The wrist and hand are commonly injured in falls and during repetitive activities. The pain can come from joint arthritis, tendon inflammation and nerve irritation, commonly seen in conditions such as carpal tunnel syndrome. Our physical medicine and rehabilitation specialists use advanced examination and diagnostic tools to diagnose the source of the pain and prescribe therapies that will improve your function and reduce pain.

How we diagnose

A comprehensive examination is performed on every patient with a focus on ferreting out various problems that can cause wrist and hand pain.

Special manual training allows our physicians to diagnose small subluxations of wrist and hand joints that may be a previously undiagnosed source of pain. Gentle manipulation of these joints is frequently performed during examination for diagnostic and therapeutic purposes.

Our physicians also examine the wrist and hand region with the help of advanced imaging techniques such as diagnostic ultrasound.

This technology is advanced enough to see inflammation of the nerves as typically found in carpal tunnel syndrome, tendonitis, and joint swelling that frequently cause acute and chronic wrist and hand pain.

Dynamic ultrasound can diagnose ligament tears of the wrist that in the past required an MRI with dye injection to see.

Electromyography (EMG) is used to examine wrist and hand pinched nerve problems, as well as a neuromuscular spasm condition known as upper limb spasticity.

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How we treat

Manipulation is occasionally used during the clinical encounter to restore normal function of the wrist and hand joint.

Therapeutic injections are guided by ultrasound for safety and accuracy and are frequently very effective in decreasing pain related to inflammation from arthritis and overuse tendonitis of the wrist and hand.

Ultrasound-guided injections are also used for injections of wrist and hand nerves that can be injured during trauma and repetitive overuse.

In cases of upper limb spasticity, Botox injections are used to calm down the spastic muscles.

Our physicians use EMG assistance to find the spasming muscles and we are one of the first groups in the country to use ultrasound technology to more accurately and safely guide the Botox injections.

We are still one of the few groups that use ultrasound for guidance of Botox therapy.

We employ state-of-the-art physical therapy for correction of joint dysfunction, muscle imbalances, abnormalities and weakness that so frequently lead to overuse- related wrist and hand problems.

Splinting is frequently prescribed for pain and inflammation control of various wrist and hand conditions.

When chronic, painful wrist and hand conditions, so often seen in trauma, are encountered, the patient is referred for specialized treatments known as ART and Graston mobilization to a chiropractor that works closely with our physicians.

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