A Caring Occupational Therapy Guide to Wrist Pain

Wrist pain can turn simple moments into daily obstacles. Opening a jar, lifting a baby, typing an email, bracing for a yoga pose, or carrying groceries can suddenly feel difficult or even impossible. As occupational therapists at A Touch of Hope OT, we focus on restoring comfort, confidence, and capability through a plan that is individualized, compassionate, and practical for real life.

This blog explains the most common sources of wrist pain, who tends to be affected and why, what symptoms to watch for, and how occupational therapy can help with a precise blend of education, activity modification, therapeutic exercise, manual therapy, massage, modalities, and testimonials that reflect the thoughtful and evidence-based care we deliver every day.

What causes wrist pain

Wrist pain has many possible causes. Understanding the pattern of your discomfort and the activities that aggravate it helps us choose the right plan from the start. Below are the major categories we see most often in the clinic, explained in everyday language.

Tendon irritation and overuse conditions

Tendons connect muscles to bone and slide through small tunnels and compartments around the wrist. Repeated strain, awkward posture, new training loads, or a sudden spike in daily activity can inflame the tendon or its sheath. One of the most common examples is De Quervain tenosynovitis, which affects the tendons that straighten and lift the thumb. People feel pain on the thumb side of the wrist when gripping, lifting a baby under the armpits, pouring a kettle, or using a phone with one hand. Many new parents develop this pattern because they repeatedly lift a child with the wrist bent and the thumb pulled away. Hairstylists, baristas, mechanics, gamers, and anyone who performs repetitive thumb motion are also at risk.

Other tendon issues include irritation of the wrist extensors or flexors, often related to heavy keyboard and mouse use, long sessions of gaming or coding, or manual tasks like using a drill. The pain usually starts as a mild ache after activity and can become sharp with specific movements or when you first use the hand in the morning.

Nerve compression

Carpal Tunnel Syndrome occurs when the median nerve is compressed within a tight space at the palm side of the wrist. Symptoms include numbness or tingling in the thumb, index finger, middle finger, and sometimes part of the ring finger. Many people describe waking at night to shake out the hand, difficulty buttoning clothing, dropping objects, or a dull ache that radiates toward the forearm. Risk increases with prolonged wrist flexion or extension during work or sleep, fluid retention, some metabolic conditions, and repetitive forceful hand use.

Ligament and cartilage injury, including TFCC involvement

The triangular fibrocartilage complex (TFCC) stabilizes the pinky side of the wrist and helps the radius and ulna bones move smoothly when you rotate the forearm. A fall on an outstretched hand, a forceful twist with the forearm, or racquet sports can injure this structure. Pain is usually on the pinky side of the wrist, often with clicking. There is a feeling of weakness during rotation, and limited weight-bearing tolerance for push-ups, plank, or pushing off from a chair.

Arthritis, including thumb base arthritis (CMC Joint)

Arthritis (OA) can affect many joints in the wrist and hand. Base of thumb arthritis, also known as carpometacarpal (CMC) arthritis, is especially common. Signs include aching at the base of the thumb, morning stiffness, difficulty with pinch tasks such as turning a key or opening jars, and reduced grip strength. While arthritis cannot be reversed, symptoms can be greatly reduced with education, joint protection strategies, soft tissue massages, and targeted strengthening.

Fractures, sprains, and post-immobilization stiffness

After a wrist fracture or a significant sprain, people often experience stiffness, scar sensitivity, and weakness. Even once the bone has healed, soft tissue tightness, edema, and altered movement patterns can keep pain lingering until the wrist is gradually retrained.

Ganglion cysts

A Ganglion Cyst is a benign fluid-filled sac that often appears on the back of the wrist. It may grow and shrink, and it can cause a sense of pressure or discomfort with certain movements. Therapy can address motion limits and pain, and we coordinate with your medical provider if further evaluation is needed.

Who tends to develop wrist pain and why

1. Repetitive hand users at work: Hairstylists, baristas, cashiers, assembly line workers, mechanics, cleaners, and healthcare professionals often perform thousands of similar hand motions every shift. Repetition, force, awkward angles, and insufficient recovery time combine to overload tissues.

2. Desk workers and students. Extended keyboard and mouse use with poor ergonomics can strain the flexor tendons and increase pressure in the carpal tunnel. Common stressors include a desk that is too high, a chair that provides poor forearm support, a mouse that is too small for the hand, and monitors positioned too low or high.

