There is a particular type of pain in the middle of the back of the wrist that is incredibly common, yet so often mis-diagnosed. The mis-diagnosis is carpal tunnel syndrome, and let me tell you why this isn't it.
Carpal tunnel syndrome is a structural abnormality in the carpal tunnel – the space between the wrist bones. This structural change puts pressure on the radial nerve, which causes pain, weakness, and muscle wastage etc.
Structural changes do happen, but they're quite rare. Carpal tunnel syndrome is just too uncommon to be the cause of so much wrist pain!
So what causes this intense pain at the back of the wrist? Tight muscles – specifically tight wrist extensors.
The wrist extensors are the same muscles responsible for tennis elbow. There are 8 wrist extensors: they all originate on the lateral side of the elbow, and insert around the wrist.
When the wrist extensors become tight, they pull on the attachment at the elbow and/or the wrist. If the elbow is effected, the elbow begins the inflammation process and develops tennis elbow. If the wrist is effected, the wrist begins the inflammation process and develops distal extensor tendinopathy – the true diagnosis for this common injury!
The reason that it is so common (unlike carpal tunnel syndrome) is that we need our wrist extensors to do almost everything: playing sport (throwing, catching etc.); at work (typing, using a mouse etc.); and just living our lives (eating, writing etc.).
The treatment of distal extensor tendinopathy is, thankfully, much easier than carpal tunnel syndrome. You don't need surgery, you just need to release the wrist extensors through stretching, massage, and needling*.
For more information on wrist pain, email me directly via the contact page. For specific information on an injury you have, or for treatment, contact one of my clinics directly. You can find that information here.
*Gadau M, Yeung WF, Liu H, Zasalawski C, Tan YS, Wang FC, et al. Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomised controlled trials. BMC Complement Altern Med. 2014;14:136.
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Dr Mitch Clark