Wrist, hand and thumb pain
Understanding wrist pain
Wrist pain is any discomfort in the wrist. Although small, the human wrist is made up of 8 bones, alongside, ligaments, tendons and tissue. Your wrists play a central part in most daily activities and because of this, they can be subject to injury or repetitive stress.
It is important to see your GP if:
your wrist pain came on following a fall or trauma
your think you may have broken your wrist
you have pins and needles, numbness or weakness in your hand
you have swollen or stiff fingers
Often, wrist pain improves with rest, ice and changes in activities but if this isn’t working, we recommend trying the exercises on this page.
About the wrist
The wrist joint is made up of two bones from your forearm, the ulnar and radius. These connect to a group of small bones in the hand called the carpal bones.
The main movements of the wrist are to go forwards and backwards (flexion and extension), however the wrist is also very important in rotational movements to place the hand in the right position to be used.
Causes of wrist pain
Wrist pain can often be caused by a stiffening of the joint, a weakening of the muscles around the joint or a combination of both. Pain in the wrist can often be relieved by working on these problems with the right exercises.
Wrist exercises
Read below for advice and exercises to manage wrist pain.This guidance has been produced by the Dynamic Health physiotherapy service. It offers simple measures to help you manage your wrist problem safely. Often the right advice and exercises are all you need to improve the problem.
This information has been made available to your GP, who may ask you to try the advice and exercises prior to consulting a physiotherapist.
Seek urgent medical advice if your wrist pain started suddenly after a recent trauma.
The following exercises do not need to be completed in any particular order and it can be helpful to try and gradually build your range of movement and strength at the same time. Choosing some challenging but manageable exercises from each section may be helpful.
How much exercise should I do?
Exercise every other day
Allowing enough rest is important to let soft tissues recover and develop.
Choose 3 or 4 exercises
Choose exercises that are challenging but manageable.
Repeat the exercise
Perform 3 to 5 sets of 5 repetitions of each exercise.
Rest
Rest for up to 1 to 2 minutes between each set.
Once an exercise is easy, progress it
Increase the number of repetitions (aim for 10). Or hold the positions for longer or move to a more challenging exercise.
How much pain is too much pain?
Read below for advice and exercises to manage your pain.
Before exercising
Before exercising, rate your pain at the moment on a scale of 0 to 10, where 0 is no pain and 10 is the worst pain you can imagine.
A maximum pain level
A maximum pain level of 4/10 whilst exercising is fine as long as it eases within 45 minutes of the session and does not interfere with sleep or activities the next day.
If your pain increases
If your pain increases beyond this, simplify the exercise by reducing the range of movement or number of repetitions, or try an easier exercise.
Stretching exercises
If your wrist has lost movement because of pain or stiffness, it needs to be regained in order to strengthen the wrist effectively.
Place the palms of your hands against each other.
Bend your wrists by pressing your hands downwards and hold the position for a moment.
Then relax.
Sit with your wrist over the edge of a table.
Bend the wrist down and gently assist this movement with your other hand.
Hold fingers and wrist straight.
Bend wrist first towards the little finger and then towards the thumb.
Stand or sit with your elbow bent.
Try to turn your hand so that the palm is facing directly upwards.
To increase this stretch you can sit with your affected hand on a table and then help turn your hand over using your other hand.
Strengthening exercises
In the images below, the model is using a weight. At home you could use a water bottle, as 1 litre = 1kg. Make sure however that whatever you are using, you are challenging yourself.
Using a dumbbell with your hand resting over a table, start with your palm facing down and your fingers pointing towards the floor (as shown in picture 1).
Raise your hand up so that your palm faces away from you (as shown in picture 2).
Slowly return to the position in picture 1.
Rest your wrist over a table with your palm facing up and your fingers pointing down towards the floor as shown in picture 1.
Hold onto a heavy object, ideally a dumbbell if available.
Curl your wrist to point your fingers up towards the ceiling.
Hold a heavy object with your wrist hanging over the edge of a table, have your thumb facing up towards the ceiling.
Slowly lower your wrist as if you are pointing your thumb towards the floor.
Slowly return to the starting position.
Pronation and supination refers to which way your palm is facing.
Hold a heavy object, start with your palm facing down, then turn your wrist so that it is facing upwards.
Turn your hand over again to return to the starting position.
Top tips
Read our top tips about wrist pain exercises.
- Don’t feel you have to replicate the full movement of the exercise straight away. Use it as a guide, and build up gradually to the full movement over time.
- It is normal for it to take 6 to 12 weeks before you notice an improvement in your pain, movement and strength. It can take longer for complete improvement.
- As long as the activity is not painful, try to keep using your wrist throughout the day.
- General exercise can really help your recovery due to its stress reducing and pain relieving effect, so try to keep going with other activities you enjoy to keep fit. Even a brisk walk could really help.
Understanding hand and thumb pain
The hand is a very intricate structure. No other region has the same density of joints or muscles. This is of course because we need our hands to act in a precise manner.