3. Parents and caregivers. Repeated lifting of an infant or toddler can place the wrist and thumb in a pulled-away position. When this posture is repeated dozens of times each day, tendons around the thumb side of the wrist become irritated. Car seats, strollers, and baby carriers that require awkward grips can add strain.

4. Athletes and active adults. Racquet sports, golf, gymnastics, yoga, Pilates, and calisthenics load the wrists heavily through repetition and weight bearing. A sudden increase in training or a change in equipment, such as a different grip size, can tip the balance toward pain.

5. Individuals with arthritis or certain health conditions. Age-related joint changes, autoimmune conditions, and metabolic factors can influence tissue health. For carpal tunnel syndrome, fluid retention or conditions that affect nerve health may increase risk.

6. People recovering from immobilization after a fracture or surgery, even once the bone or soft tissue heals, motion and strength do not automatically return. Without a progressive plan, the wrist may remain stiff and painful for longer than necessary.

Symptoms to watch for

1. Thumb side pain during lifting or gripping. This pattern often points toward De Quervain tenosynovitis. People notice pain when lifting a baby, wringing a towel, pouring a kettle, lifting a pan, or grasping a large object with the thumb spread wide.

2. Night pain and numbness in the thumb, index, and middle fingers. These are hallmark features of Carpal Tunnel Syndrome. Numbness can be intermittent at first and tends to worsen at night or when holding a phone or a steering wheel for a long time.

3. Pinky side pain with forearm rotation or weight bearing. This suggests TFCC irritation or injury. Turning a doorknob, using a screwdriver, or bearing weight through the wrist in yoga may aggravate symptoms. Some people feel clicking or a sense that the wrist is unstable.

4. Diffuse ache, stiffness, and difficulty with pinch and grip. This cluster of symptoms is typical of arthritis. It may improve after the hand warms up and worsens with prolonged or heavy tasks.

5. Acute pain after a fall or forceful twist. Seek evaluation to rule out fracture or significant ligament injury. If there is visible deformity, severe swelling, heat and redness, fever, or rapidly progressive numbness or weakness, you should seek urgent medical care.

How occupational therapy evaluates wrist pain

Your first visit includes a conversation about your routines, roles, and goals. We want to understand exactly which activities you want to return to, whether that is lifting your child safely, typing long documents, turning keys without pain, or returning to tennis. The evaluation then examines posture, movement, and tissue health.

Specific components can include

1. Observation of resting posture, swelling, and scar status, if applicable

2. Measurement of active and passive wrist and thumb range of motion

3. Grip and pinch strength with a dynamometer and pinch gauge

4. Special tests that help clarify the pain generator, such as Finkelstein for De Quervain, Phalen and Tinel for carpal tunnel concern, and TFCC provocation tests for ulnar-sided wrist pain

5. Functional screens including handwriting, keyboard, and mouse simulation, lifting and carrying drills, and sport-specific tasks when appropriate

6. Review of your workstation, tools, sports equipment, and daily lifting strategies

7. Goal setting with clear milestones such as opening jars without pain, typing for a set duration with minimal symptoms, completing a thirty-minute yoga flow without wrist pain, or returning to a sport practice schedule

Occupational therapy treatment plan overview

Your plan is individualized, but most care progresses through three overlapping phases.

1. Settle the irritation and protect the tissue. We decrease pain and swelling, improve postural support, and protect the irritated structure with the right orthosis or support. During this phase, we also make immediate lifestyle and ergonomic changes that remove the daily triggers.

2. Restore motion and gentle control. As symptoms settle, we begin pain-free mobility work, isometrics, and light strengthening to improve tendon glide and joint mechanics. We retrain the movement patterns you use most often, such as typing posture or the way you lift a child or a pan.

3. Build resilience and return to full activities. We progressively load the wrist to build capacity that matches your job, home life, and sport. The goal is not just short-term relief but long-term confidence and self-management.

Orthoses education and activity modification

This section explains how we use supports and targeted education to reduce pain right away and prevent recurrence.

