Case Study: Wrist/Hand Pain – Part 2

Before reading Part 2 of this wrist and hand case study, I would suggest reading (or re-reading) Part 1 here

It has been about one month since beginning treatment with this young woman, and she is slowly making progress towards reaching her treatment goal of being able to work a full work-day without pain/numbness. Currently, she notes that she must only stop working 1-2 times a day because of pain/numbness. I contribute much of this progress to getting her to take more breaks throughout her day as well as adding small exercises to these breaks such as nerve glides, doorway stretch, and scapular retractions.

After looking at all your suggestions and comments, I went back and took a closer look at her pec minors, neural tension tests and sitting posture. Upon this further evaluation I found that she had/has neural tension very proximal to her shoulder, as well as very tight pec minors. With some painful soft tissue work to her pec minor and the addition of a doorway stretch, her sitting postural awareness has improved significantly in just 2 weeks. She no longer is sitting with significant shoulder internal rotation and moderately protracted shoulder girdles (I’d say only minimal now).

She notes that her left wrist pain is only 3/10 at worst and she is now a 0/10 at rest. She also notes significant decrease in numbness, which usually follows her episodes of wrist pain. There have been improvements in many aspects besides the ones listed above. She also has improved left wrist extension strength, and bilateral wrist flexor flexibility.

There is still much work to be done, as she is yet to return to her previous level of functional activity including weight lifting, yoga, and a significant amount of cooking, but she is confident that the rest of her rehabilitation will get her there.

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