphone can affect the development of tunnel syndrome.

The fact is that the repeated movements of the fingers with which we leaf through the tape can deform or displace the median nerve. This increases the risk of developing carpal tunnel syndrome.

Tunnel syndrome is not too disturbing at first: it causes numbness and tingling in the palms and fingers and sometimes mild pain. If you do not pay attention to these symptoms, over time they will begin to “climb” up the arm, the pain will become stronger, weakness will occur. The thumb will become naughty, there will be difficulty in gripping.

Doctors also say that frequent typing can cause textual tenosynovitis, or de Quervain’s disease. This is a condition in which the tendons on the thumb side of the wrist become inflamed. With this disease, it becomes painful to clench your fist, take something or turn your palm. There may also be swelling near the base of the thumb and a feeling of “sticking”.

Here’s what you can do to avoid the health risks associated with using your smartphone:

Hold your phone with both hands.