Night neutral wrist orthosis for carpal tunnel symptoms

Many people with carpal tunnel symptoms sleep with their wrists bent without realizing it. A comfortable neutral wrist orthosis worn at night can reduce nocturnal numbness and pain within the first few weeks. We ensure the fit is snug but not tight, teach you how to don and doff without strain, and show you how to check skin and circulation. During the day, we identify the specific tasks that increase numbness, such as long phone holding or driving without breaks, and we add brief rests, forearm support, and changes in wrist position.

Thumb spica orthosis for De Quervain symptoms

A thumb spica orthosis limits painful tendon excursion while performing everyday tasks. In the early phase, short periods of rest in the orthosis are alternated with guided, pain-free movement to avoid stiffness. We pair this with education on safer baby lifting, jar opening, and phone use. If your medical provider recommends an injection, therapy remains essential to correct the mechanics that caused irritation in the first place.

Ulnar wrist support for TFCC irritation

When the pinky side of the wrist is irritated, a support that limits painful rotation and ulnar deviation can be helpful. We use the lightest level of protection needed and begin graded re-exposure as soon as symptoms allow. This is combined with drills that restore rotation strength and endurance.

Joint protection and workload pacing for arthritis and overuse

Here are practical strategies we routinely teach

1. Keep the wrist in a neutral position during forceful tasks

2. Use two hands to lift heavy objects and slide rather than lift when possible

3. Use jar openers, key turners, and built-up handles to reduce pinch load

4. Break long tasks into shorter sets with brief micro rests

5. Warm up stiff hands with gentle heat before a heavy kitchen or gardening session

Therapeutic exercise program with specific dosage examples

Exercise is dosed like medicine. We progress frequency, volume, and intensity based on your symptoms and goals. Below are common elements of our programs with clear examples.

For De Quervain Tenosynovitis, once acute pain settles

1. Eccentric strengthening for wrist and thumb extensors. Use a light dumbbell or resistance band. Support the forearm on a table with the wrist just over the edge. Lift the wrist or thumb with assistance from the other hand, then lower slowly for four seconds. Aim for three sets of twelve to fifteen repetitions three times per day. Start with minimal resistance and progress weekly if pain stays mild and does not linger after the session.

2. Isometric thumb abduction and extension. Press the thumb gently into a fixed object, such as the side of a rubber band or a folded towel, without moving the joint. Hold for ten seconds and repeat five times, three times per day, to recruit muscles without provoking friction.

3. Tendon gliding within a free range. Guided sequences that move the tendons through their natural paths help reduce adhesions and improve nutrition to the tissue. These are performed slowly, eight to ten repetitions, three times per day.

4. Proximal support training: Scapular stabilizers and postural muscles are trained through rows, external rotation, and chin tuck and lengthen drills to reduce distal overload. Three sessions per week are typical.

For carpal tunnel symptoms where exercise is appropriate

1. Median nerve and flexor tendon gliding. Gentle nerve and tendon movements are performed without forcing symptoms. We use five to ten slow repetitions three times per day. Monitoring is essential. If tingling increases and lingers beyond a few minutes, the range is scaled down.

2. Forearm and chest mobility with postural resets. Pec doorway stretches, thoracic extension over a towel roll, and wrist flexor and extensor stretches are used to reduce overall strain. Each stretch is held for twenty to thirty seconds for two or three rounds, three times per day.

3. Proximal conditioning for endurance, rows, serratus activation, and neck mobility improves shoulder alignment, allowing the wrist and hand to work without constant compensation. Two or three nonconsecutive days per week is a common starting point.

For TFCC-related ulnar-sided wrist pain

1. Pain-free isometrics for deviation and rotation. Using a towel or a hammer handle, resist gentle radial and ulnar deviation, and pronation and supination without actual motion. Hold each effort for ten seconds and repeat five times, three times per day.

2. Graded isotonic strengthening. Once isometrics are pain-free, light resistance bands are introduced for controlled movement through a shortened, painless arc. Volume begins with two sets of eight to ten repetitions and progresses as tolerated.

3. Closed chain tolerance training. We practice partial weight bearing on a table with both hands, shifting weight gently and symmetrically. Over time, we increase the load, then practice modified push positions on a wall or counter before returning to full floor activities if desired.

For hand and wrist arthritis

1. Range of motion and gentle mobilization. Begin with a warm-up using a heat pack or warm water to reduce stiffness. Perform wrist circles, prayer stretch, and tabletop open hand stretch for ten to fifteen slow repetitions (Gliding exercises).

