Wrist Pain from Repetitive Work in a Desk Worker

In a technology ran world filled with smartphones and computers, it is not surprising that wrist pain is extremely common. Whether you are working behind a desk clicking your mouse all day, or just passing the time swiping through news stories on your phone, over use of wrist is bound to happen. Patients with acute wrist pain that developed or increased abruptly after excessive activity, but who clearly have not sustained direct trauma, often suffer from acute-on-chronic pain related to overuse. Acute pain associated with overuse typically arises towards the end of an activity that exceeds what the patient is used to doing. A classic example is one with carpometacarpal osteoarthritis. Often patients like this one may have mild underlying chronic pain that does not bother them enough to take medication or seek medical evaluation, but after an entire day spent, for example, doing extensive activity involving the wrist, the pain can suddenly become severe. Such patients typically complain of acute pain that began on a particular day, but the underlying osteoarthritis causing the pain is a chronic condition. The same principle applies to acute exacerbations of a wrist tendinopathy (Estrada, & Vea, 2017). These patients often report a progressive pain pattern that preceded any acute increase in pain and had caused increasing functional limitations or complete cessation of a particular activity. Although the history may be different, as these characteristics suggest, the evaluation and management of acute exacerbations of pain from chronic overuse are generally the same as those for the chronic conditions themselves. Differential diagnosis for wrist pain can include; extensor carpi ulnaris tendinopathy and subluxation, triangular fibrocartilage complex injury, triquetral fracture, ulnar styloid impaction syndrome, scaphoid fracture, scapholunate instability, trapezium fracture, de Quervain’s tenosynovitis, carpometacarpal osteoarthritis, hook of the hamate fracture, pisiform fracture, carpal tunnel syndrome, ulnar neuropathy (Guyon’s canal syndrome),  perilunate and lunate dislocations (Toosi, Hogaboom, Oyster, & Boninger, 2015). If you are experiencing wrist pain call Scottsdale Sports Medicine today and make an appointment to see Dr. Carfagno for musculoskeletal ultrasound, and get back to swiping right!

References

Estrada, J., & Vea, L. (2017). Sitting posture recognition for computer users using smartphones and a web camera. In Region 10 Conference, TENCON 2017-2017 IEEE (pp. 1520-1525). IEEE.

Toosi, K. K., Hogaboom, N. S., Oyster, M. L., & Boninger, M. L. (2015). Computer keyboarding biomechanics and acute changes in median nerve indicative of carpal tunnel syndrome. Clinical Biomechanics, 30(6), 546-550.