Why Won’t My Wrist Pain Go Away?

Why Won’t My Wrist Pain Go Away? Barefoot Rehabilitation Clinic
Wrist-Pain

18 Apr Why Won’t My Wrist Pain Go Away?

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You’re frustrated and annoyed that your wrist pain hasn’t gone away yet.

I know.

I work with people like you every, single day.

At Barefoot Rehab, we specialize in fixing people’s pains that have been present for more than 2 months, even when they’ve seen 3-5 other doctors.

When you see chronic pains (our definition of chronic is any pain lasting more than 3 weeks) on a daily basis, mental patterns rise to the surface.

The first signs of pain are largely ignored by you.

You think they’re going to go away.

After a few days when the pain hasn’t gone away, you look for self-management techniques:

Foam-rolling, lacrosse-balling, stretching, exercises, ice, heat, massage.

Those techniques don’t work, so you look for conventional methods for relief people talk about:

Chiropractic adjustments, physical therapy, or you see your medical or orthopedic doctor who prescribes anti-inflammatories or gives you an injection of one type or another.

Increasingly upset with nothing you do seeming to have any positive result, you decide to google “wrist pain” and you end up here.

So happy you decided to stop by!

My hope is to save you a lot of time, money, and energy by telling you what often is happening with wrist pain that won’t go away that is very commonly neglected by 95% of healthcare providers.

Tell Me About Your Wrist Pain

Do the wrist and finger extension test. I go into detail how to do the test HERE.

wrist-and-finger-extension

The results of this test, when combined with symptoms will tell you what your problem likely is, what type of doctor you should see, and what type of sweet-spot treatment you should get.

Remember, if your problem is a screw, only a screwdriver will work. Using a hammer or wrench for your screw will only make you look silly and will result in lots of wasted time and energy.

hammer-a-screw-failure

Below, I’ll assume you’ve rested your wrist for at least two weeks.

If you haven’t rested for 2 weeks, no one’s body can heal or recover when you’re constantly adding more wood to the fire by continuing to use damaged tissue.

Stop adding wood to the fire and the fire will die down (and your inflammation will go away).

If your test is really good like below AND at least one of the following is true:

passing-wrist-extension-wrist

  • your wrist pain is worse than 7 out of 10 (where 0 = “no pain” and 10 = “worst pain ever”)
  • your wrist pain is sharp or stabby
  • when you contract your finger and forearm muscles into your other hand without shortening the muscle, you have wrist pain.

… You’ll need to see an orthopedic doctor to get an MRI of the wrist to determine which parts (muscles? bones? cartilage? tendons?) are damaged and what the potential solutions are for them.

If your test is moderately bad AND all of the following is true:C-grade-wrist-extension-test

  • your wrist pain is less than 7 out of 10 (where 0 = “no pain” and 10 = “worst pain ever”)
  • your wrist pain is NOT sharp or stabby …

… You should find an Integrative Diagnosis (ID) doctor who can diagnose all of the parts of your problem and prioritize solutions for your top #1 to #3 biggest problems.

Often, the #1 biggest problem when a test is tight, restricted, and failing, is a problem that 95% of doctors don’t talk about. More on that below.

If your test is horribly bad AND all of the following is true:failing-wrist-extension-test

  • you didn’t have a severe trauma to the wrist
  • you haven’t ignored it for years (you may have degenerated cartilage or a tear)
  • your wrist pain is less than 7 out of 10 (where 0 = “no pain” and 10 = “worst pain ever”)
  • your wrist pain is NOT sharp or stabby …

… You’re a home run for an Integrative Diagnosis (ID) doctor, as ID doctors are trained to restore flexibility. As your flexibility approaches normal, your symptoms approach normal and go away too.

The most common cause for tightness and the reason your wrist pain hasn’t gone away is a problem called:

Adhesion: The Biggest Cause of Pain You’ve Never Heard Of

Have you heard of fascia before?

It’s the spider-webbing literally between all of the different tissues of the body.

Notice the bright, white lines going up and down on what looks like this cadaver’s quad (Gil Hedley, 2005).

When the muscles are teased apart, it’s easier to observe the fascia.

Image result for fascial adhesion

When you overuse this spider-webbing (or fascia) or have a trauma (like a cut on your skin), your body lays down more of it to repair the damage.

The excessive laying down of spider-webbing is called adhesion.

Adhesion and scar tissue look the same under a microscope, except that the cause was different.

  • Adhesion = there was no trauma.
  • Scar tissue = a trauma.

If your pain came on gradually and there was no obvious trauma, then we’re talking about adhesion.

The primary way you know if you have adhesion is with the wrist and finger extension test. You already did this above.

An Integrative Diagnosis doctor confirms the suspicion of adhesion by feeling your muscles.

He/she is not looking for knots, which are very different from adhesion and in this doctor’s opinion, a waste of time to push on.

Adhesion feels like a well-done steak instead of a bunch of spaghetti that you can roll over your fingers with.

thumb-test-for-adhesion

Most of our patients are able to perceive they have a knot when her husband pokes his fingers into her neck or when the massage therapist says:

Oh wow! You’re really tight!

