Medical Treatment for Wrist & Hand Repetitive Use Injuries
NYU Langone doctors often recommend resting the injured hand or wrist. They can tell you which activities to avoid—such as the repetitive thumb movements associated with texting, or the twisting and gripping of a tennis racket—so that you can prevent symptoms from worsening. The orthopaedist may suggest immobilizing your hand or wrist for a few weeks or longer to ease your discomfort. A stabilizing device, such as a splint, can help to prevent movement of the injured hand or wrist.
Your doctor may also recommend one or more of the following nonsurgical treatments.
Rest, Ice, Compression, and Elevation
A doctor may prescribe rest, ice, compression, and elevation (RICE) for one to two weeks after diagnosis. Resting the affected tendons and muscles reduces inflammation and gives the body time to heal. A doctor may recommend applying ice for 15 minutes three times a day during the first three days after an injury.
After that, switching to a heating pad may increase blood flow to the injured area and speed healing. Elevating the hand while resting can reduce swelling, and compressing the affected area with an elastic bandage can support the hand while it hand heals.
Because overuse injuries can be job-related, NYU Langone occupational therapists can work with you to ensure that your daily routine doesn’t aggravate your symptoms. They focus on ergonomics, in which they study the way you work, and then help you adjust your surroundings to reduce stress on your wrist and hand. This can help to eliminate injuries associated with repeated tasks at home or in the workplace.
During an ergonomic evaluation, an occupational therapist observes how you use your workspace. For example, if you work in an office, he or she watches where you place your computer mouse or how you sit in your chair. The therapist works with you and your employer to make simple changes that can ease your symptoms.
Our therapists may recommend workplace modifications, such as the way you use a hand tool or hold an instrument, that suit your particular needs without affecting your performance.
Your doctor may recommend strengthening and stretching exercises for your wrist or hand. Hand therapy is offered on an outpatient basis at NYU Langone. Our certified hand therapists have completed additional training in hand therapy and have at least five years of experience in treating repetitive use injuries. They work with you and your doctor to create a customized treatment plan, with the goal of improving your range of motion and reducing pain.
Initially, you may visit the hand therapist several times a week. After you’ve learned how to perform the exercises correctly, you can then do them at home.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, are available without a prescription and can help to reduce inflammation in the hand and wrist. Doctors typically recommend using these medications for a few weeks, until the injury begins to heal.
If over-the-counter pain medications don’t provide relief, your doctor may recommend injecting corticosteroid medication into the area surrounding the affected tendon. Corticosteroids can quickly reduce inflammation, alleviating pain. They may be especially useful for the treatment of tendinitis, which occurs when a tendon—a cord of tissue that connects muscles to bones—becomes inflamed as a result of irritation or stress; de Quervain's tenosynovitis, an irritation of the tendons that run from the wrist to the thumb; and stenosing tenosynovitis, or “trigger finger,” in which inflammation in the tendons of the palm prevents the usual movement of a finger.
Our doctors administer these injections on an outpatient basis, and you can return home after the procedure. Repeated corticosteroid injections may weaken the tendon, so our doctors recommend limiting this treatment to less than three injections, separated by at least four to six weeks, in a one-year period.