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When a simple hand movement, such as making a fist or moving the thumb, becomes painful, it could be from daily overuse. 

"One of the most common is something called de Quervain's tenosynovitis," says Dr. Kakar.

He says it's primarily a tendon problem. 

"If you think of the wrist, basically what we have here is that we have the tendons, which move your thumb. And they are covered by this band, and this is natural. We all have this, but in certain patients, they can have inflammation in this area," says Dr. Kakar.

When the tendons underneath this band become inflamed, they can cause intense pain.

"Now, luckily, the treatment for this is relatively straightforward."

Hand therapy and wearing a splint may help. 

"Sometimes we need to do a corticosteroid injection to decrease inflammation, and most of the times, it gets better. But sometimes we need to do surgery," says Dr. Kakar.

It's an outpatient procedure that involves opening the sheath surrounding the tendon to release pressure, and allow the tendons to glide more freely and pain-free. 

Related posts:

• Mayo Clinic Minute: Avoiding overuse wrist injuries
• Mayo Clinic Minute: Relief for achy wrists
• Mayo Clinic Minute: Why tennis is great for the heart and mind but rough on the wrist

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Watch: The Mayo Clinic Minute

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"Ulnar wrist pain is a small area from the pinky side of your hand. And it's from this little knobbly bone called the ulnar to this area near the wrist," says Dr. Sanj Kakar, a Mayo Clinic hand and wrist surgeon. "It's very, very common."

Ulnar wrist pain can occur after a fall onto an outstretched hand. But it also happens in people who play stickhandling sports, like tennis or hockey, and certain occupations that require lifting or using a repetitive motion in the wrist. 

"And then it manifests in, for example, when they're turning a door, opening a jar, when they're pouring a glass of water — that twisting motion," says Dr. Kakar.

Bones, cartilage, muscles, tendons and ligaments — all can be sources of ulnar wrist pain. Treatment varies.

"Sometimes it may be a simple sprain. And so we have a sort of acronym, RICE. We can rest it; we can ice; sometimes put on a sleeve — a compression sleeve — or a splint; and elevate," says Dr. Kakar. "But if it doesn't get better and if you have lingering pain, this is not something that you should sort of just work through it because there could be an underlying problem that needs to be diagnosed and treated effectively."

Your health care team, led by a hand and wrist specialist, may recommend hand therapy, a wrist brace, injections and possibly surgery.

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was either recorded prior to COVID-19 or recorded in a nonpatient care area where social distancing and other safety protocols were followed.

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Dear Mayo Clinic: Earlier this spring, I developed pain in my wrist and on the inside of my elbow after a long weekend of tennis and yardwork. I applied ice for a few days, but the pain remains anytime I rotate my arm a certain way or try to lift anything heavy. I even feel some pain while holding my cellphone. While I can hire someone to complete the landscaping activities, I have a tennis tournament coming up. I’m wondering what I can do to get back on the court pain-free.

Answer: The wrist and elbow certainly can be affected by robust activity ― athletic or otherwise ― especially if you have not been using the muscles a lot. The condition you're describing sounds like medial epicondylitis, a common injury associated with overuse. Although you mentioned playing tennis, this condition is also known as "golfer's elbow." But it isn’t limited to golfers.

Medial epicondylitis is a painful condition that develops when the muscles and tendons that control flexing of your wrist and fingers become inflamed and damaged, often by repeated stress due to gripping, or forceful wrist and finger motions. Golfers or tennis players may develop this condition when they repeatedly hit the ball incorrectly or use improper swing techniques.

With the increased use of mobile devices and computers, many people are developing wrist and arm pain as a result of improper ergonomic positioning while typing or texting. The best way to treat medial epicondylitis is to reduce repetitive wrist and hand activities until your symptoms improve. This means refraining from things such as excessive typing, yardwork, tennis, golf and other activities.

Ice the painful area for 15 to 20 minutes at a time, three to four times a day, for several days. Take an over-the-counter nonsteroidal anti-inflammatory drug, such as ibuprofen or naproxen sodium. Basic home rehabilitation stretches and exercises also can help minimize pain and get you back on the court faster.  

For many people, self-care measures often are enough to take care of the problem. But, because you still have symptoms after icing it for several days, I would recommend an evaluation with your primary health care provider or a sports medicine specialist to determine if you need additional treatment.

Based on an exam and severity of your symptoms, your health care provider may recommend that you wear a counterforce brace on the painful arm. This type of brace can reduce strain on your muscles and tendons temporarily. Your provider also may refer you to a physical or occupational therapist who can teach you techniques to help ease your symptoms, as well as stretching and strengthening exercises. In most cases, no further evaluation or treatment will be needed beyond that point.

In the rare instance that your pain remains persistent, your provider may suggest a musculoskeletal ultrasound study or MRI to evaluate if there's a tear in one of your muscles or tendons.

Additional treatment may include corticosteroid injections. Although they can help ease pain for a while, these injections generally are not effective long term. Another newer treatment is platelet-rich plasma injections. The goal of this approach is to help heal tendon damage and promote the growth of new, healthy tissue.

When pain lasts despite other treatments, more invasive approaches may be necessary. Then if symptoms don't improve after thorough use of other treatments, surgery could be an option to remove the damaged tissue.

Once your symptoms resolve, it is important to take steps to prevent golfer's elbow from returning. Weight training to strengthen your forearm muscles and stretching exercises before you go play will help avoid injuries. If you golf, consider upgrading to lighter graphite clubs to reduce stress and strain on your wrists. For tennis, in addition to limiting the amount of time you spend on the court, you may need to adjust your grip. Consider having your swing or form evaluated by a tennis or golf pro, as adjusting underlying mechanics can reduce your risk for reinjury.

