Will wrist tendonitis stop my career? My hands are all i have...

by Rohise

I think i have right wrist tendonitis. I've had it for like 5-8 years, but recently aggravated for the past year.


Typing my wrist pain story now even brings the fear of wrist pain. I hope my wrists can take it as i type my story.

I believe there are a lot of factors which contribute to my Wrist Tendonitis.

I write heavily, do household chores (sweeping), type a lot in the computer, used my right pisiform as mouse pivot and put my hands under my head when sleeping so these things added to my pain...

I write heavily, as in there are marks at the back side of my paper. I write this way because i want to see my writings as dark and nice as it could be. That was how i wrote, and every time i finished writing, my wrist would feel pain.

I also observed that my right ring and pinky fingers (right-handed) would hurt the most (because they are 'crushed' with my hand-writing position)...I wrote like this for about 8-10 years.

Then I changed my writing style. I tried to write lighter, and with my ring and pinky fingers outstretched, but the pain is still there. Now i extend my ring and pinky finger and try to write lightly....which resulted to sloppy handwriting (but I could trade sloppiness for a pain-free hand).

The next factor would be my improper computer use. It's only about a year or so that I've learned about proper computer use. My mortal sin: I've used the pisiform of my right hand (yes, additional stress to my right hand) as pivot when using the mouse. Also, I wasn't aware of proper hand position during typing (my wrists were bent when typing)...I even over-reach for the keyboard and mouse during typing.

I know my mistakes, but now I try not to bend my wrists when typing, and use my mouse better. But I hope my renewed computer practices could make up for the 8 years of strain injury to my wrists.

Then there are other hand activities which add stress to my hands. I do occasional sweeping, where i would rotate and rotate my wrists. During sleep, I like to put my hands under my head which literally crush them for hours.

I have been putting off consulting medical advice. For one, i was very busy with school.

Also, I was considering the ever-popular carpal tunnel syndrome, but after doing self-Phalen's maneuver test, and coming with negative results, i was half-convinced i don't have problems. For the time being, i was contented with heat application to ease my pain. During this time, I had wrist-pain only during after-writing, after-typing events or after-activity events.

The last months of college required extensive handwriting requirements and papers to be typed, thus resulted to additional stress. I also worked as a transcriber, which basically "murdered" my wrists. For the last year, I've had a standing pain in my right wrist, with a rating of 4-6 out of 10, and after-activity rating of 8-9/10.

Finally, 2 months ago I had time to schedule a consultation.

I first went to a rehab MD. I narrated my symptoms, and even demonstrated the clicking sound of my right hand when i rotate it (yes, it developed clicking sounds during my 2-3 years ago). Thinking it was physical therapy, i hope to get good results. I was diagnosed with ulnar nerve compression (maybe that's why the phalen's test came negative) and treatment for my right hand included:
a. paraffin wax
b. ultrasound
c. TENS

I had five sessions of it, about 1-2x per week. Every after-therapy, my right hand had a pain scale of 0-2/10. But the pain came back.

Now i consulted an ortho doctor. After examining my right hand, he said i had extensor carpi ulnaris adhesions and this formed from inflammation processes with my repetitive strain injury. And he advised that i go back to my usual activities only being mindful of good hand position. He also suggested wearing a wrist brace and prescribed celecoxib 200mg PRN for unbearable pain.

I went, thereafter, to buy a wrist brace, but i was not able to find one that day. Thus that night, i improvised and splinted my right hand and went to sleep. But i committed another mistake: I splinted the palmar side super straight, thus upon waking up and after a few hand movements, I've got so much pain i just wanted to chop my hand off. After taking pain meds, I bought a right wrist brace (brand name: LP Support).

However, now i have a standing wrist pain of 6-7/10 and everytime i move my hand, my joints and tendons feel weak and i think i would break any moment (there are clicking sounds almost all the time i'm moving them). And now that my right hand is braced, my left hand is doing most of the work that i think it is starting to feel fragile and have clicking sounds too.

I'm starting to feel that my left hand is also having tendonitis.

Currently I'm trying ice application and doing some stretching. Sometimes they work, sometimes they just worsen my pain. What should i do?

