Great Health Guide - - CONTENTS - Mar­garita Gure­vich & Justin Bal­bir

How phys­io­ther­apy can help RSI & Os­teoarthri­tis of the wrist

IN the pre­vi­ous ar­ti­cle we looked at carpal tun­nel, a com­mon cause of wrist pain. In this ar­ti­cle we will high­light RSI, os­teoarthri­tis and wrist pain and how phys­io­ther­apy can help th­ese con­di­tions.


Repet­i­tive Strain In­jury is a con­di­tion that de­scribes in­juries oc­cur­ring as a re­sult of overuse. While our bod­ies are built for move­ment and rep­e­ti­tion, some­times this rep­e­ti­tion can be ex­ces­sive and ul­ti­mately lead to ir­ri­ta­tion, in­flam­ma­tion, dam­age and pain to cer­tain soft tis­sues of the mus­cu­loskele­tal sys­tem. This in­cludes such struc­tures as nerves, mus­cles and ten­dons. This type of con­di­tion is es­pe­cially com­mon in the wrists, as there are many daily and oc­cu­pa­tional tasks which re­quire many rep­e­ti­tions of the same move­ments. As ex­am­ples, some­one work­ing on a con­veyer belt hav­ing to re­peat­edly screw/un­screw ob­jects or an in­di­vid­ual who spends hours scrolling with their mouse while us­ing a com­puter. Th­ese tasks re­quire re­peated use of spe­cific mus­cles.


Pro­longed per­for­mance of the par­tic­u­lar task • Poorly fit­ted equip­ment • Work­ing too quickly • In­ad­e­quate re­cov­ery time • Lack of train­ing in op­ti­mal tech­niques. Treat­ment will vary largely, depend­ing on the na­ture of the in­jury (i.e. which struc­tures are da­m­aged) and the type of work that has caused the in­jury. A sim­ple in­ter­ven­tion can be ed­u­ca­tion around how to safely per­form the task and what move­ments to avoid. Then, based on a thor­ough ex­am­i­na­tion, treat­ment may in­clude a mix­ture of hands-on ther­apy, soft tis­sue mas­sage, stretch­ing, strength­en­ing, nerve glid­ing ex­er­cises, tap­ing, elec­trother­apy, ul­tra­sound and drug phore­sis.


Os­teoarthri­tis does not al­ways have a clear and ob­vi­ous cause. Those who have chron­i­cally over­stressed their hands and wrists may be at higher risk, such as gym­nasts or weightlifters. The like­li­hood of suf­fer­ing from this con­di­tion in­creases as we age.

Wrist pain, loss of hand range of mo­tion and de­creased func­tion are all typ­i­cally seen with os­teoarthri­tis suf­fer­ers. The ex­tent of th­ese may de­pend on how se­vere the con­di­tion has be­come; how­ever, there is not al­ways a di­rect cor­re­la­tion be­tween the ex­tent of arthritic changes and level of func­tion. Ex­er­cise is typ­i­cally the best rem­edy for arthri­tis. Depend­ing on what the in­di­vid­ual can tol­er­ate, this may range from very gen­tle ac­tive move­ments to higher level strength ex­er­cises. Range of mo­tion and stretch­ing ex­er­cises may also be pre­scribed if in­di­cated. When wrist pain does not per­mit ex­er­cise, pas­sive treat­ments need to be utilised first. This can in­clude ul­tra­sound, elec­trother­apy, drug phore­sis, gen­tle pas­sive move­ments per­formed by the ther­a­pist, as well as mas­sage of the sur­round­ing mus­cu­la­ture. RSI and os­teoarthri­tis are com­mon con­di­tions that cause de­bil­i­tat­ing wrist pain. How­ever, with spe­cific phys­io­ther­apy treat­ment and ex­er­cise th­ese con­di­tions can be al­le­vi­ated.

Mar­garita Gure­vich is Se­nior Phys­io­ther­a­pist and uses Clin­i­cal Pi­lates, SCENAR Ther­apy & other ev­i­dence-based tech­niques, in­clud­ing Real Time Ul­tra­sound and McKen­zie Treat­ment. Mar­garita spe­cialises in sports in­juries, women’s health (in­clud­ing in­con­ti­nence) and gas­troin­testi­nal is­sues. Mar­garita may be con­tacted via her web­site.

Justin Bal­bir has a Bach­e­lor of Health Sci­ences & Mas­ters of Phys­io­ther­apy Prac­tice. He has worked for five years as a sports trainer for the Ajax Football Club, with ex­pe­ri­ence in soft-tis­sue mas­sage & in­jury man­age­ment. Justin spe­cial­izes in man­ual ther­apy & sports in­juries and may be con­tacted via web­site.

Very gen­tle ac­tive move­ments or gen­tle pas­sive move­ments per­formed by the ther­a­pist, form part of the treat­ment for wrist pain.

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