Pain in the hand is usually caused either from osteoarthritic changes to the joints, or from repetitive strain tendon injuries. The most common regions to experience pain are at the base of the thumb, back of the thumb or in the joints in the fingers.
Often, hand or thumb pain improves with rest, ice and changes in activities but if this isn’t working, we recommend trying the exercises listed in our leaflet.
If your hand or thumb pain started after recent trauma, please seek
medical advice.
About the hand and thumb
The hand and thumb are made up of seven carpal bones (the small bones at the base of the hand) and each finger is then made up of four bones as shown in the diagram to the right. The thumb is slightly different, in that it is made up of three bones.
There are more than 30 active muscles operating the hand, which attach in the hand and fingers through tendons. There are of course also many ligaments in the hand, attaching the bones one by one to each other.
The hand is a very intricate structure. No other region has the same density of joints or muscles. This is of course because we need our hands to act in a precise manner. Because our hands are so vital, it can cause very noticeable problems when something goes wrong.
Causes of hand and thumb pain
Pain in the hand is usually caused either from osteoarthritic changes to the joints, or from repetitive strain tendon injuries. The most common regions to experience pain are at the base of the thumb, back of the thumb or in the joints in the fingers.
Braces and supports
If your pain is worse at the back of the thumb, especially first thing in the morning, you should purchase and try wearing a thumb spica brace that will stop your thumb moving across your hand at night. For some people this can provide a degree of relief from their pain.
If your pain is worse at the base of the thumb on the side of your palm, you may wish to consider purchasing a thumb stabilising support. These come in either firm or movable variations. Generally it is more practical to purchase a support that will still allow some movement.
Activity modification
Usually with pain in the hand or thumb there will be one of two activities that particularly aggravate the pain. These will normally involve repetitive motions. Most commonly this will be computer based work. Sometimes small modifications can make a big difference to hand pain. For example, you could try resting your wrist on a towel or wrist support when typing, or purchasing an ergonomic keyboard or mouse. If possible, take regular breaks where you can complete the stretching exercises.
Sometimes the pain will not be linked to one specific activity, but will be aggravated by any strenuous force through the hand. If this is the case try to be mindful of your activities and consider how these can be adapted. Could you use your other hand for the activity? Is there a helpful friend or companion who could do the task for you?
In addition to modifying specific activities you should consider pacing yourself with your activities throughout the day.
Range of movement exercises
If your hand has lost movement because of pain or stiffness, it needs to be regained in order to strengthen the hand effectively.
Aim your thumb to the base of your little finger. If you are not able to reach quite this far, start at the top of your little finger and slowly work down.
Stop this exercise if it is causing pain at the back of your thumb.
Place your little finger down on a table.
Then take your thumb inwards, so that it comes away from your other fingers. The thumb should go across towards your opposite arm, not upwards towards your body.
Place your hand with the palm down, onto a table.
Then slide your thumb away from the other fingers.
Keep your thumb down on the table.
Bend your fingers at the knuckle joints, keeping the other joints straight.
Bend your fingers, focusing the movement on the second row of joints.
Try to touch your fingertips down to the pad at the base of your fingers.
You can complete these three finger flexion exercises together, going from the first to second to third exercise and then repeating this cycle.
If you are not able to complete these movements with every finger, consider helping the movement with your other hand.
Strengthening exercises
Search online for “finger strengthening putty”. This will be required for many of the exercises below. Unfortunately, this is not available in any high-street stores. You can instead however purchase playdough, which will work in a similar way.
Place your hand on a table with palm up and putty on the base of your little finger.
Push your thumb against the putty towards the base of your little finger.
Place your hand on a table with palm up and thumb pointing upwards to the ceiling.
Put putty in the web between the base of your thumb and index finger.
Push your thumb towards the index finger.
Place your forearm on a table with thumb and index finger together and a broad elastic band around them.
Pull the thumb and index finger apart as far as possible.
Place your hand on a table with the palm facing up and a broad elastic band around your thumb and index finger.
Lift your thumb straight up against the resistance.
Put putty on a table and push your fingertips deep into the putty keeping your forearm on the table.
Bend fingers into a fist pushing them deeper into the putty. Try to focus on curling in the joints at the tips of your fingers.
Then straighten your fingers out again.
Sitting or standing. Hold a foam ball, a tea towel, grip strengthener or putty.
Squeeze firmly and hold for 5 seconds.
Top tips
Read our top tips about hand and thumb pain exercises.
- Try to build your exercises into your daily activities.
- You don’t have to do all the exercises in one go.
- It is normal for it to take 6 to 12 weeks before you notice an improvement in your pain, movement and strength, and it can take longer for complete improvement.
- Don’t stop moving your hand throughout the day.
Need more help?
Consider self referring using the link below
If you have a new injury or problem, please look at the self help information in our advice pages. We will often complete the same exercises and share information in clinic appointments.
If you still need some more help you can self refer into our service. Please note that the NHS is currently experiencing longer than normal waits, for more information visit our waiting times page.
Click the link below for self-referal
Need more information?