Believe me, I am too nervous to do any movement with my hands. Now, I am eager to have any tendon-improving supplement, and have been doing stress ball stretching exercises for my hands during the mornings. and

Sorry for this long narrative. But after I've read your wrist tendonitis article, i was surprised to see "that having wrist problem is lucky" when I feel like I'm in hell. And I have been very detailed as i can.


My questions:
1. is my handwritng style ok? (extended ring and pinky fingers)
2. do you have additional advice for safe computer practices?
3. i've read that cold applications should be the treatment, did my paraffin wax and other heat therapy aggravated my condition?
4. I hope you can shed some light on what i can do for my hand. I am a fresh graduate nurse and I am fearing that this problem can interfere with my career.

I am hopeful that you can help me. Thanks in advance.



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Joshua Answers:


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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for Will wrist tendonitis stop my career? My hands are all i have...

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Dec 10, 2010
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Joshua Responds - Will wrist tendonitis stop my career? My hands are all i have...
by: The Tendonitis Expert

Joshua Comments:

Hello Rohise.

First, your questions:

1. is my handwritng style ok? (extended ring and pinky fingers)

Yes, that's great. You should definitely stop putting weight on your pisiform, etc.


2. do you have additional advice for safe computer practices?

Here's my thoughts on ergonomics.


3. i've read that cold applications should be the treatment, did my paraffin wax and other heat therapy aggravated my condition?

No. Heat brings blood to the area, that's good. But the Process of Inflammation traps fluid in the area, so that new fluid can be problematic.

It is my observation that ice is by far the most effective, when used appropriately.


4. I hope you can shed some light on what i can do for my hand. I am a fresh graduate nurse and I am fearing that this problem can interfere with my career.

It absolutely can interfere with your career. It already is.


Tendonitis follows a very predictable pattern of progression. You're at the 'bad' end of the spectrum. You're rather stuck there, at this point.

The ecology is creating more problem, faster than your body can compensate for it. In fact, the compensation is causing even more problem.

Unfortunately, Rest won't cure anything.

* There certainly is some nutritional component.
* Your tissue is 'stuck' in this dynamic.
* Yes there's weakness, but it's because your muscles are TOO TIGHT and they don't have much contraction potential left. Plus they're overworked and tired.


My questions to you, are:

1. One hand or both?

2. Do you have numbness and tingling?

3. What exactly have you done for this, in detail (other than changing how you write/type)?





Dec 13, 2010
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Re: Will wrist tendonitis stop my career? My hands are all i have...
by: Anonymous

Thank you very much for responding.

Here are my replies:
1. Initially, the one hurting is my right hand. But because i want to let my right hand get its rest, my left hand has been doing most of the work. And it has started to develop clicking sounds.

2. The predominant symptom for my right hand is pain. Only when i overuse my hand will it develop numbness and tingling (like after writing or typing for hours)

3. These are the measures i've been implementing:

a. I bought a wrist brace (with metal support to keep my wrist fixed) for my right hand. I use it mostly at night, when I'm asleep. Sometimes during the day, I will also wear my right wrist brace. For my left hand, sometimes i also use a wrist band (without metal support) to limit my wrist movements.
*This method helped me ease the pain, but sometimes after removing the brace upon waking up, when i would just slightly flex my wrist there would be great crackling sounds.

I also use wrist bands when I type to prevent my wrists from bending too much.

b. I do stretching exercises for my fingers and wrists, especially during the mornings. I also feel pain when i do my stretches (more on the right hand than on the left), but i believe these exercises should help.

I also use a stress ball because i want to strengthen my wrists. I want to strengthen them and overcome the weakness my tendonitis does for my wrists (Will this exercise give my wrists strength or will it just add to the inflammation process my tendons are already in?)

c. Then after exercising my hands and stretching, I will do cold application therapy. I will dip my hands in ice and cold water for about 7-10s, alternately for a total of 20 minutes/day. Sometimes i will use an ice bag and place it on my wrists for about 7-10s also (alternately, total of 20 mins/day).

d. I came across one of your articles regarding Mg deficiency. Now I'm trying to increase my Mg intake. I'm also taking vitamin B1,6,12 for my nerves.

REALIZATIONS:
I've read your new definition for ergonomics and i quite agree with you. I will continually strive to do my tasks in a different way everyday.