I’ve found that most patients are unable to perceive adhesion until I’m treating them and they can feel the adhesion tearing under my fingers.

The cool thing about adhesion is that you’ll notice progress immediately that is permanent.

The only occurrences when it won’t be permanent or last are when you have:

  • active inflammation because you haven’t rested.
  • adhesion, but you also have a more serious issue (that would be diagnosed with MRI)
  • a metabolic problem that prevents your body from healing (like diabetes or a thyroid condition).

The first bullet point on rest is the #1 reason why people with wrist pain don’t heal.

Excluding CrossFitters or other lifters who do a ton of group work, it’s really hard for people to stop:

  • typing
  • texting
  • using their hands.

When I fail patients and don’t get them progress within our 5 Visit Rule, it’s most often because we couldn’t take stress off of the wrist enough to cause damage to the adhesion and increase the flexibility.

pain-doctor-fail

The constant workload of the patient combined with the dosage of adhesion removal I do means the pain level doesn’t change.

Details like which parts of your pain matter (how much work you’re doing with your wrist) and which parts don’t (stretching, ice, heat) is why seeing a detail-oriented doctor or therapist is so important.

Only when the odds are stacked in your favor can treatment for the adhesion take hold and get you out of pain.

Treatment to Remove Adhesion Causing Wrist Pain

To get your adhesion removed, your doctor or therapist must:

  • Test your range of motion and flexibility (tells the doctor how much adhesion you have)
  • Treat you to remove your adhesion
  • Re-test your range of motion and flexibility (tells the doctor if the primary problem causing your pain was removed)

Below is an example of how we treat in our office at Barefoot Rehab.

The cool thing about getting your adhesion removed is that you’ll know if it’s REALLY helping you the first visit.

You’ll know if you’re permanently improved in 5 visits or less. In fact, it’s a rule.

The 5 Visit Rule

So you can get fixed and not be worried about wasting your time, energy, or money.

When it comes to pain:

  • Fix the problem … and your pain will go away.
  • Don’t fix the problem … and your pain will stay and get worse.

Isn’t it common sense?

speechbubblesWhat have you tried for your wrist pain? Did it work? Not work?

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Dr. Chris Stepien, DC, Full-Body ID Certified, ART Certified, CSCS, and CrossFit Level 1 Certified, fixes your annoying and frustrating pains, even when it's been over 6 months and you've seen 3-5 other doctors or therapists without lasting relief Barefoot Rehab in Denville, NJ. And when you're sad, depressed, or not enjoying life, Dr. Chris wants to hug you. He invites you to reach out, no matter what your concern is. Barefoot Rehab is here to serve you.
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14 Comments
  • Nancy Dunne
    Posted at 17:56h, 24 January Reply

    Wish that worked. My pain was after lifting boxes and nothing was felt until few days later. Just uncomfortable and once in awhile a stabbing pain if moved incorrectly. Wrist and thumbs primarily. Both hands. Right more than left. Sometimes if I rest on it feels almost like a burning sensation only on the right hand. Asked my doctor since in my early 70’s assumes arthritic. Ruled out carpel tunnel. This started suddenly. Sometimes it seems to have gone completely away. But when and often when my stomach is upset with IBS symptoms it magnifies and then goes away until if move thumb or wrist suddenly as now typing. Left thumb just said ouch. The tests didn’t phase me at all. No pain. Zero …. All there is to comment on. Wished it would have helped!

    • Dr. Chris
      Posted at 14:22h, 26 January Reply

      If you have full ROM and no symptoms, then this is MOSTLY a metabolic problem (IBS)> I suggest seeing a functional medicine doctor specializing in IBS. You may still have adhesion, but it’s def not first priority if your range is full and symptom-free.

  • Jayne Hurford
    Posted at 02:19h, 23 March Reply

    Hi
    October last year worked 2 weeks straight doing a heavy ironing at work. Woke up saturday morning and put my hands on bed to get out and my right wrist really was painful and weak.
    Over the years of ironing have had slight aches to this wrist. Usually only do 2 days a week as we have another casual.
    But i hadnt been back into iron for 5 months prior to injury and did 2 weeks straight then my wrist went.

    Have had trouble opening jars but no pain after prior to injury and was wondering was the injury from wear and tear from all the above mentioned or would i call it a work injury as it happened the day after the 2 weeks on the saturday when i got up and day off.
    Had a pyhsio say it was a tfcc injury put on a widget brace to 6 weeks gradually taking it off and then 4 weeks later opened a jar and it hurt it all over again. Had a MSI and showed a tear and perforation.

    How do i distiisguish if its from work or home injury?

    • Dr. Chris
      Posted at 20:08h, 24 March Reply

      Hi Jayne, I assume this is for disability purposes? If you’ve been having this ache for years after doing your iron work, I’d say it’s safe to say it’s from work.

