Hand, Wrist & Elbow Conditions

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Understanding hand, wrist and elbow problems

The hand, wrist and elbow work together as part of the upper limb, allowing us to grip, lift, push, pull, reach and perform both fine and powerful movements.
Problems in these areas can develop following injury, repetitive activity, sport, arthritis, nerve irritation, surgery or a period of immobilisation.
Because the hand, wrist and elbow are involved in so many everyday activities, even relatively small changes in movement, strength or comfort can have a significant impact on work, sport and day to day function.
Assessment aims to identify which structures are involved, understand what is contributing to the problem and establish the most appropriate route for treatment and rehabilitation.
Some conditions respond well to physiotherapy and rehabilitation, while others may require imaging, nerve testing or specialist review before or alongside treatment.
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Common hand and wrist presentations

De Quervain’s tenosynovitis

Pain and irritation around the thumb side of the wrist, often aggravated by gripping, lifting, repetitive thumb movement or certain wrist positions.
Injuries involving the triangular fibrocartilage complex can cause pain on the little finger side of the wrist, particularly during twisting, gripping or weight bearing through the hand.
Pain and stiffness around the base of the thumb, often affecting gripping, pinching, opening jars and other everyday hand activities.

Compression or irritation of the median nerve at the wrist can cause numbness, tingling, pain or weakness in the hand.

Assessment can help establish whether physiotherapy is appropriate or whether further investigation or specialist review is required.
Pain, stiffness or catching affecting movement of a finger or thumb, sometimes associated with difficulty fully bending or straightening the digit.
Ligament and other soft tissue injuries can occur following falls, twisting injuries, sport or other trauma and may result in pain, swelling, weakness or reduced movement.
Repetitive loading or sudden increases in activity can irritate the tendons around the hand and wrist, leading to pain and reduced tolerance to gripping or movement.
Stiffness, weakness and loss of function are common following fractures such as distal radius or scaphoid fractures, particularly after a period in a cast or splint.
Rehabilitation following hand or wrist surgery is tailored to the procedure performed, the stage of healing and any restrictions provided by the surgeon.
Hand and wrist injuries are common in racquet sports, contact sports, climbing, cycling, weight training and other activities involving gripping, impact or loading through the upper limb.
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Common elbow presentations

Tennis elbow

Tennis elbow, also known as lateral elbow tendinopathy, typically causes pain around the outside of the elbow.

Symptoms are often aggravated by gripping, lifting, racquet sports, gym work or repetitive use of the wrist and forearm.

Golfer’s elbow, or medial elbow tendinopathy, causes pain around the inside of the elbow.

It can be aggravated by gripping, lifting, throwing and repetitive wrist or forearm activity.

The tendons around the elbow can become painful or less tolerant of load following repetitive activity, sport or changes in training or work demands.

Rehabilitation usually focuses on progressively restoring strength and tolerance to activity.

Loss of elbow movement can develop following injury, fracture, surgery, immobilisation or joint irritation.

Physiotherapy can help restore movement and progressively rebuild function where appropriate.

Ligament, muscle and other soft tissue injuries around the elbow can occur following falls, twisting injuries, direct impact or sport.

Symptoms may include pain, swelling, weakness or a feeling of instability.

Fractures involving the elbow or surrounding structures can result in significant stiffness and weakness, particularly following a period of immobilisation.

Rehabilitation is guided by healing, any surgical restrictions and the demands the patient needs to return to.

Physiotherapy following elbow surgery is tailored to the operation performed, the stage of healing and any restrictions provided by the surgeon.
Elbow problems are common in racquet sports, throwing sports, climbing, weight training and other activities involving repeated gripping, loading or upper limb force.

Nerves travelling through the neck, arm, elbow and wrist can also contribute to pain, tingling, numbness or weakness in the hand and upper limb.

Symptoms can sometimes arise from irritation around the elbow or wrist, while in other cases the source may be higher up the arm or neck.

Assessment helps determine whether physiotherapy is appropriate or whether nerve testing, imaging or specialist review may be required.

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How physiotherapy can help

Treatment is guided by the diagnosis, symptoms, activity demands and stage of recovery.
This may include:
  • Movement and mobility work
  • Progressive strengthening
  • Grip and functional rehabilitation
  • Exercise therapy
  • Hands on treatment
  • Activity modification and load management
  • Splinting where appropriate
  • Adjustment of existing supports or braces
  • Rehabilitation following immobilisation or surgery
  • Advice around return to work, sport and normal activity
Where symptoms suggest a fracture, significant nerve involvement or another condition requiring further investigation, we can also help guide patients towards appropriate imaging or specialist review.
The aim is not simply to reduce pain, but to restore movement, strength, confidence and practical function of the hand, wrist and elbow.
Hand, Wrist & Elbow Physiotherapy is available at our Winchester clinic and Medicana Winchester.
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Rehabilitation after fracture or surgery

Following fracture, surgery or a period of immobilisation, stiffness and weakness can significantly affect the hand, wrist or elbow.
Rehabilitation is progressed according to the injury or procedure, the stage of healing and any restrictions provided by the surgeon.
This may involve restoring movement, rebuilding grip and upper limb strength and gradually progressing back towards normal day to day activities, work and sport.
Where patients have undergone surgery at Medicana or elsewhere, physiotherapy can form part of the wider post operative rehabilitation pathway.
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Returning to work and sport

The hand, wrist and elbow are heavily involved in many occupations and sports, so rehabilitation needs to reflect what the individual actually needs to be able to do.
For some patients this may mean restoring grip, dexterity and upper limb function for everyday activities or work.
For others it may involve progressing towards racquet sports, climbing, cycling, throwing sports, weight training, contact sport or other activities involving gripping, impact or loading through the upper limb.
The aim is not simply to reduce pain, but to restore movement, strength, confidence and practical function of the hand, wrist and elbow.
Rehabilitation can be progressed from basic movement and strength through to more demanding and activity specific tasks as recovery allows.
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When further investigation is needed

Not every hand, wrist or elbow problem is best managed with physiotherapy alone.
Where symptoms or examination findings suggest that imaging, nerve testing or specialist medical review may be appropriate, we can help guide the next stage of assessment.
Where further investigation or specialist opinion is required, appointments at Medicana Winchester can also support a more joined up pathway with consultant and imaging services where clinically appropriate.
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Hand, Wrist & Elbow Physiotherapy

If you are experiencing hand, wrist or elbow pain, injury, stiffness or weakness, our Hand, Wrist & Elbow Physiotherapy service provides assessment and rehabilitation tailored to your symptoms and activity goals.
Appointments are available at our Winchester clinic and Medicana Winchester.
Learn more about Hand, Wrist & Elbow Physiotherapy
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Conditions

Other Conditions We Treat

Back Pain

Arthritis

Neck Pain

Joint Injury

Sports Injuries

Post Surgical Management

Whiplash

Temporomandibular Joint (TMJ) Pain

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