And if ever i use heat application, i'll end it with a cold one.

I definitely don't want my career to stop. And with your help and advice, I believe I could win over my wrist tendonitis.

Thank you very much.


Dec 15, 2010
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Joshua Responds - Will wrist tendonitis stop my career? My hands are all i have...
by: The Tendonitis Expert



Joshua Comments:

Great. Thanks for the details.

Notice how hours of writing and typing cause numbness? What is your neck/head/shoulder posture while you're doing that. Maybe it's the muscles on the front of your neck/chest that get compressed and cause the numbness.....

The strengthening ball is great. But as to your question, it will either help, or it will irritate things.

'Weakness' isn't the problem, though it feels that way.

Too many of the muscle fibers in your forearm structures are constantly firing. Let's say, 90 out of 100. So you have very little strength potential left, and the muscles are constantly working, constantly tired, and likely undernourished.

Stretching good. Exercising good. Nutritional intake good. Icing good.

Would you say it's helping, so far?



Jan 15, 2011
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Re: Will wrist tendonitis stop my career? My hands are all i have...
by: Rohise

Hello!...
Sorry for the overdue reply...I've been away for the holidays!
Hope you had a great new year too...

As for my problem, you're suggestions really helped a lot. Though I must say, my wrist would still ache from some handwriting and typing jobs, but nevertheless I am able to manage them.

Thank you and if ever I have future tendon problems, I know whom I'll be looking for. :)

Jan 05, 2013
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Adhesions after ASTYM treatment
by: Emily

Based on your website, it sounds like I have wrist tendonitis on my dominant hand, my left hand. I had 3 months worth of Astym to break up adhesions on the back of my left hand, and I think I may have overstretched something while doing my stretches during Astym to break up the adhesions.

My PT says my adhesions are gone, but I can palpate a small bump that feels like it's attached to my tendon leading down from my index finger to the point of pain on the back of my hand. How can I can rid of that bump and therefore get rid of the pain?


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Joshua Comments:

Hi Emily.

1. Please describe for me why you think the bump is the cause of pain?

2. Please say more about "I think I may have overstretched something while doing my stretches during Astym to break up the adhesions."

What and why? Is that in relation to the bump?

3. What other self care, if any, did you do/are you doing?

4. Please describe in detail your current symptoms, and we'll go from there.





Jan 23, 2013
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tender knot on back of hand
by: Emily

Here are my answers:

1. Please describe for me why you think the bump is the cause of pain?
The bump is tender when I touch or press it. It's so small it's really more like a knot. It almost feels like a knot of scar tissue wrapped around that tendon, but that's purely a guess. The knot seems to move with the tendon if I try and move the tendon side to side, which makes me think the knot is adhered to the tendon perhaps.

2. Please say more about "I think I may have overstretched something while doing my stretches during Astym to break up the adhesions."

What and why? Is that in relation to the bump?

I did a lot of stretching after the ASYTM and the pain was COMPLETELY gone for 6 weeks. I didn't notice the knot during this time of being pain-free. Then I noticed the knot when the pain started up again.

3. What other self care, if any, did you do/are you doing?

I apply topical creams to it (ie Biofreeze) to hide the pain. I just bought a paraffin wax bath to dip my hands in and then stretch afterward in hopes of breaking up the knot if it is in fact scar tissue but have not started this regimen yet.

4. Please describe in detail your current symptoms, and we'll go from there.

Currently I have a knot on the back of my hand around my carpal bones. It feels like the knot is surrounding the tendon that runs from my index finger to this area of pain (the place where that tendon joins the carpal bones). The pain gets worse if I touch the area, press it, or move certain ways. If I hold my fingers out straight and my hand is still in a neutral position, the pain will often go away.

Thank you!


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Joshua Comments:

Thank you.

And was the ASTYM working the forearm etc, or just the back of the hand?

What were your original symptoms?

Any history of trauma or injury to the back of the hand? And/or something that might have cut/nicked/hurt the tendon there where the bump is?

Probably it's just scar tissue build up. If it's -part- of the tendon, meaning a growth of the tendon. If it's separate from the tendon, that's different.

Potentially it's a tiny cyst or something that the body has tried to encapsulate with scar tissue.