Most importantly, don't play through pain. If you notice discomfort in your wrist, elbow or forearm, take a break. Pain is your body’s way of signaling to you something is wrong. Many overuse injuries will improve with rest and home care. Hopefully, you will get back in the swing of things quickly and pain-free. — Dr. Kristina DeMatas, Family Medicine, Mayo Clinic, Jacksonville, Florida

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In this Mayo Clinic Radio Health Minute, Dr. Sanj Kakar discusses several treatment options are available to relieve tingling and numbness, and restore wrist and hand function.

To listen click the link below.

Symptoms and solutions for carpal tunnel syndrome

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"The problem wasn't in Juan Martin's head ... it was in his wrist."

The 2009 U.S. Open tennis champ Juan Martin del Potro is making another run for the championship ... seeded sixth in this year's U.S. Open. Mayo Clinic orthopedic surgeon Richard Berger, M.D., Ph.D., helped the Argentinian tennis star overcome a debilitating wrist injury suffered after del Potro won the 2009 U.S. Open. Read more in Reeves Wiedeman's article in Grantland. 

Journalists: For interviews with Dr. Berger contact Lee Aase at aase.lee@mayo.edu or call 507-266-2442.

 Learn more about Dr. Berger's work in this video on treating wrist pain.

The post Mayo Doctor Puts Tennis Great Back in the Game appeared first on Mayo Clinic News Network.

The 2009 U.S. Open tennis champ Juan Martin del Potro is making another run for the championship ... seeded sixth in this year's U.S. Open. Mayo Clinic orthopedic surgeon Richard Berger, M.D., Ph.D., helped the Argentinian tennis star overcome a debilitating wrist injury suffered after del Potro won the 2009 U.S. Open. Read more in Reeves Wiedeman's article in Grantland. 

Learn more about Dr. Berger's work in this video on treating wrist pain.

The post “The problem wasn’t in Juan Martin’s head … it was in his wrist.” appeared first on Mayo Clinic News Network.

For five years, Erin Turner battled pain that ranged from nagging to excruciating in her right wrist. Turning a doorknob hurt. Opening a jar of spaghetti sauce was impossible. She repeatedly visited an orthopedic surgeon in Washington, D.C., where she works for a communications firm, and couldn’t get an answer for her pain.

That is, until she saw a “tweet” on Twitter on Nov. 12, 2009 about an online chat about wrist pain that Mayo Clinic orthopedic surgeon Richard Berger, M.D. was holding in conjunction with USA Today. That morning’s edition of the newspaper had carried a story about Jayson Werth, an outfielder for the Philadelphia Phillies, who had just played in his second World Series after coming back from a career-threatening wrist injury. Jayson had credited Dr. Berger with saving his career by repairing a split tear of the UT ligament in his wrist. The story told how Dr. Berger had discovered this type of injury a few years earlier, and that it is quite common but almost always undiagnosed because it doesn’t look link the typical ligament tear, either on physical examination or through an MRI.

To enable readers with questions about wrist pain to interact with Dr. Berger, Mary Brophy Marcus of USA Today and her editors agreed to sponsor a joint Twitter chat with Dr. Berger and @MayoClinic.

That’s how Erin met Dr. Berger, as she tells the story here in her blog post. And on Monday of this week, six weeks after her surgery, Erin returned to Mayo Clinic to have her cast removed, receive physical therapy instructions, and be fitted with a splint.

After her appointments, Erin reflected on her story and shared her thoughts about its meaning as a patient and as a professional communicator:

Update (4/12/10): Last week the Phillies opened their season in Washington, D.C. against the Nationals, and Erin was joined by a reporter and photographer from USA Today in getting to meet Jayson Werth and thank him for sharing his story. Read the story on USA Today online.

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Dr. Richard Berger describes the ulnar fovea sign, a simple test he developed that has 93 percent specificity in diagnosing a type of mysterious wrist pain that can be surgically repaired with a 95 percent success rate.

The post Wrist Pain- UT Split Tear, Diagnosis and Treatment appeared first on Mayo Clinic News Network.

Now Jayson is a member of the World Champion Philadelphia Phillies, and I had the opportunity to interview him yesterday before their home game against the Washington Nationals. Jayson recalled the pain, frustration and anxiety that brought him to Mayo Clinic in August 2006 to see Richard Berger, M.D., an orthopedic surgeon and wrist specialist.

Jayson described meeting Dr. Berger and the subsequent examination, diagnosis and arthroscopically guided surgical procedure that helped him begin the rehabilitation journey and led to him signing a major league contract with the Phillies in December 2006.

http://www.youtube.com/watch?v=zQ_Q_qYO--M

The type of injury Jayson Werth experienced, which is called a “split tear” of the ulnotriquetal (UT) ligament, is one that Dr. Berger first identified, and for which he has pioneered the successful treatment (see the animation). In this podcast audio interview, Dr. Berger explains the injury in greater detail and describes the people typically affected, as well as why it is typically missed when a physician looks at an MRI of the injured wrist. Because it involves a lengthwise split of the ligament instead of a complete rupture, it is often undiagnosed. And as this Mayo Clinic Medical Edge story indicates, the UT split tear affects not just elite athletes like Jayson, but people from various occupations as well as recreational athletes.

After a strong 2007 season with the Phillies, Jayson became a regular on the 2008 team that defeated the Tampa Bay Rays in the World Series. Jayson hit 24 home runs during the season, and also homered in the fourth game of the Fall Classic. He reflected yesterday on his comeback from injury and why he wants to share his story:

http://www.youtube.com/watch?v=i_ivHzFQwCs

Related Diseases

• Ulnar Wrist Pain

Related Departments

• Orthopedics
• Physical Medicine and Rehabilitation

Lee Aase is manager for syndication and social media at Mayo Clinic.

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