Common Wrist and Hand Conditions at Work

Wrist and hand conditions are often injured in the workplace. Here are the most common conditions we see and some tips to help prevent them

Work-related musculoskeletal disorders of the hand and wrist can involve the muscles, nerves, tendons, joints or cartilage. These disorders are associated with some of the longest absences from work and are thus associated with greater lost productivity and wages than many other anatomical regions.

They are worsened by tasks in awkward or extreme wrist and forearm postures, cold temperatures, prolonged and sustained positions and vibration.

The problems with desk work

Office and desk based work puts the hands in the very narrow spectrum of hand movement, mainly wrist extension and deviation. Sustaining this same position and doing only small amount of movement actually creates an excessive load. Fatigue of the hand and wrist structures also occurs which can then precipitate injury.

If there are poor ergonomics this further loads the wrist joint and tendons more than usual. And poor desk setup e.g., the height of the desk or keyboard relative to the person’s height and arm length, the size or layout of the keyboard, the position of the mouse/keyboard on the desktop, can exacerbate that load even further leading to strain or injury.

The prolonged hours of stressful work tasks in addition to outside-work activities that we still need to do, such as looking after ourselves and family, housework and hobbies combine to exacerbate the problems. Our arms are always in use and many hours of work only adds to the load.

Although the oversuse injuries are most common at work, acute injuries from falls can also happen.

Some of the most common wrist and hand disorders we see are:

Carpal tunnel syndrome ( see our blog)

This refers to compression of the median nerve (one of the nerves in your arm) as it passes through the carpal tunnel in the wrist and can cause symptoms like wrist pain, pins and needles, numbness and weakness of the hand.

Dequervains Synovitis

This is the result of inflammation or irritation to two tendons, abductor pollicis longus and extensor pollicis brevis as they pass through the wrist up to the thumb. It causes pain around the thumb side of the wrist or even up the forearm.

Ligamentous injuries

Usually associated with trauma from slips and falls or sport

Instability with triangular fibrocartilage complex tears (TFCC)

The TFCC, is an important structure in the wrist made of tough fibrous tissue and cartilage. This tissue supports the joints between the end of the forearm bones and some of the lateral small bones of the wrist adding to their stability. It both stabilize and acts as a cushion.

This debilitating condition has two main causes - the force of falling on your hand or wrist or a sudden twist of your arm that over-rotates your wrist.

Fractures and dislocations

Again most commonly caused by traumatic injuries such as falls onto an outstretched hand.

Finger injuries

These are often acute tears and injuries to the tendons and if complete will require surgical intervention

Osteoarthritis of the wrist and thumb

Osteoarthritis can occur in any joints in the hand and wrist but is most commonly seen around the thumb area and in the fingers. Symptoms can include pain, stiffness, aching and sometimes swelling around the affected area and can be aggravated by both office and manual work.

Some tips to minimize risk and maintain good function

1. Include some wrist range of motion exercises into your day

Every 30 minutes aim to do 5 minutes of gentle wrist movements such as wrist rolling, flexion, extension and finger open and closing.
Do some shoulder rolls, tricep and biceps stretches to mobilise the upper limb

2. Posture

Ensure that your desk is at a height where your shoulders aren’t raised, the keyboard sits so that the wrists are in a neutral position when typing
A stand up desk can be a great way to break up long hours of sitting in the day
Get professional advice on good desk posture

3. Rest breaks