Potentially it's a lipoma, which is a benign fatty growth.

There's a slight possibility it's cancerous tumor. I can't imagine that it is, but I'm just running through the options of what it could be.


Answer the above questions, and see if you can describe the bump in more detail, and the sensations when pressing the bump in more detail.



Jan 23, 2013
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Answers re tender knot on back of hand
by: Emily

My answers:

And was the ASTYM working the forearm etc, or just the back of the hand?

It was working the forearm and the hand/fingers as well.

What were your original symptoms?

I had a carpal boss surgically removed from this area in August 2009. The pain was gone. Then in January 2011 the pain came back again. I feared it was the carpal boss recurring. The xray was thankfully negative. The MRI was negative except for a small amount of scar tissue, which my surgeon didn't seem to think anything of.

I tried various modalities to break up the scar tissue (deep tissue massage, iontophoresis, microcurrent therapy with heat, ultrasound, Graston technique) but the ONLY one that worked was ASTYM. But the relief from pain only lasted for 6 weeks.

Any history of trauma or injury to the back of the hand? And/or something that might have cut/nicked/hurt the tendon there where the bump is?

No trauma except the surgery in 2009 in this location. But the pain was gone for 1.5 years after surgery, which baffles me.

Probably it's just scar tissue build up. If it's -part- of the tendon, meaning a growth of the tendon. If it's separate from the tendon, that's different.

Potentially it's a tiny cyst or something that the body has tried to encapsulate with scar tissue.

Potentially it's a lipoma, which is a benign fatty growth.

There's a slight possibility it's cancerous tumor. I can't imagine that it is, but I'm just running through the options of what it could be.

Answer the above questions, and see if you can describe the bump in more detail, and the sensations when pressing the bump in more detail.


The bump is very tiny and tender to touch or pressing it or rubbing it side to side. Not a sharp pain but more like a nagging irritation.

A cyst, lipoma, or tumor as you mentioned above would have shown up on the MRI, right? Is it possible the ASTYM got rid of the scar tissue and gave me pain relief for 6 weeks, then the scar tissue regrew? If so, any recommendations to keep the scar tissue gone PERMANENTLY?

Many thanks again!


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Joshua Comments:

Hi Emily.

1. The scar tissue isn't really the problem. The mobility of the tissue is a problem. The muscle's ability or not to function is a problem. The overall tone of connective tissue is a problem. Nutritional insufficiency is a problem. A chronic Process of Inflammation is a problem.

All those problems make up the ecology of an area/a problem.


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Jan 23, 2013
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Joshua Replies to Emily - Tender knot on back of hand
by: The Tendonitis Expert

-CONTINUED FROM LAST SECTION-

Just dealing with one factor can't/won't adequately affect the area/a problem. You felt relief for 6 weeks before symptoms returned. This is one explanation why.

If you're short on, say, Magnesium, muscles literally can't loosen up. One can help them to/force them to with something like ASTYM, but as you've noticed, it's temporary.

If one has too tight muscle and connective tissue and takes enough Magnesium, symptoms can/do decrease, but won't disappear because the connective tissue constriction never got adequately dealt with.


BTW, ASTYM works on a paradigm of 'Everything is scar tissue'. Meaning, they treat everybody's scar tissue, and everybody they treat has scar tissue, because to them everything is scar tissue.But scar tissue is just one possible component, if it even is a component.


2. I'm going with that if a doctor took an MRI, etc, cyst and tumor have been ruled out.

So you have some buildup on the tendon. If the ecology isn't fixed, slowly over time more build up will happen, predictably. It's sore and tender ALL the time, not just when you touch it. You only consciously feel it when you touch it, but your nervous system feels it all the time.

So it's constantly being told there's a problem, so it does all it knows how to do to protect you, which is to tighten up and turn on an inflammatory response.

Plus, you had a boss form, and surgically removed. Maybe it grew for no reason, maybe the ecology caused it to grow. No real way to tell, but it might be smart to deal with the ecology to reduce the odds of forces causing it to grow again.

You may want to get my Reversing Wrist Tendonitis ebook. It shows you how to deal with the entire ecology. Then once you get into that email me and I'll specifically fine tune what to do for your specific scenario.



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