2. Stability and strength for the base of the thumb. Perform thumb to index press, then thumb to middle, ring, and small fingers, holding each for three seconds. Add gentle resistance with a rubber band for abduction and extension. Use two to three sets of ten repetitions, three times per day.

3. Grip and pinch endurance with minimal joint strain. Use soft therapy putty or a sponge for gentle squeezes. Avoid forceful tip pinch, which increases joint stress. Perform two sets of ten to fifteen repetitions, resting between sets.

4. Functional circuit. We simulate common tasks such as jar opening with a strap opener, key turning with a key wing, and lid twisting with a two-hand technique. The goal is to build skill and confidence while protecting the joint.

Functional activities and real-life skill practice

Therapeutic exercise is necessary but not sufficient. The brain learns best when practice looks and feels like everyday life. We therefore build activities that mirror your goals.

1. Baby lifting drill for new parents. We practice lifting a weighted doll or kettlebell held close to the body using forearm support and a neutral wrist. We teach the forearm scoop technique for crib to chest transfers and the forearm under thigh technique for car seat maneuvers. Parents learn to avoid the thumb-pulling-away posture that aggravates the first dorsal compartment.

2. Kitchen confidence routine. We practice opening jars with a strap opener while keeping the wrist neutral, lifting pots with two hands using silicone grips, and sliding heavy items across the counter rather than lifting them. We place commonly used items in accessible shelves to reduce strain.

3. Workstation performance session. We adjust keyboard height, chair and armrest positioning, monitor height, and mouse size. We then rehearse typing and pointing in short bursts with built-in micro rests. A forty ten rhythm is common. That means forty minutes of focused work followed by ten minutes that include two mini breaks for thirty seconds of wrist and shoulder resets.

4. Return to sport progression. For racquet and club sports, we check grip size, hand position, and swing path. We rebuild forearm rotation strength and endurance. For yoga and calisthenics, we introduce the first plank, the forearm plank, and the incline push positions before returning to full palm-loaded positions. We also teach load sharing with yoga blocks and wedges.

Manual therapy and massage

Manual techniques help reduce pain, improve tissue glide, and restore joint play. They are always performed within tolerance and followed by active movement to reinforce the gains.

1. Soft tissue mobilization, gentle to moderate pressure along the wrist and thumb extensors and flexors, helps decrease tone and improve the slide between layers. For De Quervain patterns, we address the first dorsal compartment with light longitudinal strokes followed by active tendon glides. For computer-related forearm pain, we focus on the belly of the flexor pronator group and the extensor mass.

2. Joint mobilization. When indicated, we use graded mobilizations to the carpal bones, the distal radioulnar joint, and the base of the thumb to reduce pain and improve motion. These are low-amplitude oscillations for comfort or slightly larger movements for stiffness, always calibrated to your response.

3. Edema and scar management. Post-immobilization swelling slows recovery and causes stiffness. We use retrograde massage, elevation strategies, gentle compression sleeves when appropriate, and kinesiotape for decongestion. Scar remodeling includes small circular motions, vertical and horizontal lifts, and desensitization with various textures.

4. Relaxation and recovery massage. Many people guard against pain by tensing surrounding muscles. A short, focused massage sequence to the neck, shoulder, and forearm helps reset this pattern. We often end with diaphragmatic breathing to build a relaxation association.

Modalities used as supportive tools

Modalities can assist with pain control and tissue preparation, and we always place them within a larger program of education and active practice.

1. Thermotherapy and cryotherapy. Warmth before exercise helps decrease stiffness and improve comfort. A heat pack for ten minutes or a warm water soak prepares tissues. Ice may help after tasks that flare symptoms. We use short applications of ten to fifteen minutes with a protective layer and careful skin checks.

2. Transcutaneous electrical nerve stimulation, also known as TENSLow-risk, noninvasive electrical stimulation can provide short-term analgesia for people who have trouble performing exercises due to pain. We place electrodes with careful instruction and test settings to ensure comfort.

3. Ultrasound, when indicated. These approaches are considered selectively for tendon irritations or stubborn focal pain. If used, they are paired with clear functional goals and active components.

4. Paraffin for hand arthritis. A paraffin bath warms the small joints and soft tissues of the hand, making exercise more comfortable and effective. We layer the wax carefully and monitor skin integrity.

