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What is wrist pain?

Much akin to elbow pain, wrist pain may be simply caused by trauma.  Over working the muscles or joints of the wrist will definitely cause pain local to the area.  Excessive strain of the wrist may cause the nerves that pass through it to inflame, which may cause a condition known as carpal tunnel.  However, that same condition may be caused by nerve irritation and inflammation further up stream, in the forearm, elbow, shoulder or neck.

What if I didn’t just traumatically injury my wrist?

The majority of non-traumatic pain that occurs in the wrist is due to Thoracic Outlet Syndrome (TOS) from the shoulder, or is radicular pain from nerve impingement somewhere between the neck and hand.  This is where diagnosis of the pain becomes complicated.

For there to be irritation in the wrist from the neck, there doesn’t have to be any actual pain in the neck.  It is this very point that many patients don’t understand.  Just because there is nerve irritation, does not mean there is enough damage or inflammation present to cause substantial pain in the neck.  There may also be very minimal irritation in the neck but it might compound with a little more in the shoulder, then some more in the forearm prior to the nerves crossing the wrist.  When the wrist is then utilized, the nerves in the wrist will become very easily irritated because they are already moderately inflamed throughout their whole path to their location.  This pain is known as radiculitis, or inflammation of a nerve.  In the neck, radiculitis typically causes pain somewhere in the arm.

Wait, so my neck can make my wrist hurt?

If you were to look at the bones in the neck, they are numbered from 1-7.  The bottom half of the nerves from the neck, pertain to the sensation and movements of the hand.  From C7 through the first thoracic nerve (T1) The nerve levels that apply to the hand are C7, C8, T1 with the pain distribution being split.  The thumb, index finger and ½ of the middle finger are typically given sensation by the Median nerve C7/C8 and the other half of the middle finger, ring finger and 5th digit (pinky finger) are supplied by the Ulnar nerve C8/T1.  The palm of the hand follows the same split pattern, but the back of the hand is typically given sensation by the Radial nerve, which gives skin sensation to most of the back of the hand and allows many muscles of the forearm to move properly.

So the nerves from the neck affect my wrist, but how does that cause wrist pain?

Pain in the wrist is a common result of poor posture and repetitive strain activities like frequently turning your hand over or frequent wrist bending (flexing).  The last two activities are commonly seen with manual labor type activities while the first is more common for the desk worker.  These are not “absolute” activities that will cause these problems, however.

How can chiropractic treatment help this?

Similar to the elbow pain treatment, identifying the source of the pain is the most important part of the treatment.  Carpal tunnel frequently starts before the wrist, so the pain in the wrist is the symptom, not the problem.  Chiropractic adjustments to the lower cervical spine and upper thoracic aid in resolving the tension on the afflicted structures at their source, which in turn will help resolve the pain in the wrist.  These adjustments coupled with myofascial treatments to the pathway of the nerve or blood vessel greatly reduce a patients pain and restore proper function.

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