  • Fran Schiansky
    Posted at 18:52h, 22 April Reply

    Hi Chris,

    I am a physiotherapist (never had much training about hands/wrists..) and since studying have suffered from wrist pain for the last 3 years. It got very intense last year so I finally went to a ‘specialised’ hand therapy clinic.
    They concluded overuse provoked irritation (around the pisiform) and mid carpal instability. Prescribed me a brace which I’ve been wearing for a couple of months during sleep and the more provoking activities eg. biking. This helped reduce the pain but since then other than coordination and strength training of the forearm exercises, now recently incorporating pronation supination strengthening in neutral – I haven’t felt any progress. I really want to increase yoga intensity and climb/do other weight bearing sports etc..
    Putting weight through the wrist is provoking like it did before so I’m still avoiding as much as possible.
    Computer work, daily PT work provokes also but this can’t be avoided.

    Any advice very very welcome!

    • Dr. Chris
      Posted at 17:18h, 25 April Reply

      Hi Fran, it sounds like you need some adhesion removed. There’s nothing more we can offer you cuz if it’s there, strengthening, stretching, massage, PT etc – none of it will work.

  • Rosemary Grieve
    Posted at 23:02h, 24 June Reply

    Hello Chris 🙂
    I wonder if you can help shine some light….I forced my left wrist unscrewing the tight lid of my Thermos flask about 2.5 months ago. I felt a momentary pain that made me think I’ll pulled it. I’m also left-handed. Unfortunately I also work in a factory packing plastic bottles into boxes (oh the glamour!)…I have to examine the bottles as they come off the machine and make boxes up from flatpack, plus handle pallets of 30x boxes to take them to the warehouse. This means that my wrist never recovered from the Thermos injury (my diagnosis, I never went to see a doctor) . In fact, after a week or two I started to think of my wrist as suffering RSI from factory work. Luckily I’ve since been promoted to a job involving a lot less lifting and articulation of my arms, wrists and hands and as a result the chronic mild pain in my left wrist went away, although I still feel an overall weakness. In spite of relative rest I’ve done 2 dance classes in the past 2 days involving wrist shaking and head-down-dog movements and now my left wrist is throbbing. I’m worried because I’m also an artist, I draw and paint and don’t want to jeopardise my dexterity. I’ve been compensating in general by using my right hand, wrist and arm to do more like opening a heavy door, lifting a heavy bag, etc. in order to rest my left. I’d love to hear your point of view!

    • Dr. Chris
      Posted at 17:19h, 30 June Reply

      Yeah it sounds like generalizede overload. Rest should help it with your new promotion. Then I’d slowly start to strengthen ie 2 sets of bicep curls 3 days a week. If you can find an adhesion release doc that would go a long way too.

  • Matthew Robyn Ballantyne
    Posted at 21:01h, 01 November Reply

    so I had a car accident just over 2 years ago and have been in pain ever since. i had to have ucl surgery on my thumb and had visible adema on my lunate where it contacted my ulna. I have been through physio for the rom after getting out of a cast and also for the adema later on when I felt i wasnt getting better. i had an mri which diagnosed the adema and recently had a ct scan and an injection guided by x-ray for what they think is a problem with the stt joint in my hand. the ct scan didnt show anything that would warrent surgical intervention and am now back at physio where i hope to reduce my pain. I am a carpenter and the lack of strength and sharp pain is preventing me from getting back to building. my hand aches all day every day and is worse at night which is disrupting my sleep. doctors seem to only be able to diagnose things that are typical and this is extremely frustrating. my wrist is very tight when i check against your test I would say its a 9 mabe a little less. obviously i dont expect you to have much of an opinion on what is wrong but my question is if I go through stretches to regain some flexibility what are the chances that my pain will reduce to a managable level. im scared that this is something that wont go away and my doctors are literally shrugging their sholders. my gp said “im only a family doctor” but the orthapedic surgeon said she doesnt know what to say either. have you ever had patients that are in this much pain 2 years after an accident but ddnt show anything on mri or ct scan?

    • Dr. Chris
      Posted at 16:17h, 02 November Reply

      Hi Matt, so sorry to hear this. This is our specialty – so take it with a grain of salt. 9 out of 10 of our patients (all who have been to at least 3 docs before) have never been told what adhesion is. With what you’re saying it’s highly probably you have tons of adhesion or scar tissue. Are you able to travel like Lillian did?

      https://www.youtube.com/watch?v=N_ODZiA_6Bk&t=137s

  • Carryn Kruger
    Posted at 15:25h, 03 September Reply

    Hi, I fell 9 months ago and still have pain in my wrist. I’m a 37 yr old female. It’s an ache that goes away if I don’t use my wrist but if I life something heavy, type, wrote, use a mouse, use chopsticks, the ache returns. I have a spot that is sensitive to the touch, painful if pushed on, on the ulner side of my wrist. It’s not tfc. I’ve had mri, and x rays which are normal. The only thing that makes it feel better is icing it multiple times a day. I just want to know why it’s still hurting.

    • Dr. Chris
      Posted at 17:32h, 24 September Reply

      Our hypothesis is that most chronic pain is adhesion. Your problem sounds like it.

  • Carryn Kruger
    Posted at 03:04h, 15 January Reply

    I thought adhesion is when there was no trauma? In my case there was trauma- I fell.

    • Dr. Chris
      Posted at 16:34h, 15 January Reply

      Adhesion forms in 2 ways – overuse and trauma. Yours is the more obvious cause.

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