Putting it all together

A sample of an 8-12 week plan:

Week 1 to Week 2The goal is to reduce irritability and remove daily triggers. You may receive an orthosis, such as a neutral wrist support at night for carpal tunnel symptoms or a thumb spica for De Quervain symptoms. We adjust your workstation, teach joint protection strategies, and begin very gentle mobility work. If swelling or scar sensitivity is present, we start a focused home routine. Many people already report improved sleep and fewer sharp pains by the end of this phase.

Week 3 to Week 6The goal is to restore motion and light strength. We begin with isometrics, tendon or nerve gliding within tolerance, and progress to light bands or small weights. Functional tasks are integrated such as kitchen practice, lifting drills, and brief work sprints with micro rests. If you are an athlete or an active adult, we introduce controlled return to low-load sport components.

Week 7 to Week 12The goal is to build resilience for real-life demands. Exercise volume and complexity increase. Closed-chain tolerance for yoga or pushing tasks is rebuilt step by step. Endurance for typing, manual work, or childcare tasks is increased with structured intervals. Orthoses are weaned as tolerated and replaced with movement skills and strength.

Note that your timeline may be shorter or longer depending on severity, other medical factors, and the specific demands of your roles at home, school, or work. Communication is constant. We adjust the plan based on your weekly experience and your objective measures.

Success stories from A Touch of Hope OT

Back to lifting my baby without pain. Three weeks after having her son, Miriam felt sharp pain on the thumb side of her wrist every time she lifted him. During the evaluation, we noticed a repeated pattern of lifting with the thumb pulled away and the wrist bent. We fitted a comfortable thumb spica support for short rest periods, taught a safer forearm scoop technique for crib to chest lifts, and started gentle isometrics followed by tendon gliding. At week three, we added light eccentric strengthening and a baby carrier setup that reduced thumb strain. By week six, she was lifting and carrying the car seat without pain. At her three-month check-in, she reported zero flare-ups despite a very active routine, and she continues to use joint protection strategies when the day is especially busy.

Typing and sleeping through the night again, Jamie is a software engineer who woke up nightly with tingling in the thumb, index, and middle fingers. We initiated a neutral wrist orthosis at night, reshaped his workstation so the forearms were supported and the keyboard height matched his elbows, and started a structured rhythm of focused work with micro rests. Gentle nerve and tendon glides were introduced with strict symptom monitoring, along with shoulder and neck mobility to reduce overall strain. Within two weeks, night waking improved. Within five weeks, he worked full days with minimal symptoms. At a two-month follow-up, he maintained results by keeping the workstation setup and taking brief posture resets.

Golf without the ulnar wrist sting. Kim slipped on wet pavement and developed pinky-side wrist pain that clicked with rotation and ached during golf. We protected the wrist early with a light support, then began isometrics for deviation and rotation. As pain decreased, we progressed to graded band work and a swing mechanics review. We checked club grip size and taught a follow-through path that reduced excessive ulnar deviation at impact. By week eight, he completed a full round without a flare and resumed his twice-weekly practice schedule.

Cooking and jars are doable again. Sue is a devoted home cook with base-of-thumb (CMC) arthritis. Her goals were simple and meaningful: open jars without asking for help and knead dough for family pizza night. Her plan included heat before exercise, stability training for the thumb base, gentle grip and pinch endurance, and functional practice with adapted tools. We showed her how to use a strap opener and a key wing, and how to slide heavy items instead of lifting. At week six, she reported that jar opening was easy most days. At week ten, she kneaded dough again with a two-hand method and neutral wrist posture.

Your Next Step

If wrist pain is affecting your work, your caregiving, your hobbies, or your peace of mind, we are here to help. At A Touch of Hope OT, you will receive compassionate care grounded in current best practice and delivered with real-world practicality. We listen closely, tailor each plan to your life, and teach you the skills and strategies you can keep using long after therapy ends.

Call us to schedule a thorough evaluation. Together, we will reduce pain, restore function, and help you return to the activities that make your life full.

Important Note

This guide provides general information for education. It is not a diagnosis or a substitute for medical evaluation. If you experience acute trauma with deformity, severe swelling, fever or redness, sudden loss of motion or strength, or rapidly progressive numbness, seek urgent medical care. From our hands to yours, A Touch of Hope OT is here to support your recovery and help you return to the things you love.

Contact us today and take the next step toward healing.