Wrist Pain

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The hand is composed of many small bones called carpals, metacarpals and phalanges. The two bones of the lower arm -- the radius and the ulna -- meet at the hand to form the wrist. The Median and Ulnar nerves are the major nerves of the hand, running the length of the arm to transmit electrical impulses to and from the brain to create movement and sensation.

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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a compression neuropathy, i.e. a pinching of the median nerve within the wrist. The carpal tunnel is a bony canal within the palm side aspect of the wrist that allows for the passage of the median nerve to the hand. Pinching or compression of this nerve by the transverse carpal ligament sets into motion a progressively crippling disorder which eventually results in wrist pain, numbness and tingling in the hand, pain consisting of a "pins and needles" feeling at night, weakness in grip and a feeling of incoordination.

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Triangular Fibrocartilage Complex

This is a cartilage similar to the cartilage in the knee that is often torn and does not have an adequate blood supply to it. The reason it is causing discomfort is usually there is a flap of tissue that is flapping back and forth and causes irritation of the joint. For this problem there are three modes of treatment; no treatment, conservative, and surgical.

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Thumb (CMC Joint) Arthritis

This is the most common location for arthritis in the hand is due to wear and tear with use of the thumb throughout the patient's years. There is no cure for arthritis but there is treatment falling into three categories; no treatment, conservative, and surgery. Surgery -- as the last resort, when conservative treatment has failed -- consists of a joint replacement using the patient's normal body tissues and involves excising the arthritic bone and replacing it with a tendon taken from the wrist which is rolled up into a ball and used as a spacer and a portion of it is used to reconstruct the ligament.

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Dupuytren's Disease

Dupuytren's disease is a genetically inherited disorder which primarily involves the palmar aponeourosis and its digital prolongations. The primary pathological change is in the fascial tissues of the palm which results in thickening, cord-like formation of contractile bands, and then eventual contractures at the level of the interphalangeal joints.

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Injections can be performed for some of the common pathologies to help decrease inflammation and alleviate pain.

Nonprocedural Treatments

Physical and Occupational Therapy

This type of therapy may consist of exercises to improve range of motion, strength and conditioning. A good therapist will examine you, assess your deficits and disease and formulate a plan based on optimizing function and minimizing pain. These exercises are specific for the nature of your injury and should be executed under the supervision of a physician who understands your case.


Modalities include simple age-old treatments such as heat, cold and massage as well as newer treatment methods such as acupuncture, manipulation, and electrical stimulation. Your physician and therapists should formulate an optimal treatment protocol to maximize your healing potential. These modalities are often used in conjunction with Physical and Occupational therapy.


Depending on the nature of your problem, Non-steroidal antiinflammatory drugs ['NSAIDS'], corticosteroids, and opioids [narcotic] medications may be used. If there is a muscular spasm, a muscle-relaxant may help alleviate that aspect of your pain. Narcotics should be minimized and used only for short periods if at all possible due to rapid tolerance and all the attendant risks associated with abuse of a controlled substance.

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Dr. Sandhu performs minimally invasive surgeries which result in a rapid recovery and minimal risk to the patient. Although we do not perform large-scale open surgeries in our clinics, there are occasions where a problem requires surgical intervention.

We can help screen potential surgical candidates and send them for evaluation by the appropriate specialist. These surgeons are usually orthopedic surgeons or neurosurgeons with specialized training for the particular disease process involved.

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