18 Apr Why Won’t My Wrist Pain Go Away?

You’re frustrated and annoyed that your wrist pain hasn’t gone away yet.

I know.

I work with people like you every, single day.

At Barefoot Rehab, we specialize in fixing people’s pains that have been present for more than 2 months, even when they’ve seen 3-5 other doctors.

When you see chronic pains (our definition of chronic is any pain lasting more than 3 weeks) on a daily basis, mental patterns rise to the surface.

The first signs of pain are largely ignored by you.

You think they’re going to go away.

After a few days when the pain hasn’t gone away, you look for self-management techniques:

Foam-rolling, lacrosse-balling, stretching, exercises, ice, heat, massage.

Those techniques don’t work, so you look for conventional methods for relief people talk about:

Chiropractic adjustments, physical therapy, or you see your medical or orthopedic doctor who prescribes anti-inflammatories or gives you an injection of one type or another.

Increasingly upset with nothing you do seeming to have any positive result, you decide to google “wrist pain” and you end up here.

So happy you decided to stop by!

My hope is to save you a lot of time, money, and energy by telling you what often is happening with wrist pain that won’t go away that is very commonly neglected by 95% of healthcare providers.

Tell Me About Your Wrist Pain

Do the wrist and finger extension test. I go into detail how to do the test HERE.

The results of this test, when combined with symptoms will tell you what your problem likely is, what type of doctor you should see, and what type of sweet-spot treatment you should get.

Remember, if your problem is a screw, only a screwdriver will work. Using a hammer or wrench for your screw will only make you look silly and will result in lots of wasted time and energy.

Below, I’ll assume you’ve rested your wrist for at least two weeks.

If you haven’t rested for 2 weeks, no one’s body can heal or recover when you’re constantly adding more wood to the fire by continuing to use damaged tissue.

Stop adding wood to the fire and the fire will die down (and your inflammation will go away).

If your test is really good like below AND at least one of the following is true:

• your wrist pain is worse than 7 out of 10 (where 0 = “no pain” and 10 = “worst pain ever”)
• your wrist pain is sharp or stabby
• when you contract your finger and forearm muscles into your other hand without shortening the muscle, you have wrist pain.

… You’ll need to see an orthopedic doctor to get an MRI of the wrist to determine which parts (muscles? bones? cartilage? tendons?) are damaged and what the potential solutions are for them.

If your test is moderately bad AND all of the following is true:

• your wrist pain is less than 7 out of 10 (where 0 = “no pain” and 10 = “worst pain ever”)
• your wrist pain is NOT sharp or stabby …

… You should find an Integrative Diagnosis (ID) doctor who can diagnose all of the parts of your problem and prioritize solutions for your top #1 to #3 biggest problems.

Often, the #1 biggest problem when a test is tight, restricted, and failing, is a problem that 95% of doctors don’t talk about. More on that below.

If your test is horribly bad AND all of the following is true:

• you didn’t have a severe trauma to the wrist
• you haven’t ignored it for years (you may have degenerated cartilage or a tear)
• your wrist pain is less than 7 out of 10 (where 0 = “no pain” and 10 = “worst pain ever”)
• your wrist pain is NOT sharp or stabby …

… You’re a home run for an Integrative Diagnosis (ID) doctor, as ID doctors are trained to restore flexibility. As your flexibility approaches normal, your symptoms approach normal and go away too.

The most common cause for tightness and the reason your wrist pain hasn’t gone away is a problem called:

Adhesion: The Biggest Cause of Pain You’ve Never Heard Of

Have you heard of fascia before?

It’s the spider-webbing literally between all of the different tissues of the body.

Notice the bright, white lines going up and down on what looks like this cadaver’s quad (Gil Hedley, 2005).

When the muscles are teased apart, it’s easier to observe the fascia.

When you overuse this spider-webbing (or fascia) or have a trauma (like a cut on your skin), your body lays down more of it to repair the damage.

The excessive laying down of spider-webbing is called adhesion.

Adhesion and scar tissue look the same under a microscope, except that the cause was different.

• Adhesion = there was no trauma.
• Scar tissue = a trauma.

If your pain came on gradually and there was no obvious trauma, then we’re talking about adhesion.

The primary way you know if you have adhesion is with the wrist and finger extension test. You already did this above.

An Integrative Diagnosis doctor confirms the suspicion of adhesion by feeling your muscles.

He/she is not looking for knots, which are very different from adhesion and in this doctor’s opinion, a waste of time to push on.

Adhesion feels like a well-done steak instead of a bunch of spaghetti that you can roll over your fingers with.

Most of our patients are able to perceive they have a knot when her husband pokes his fingers into her neck or when the massage therapist says:

Oh wow! You’re really tight!

I’ve found that most patients are unable to perceive adhesion until I’m treating them and they can feel the adhesion tearing under my fingers.

The cool thing about adhesion is that you’ll notice progress immediately that is permanent.

The only occurrences when it won’t be permanent or last are when you have:

• active inflammation because you haven’t rested.
• adhesion, but you also have a more serious issue (that would be diagnosed with MRI)
• a metabolic problem that prevents your body from healing (like diabetes or a thyroid condition).

The first bullet point on rest is the #1 reason why people with wrist pain don’t heal.

Excluding CrossFitters or other lifters who do a ton of group work, it’s really hard for people to stop:

• typing
• texting
• using their hands.

When I fail patients and don’t get them progress within our 5 Visit Rule, it’s most often because we couldn’t take stress off of the wrist enough to cause damage to the adhesion and increase the flexibility.

The constant workload of the patient combined with the dosage of adhesion removal I do means the pain level doesn’t change.

Details like which parts of your pain matter (how much work you’re doing with your wrist) and which parts don’t (stretching, ice, heat) is why seeing a detail-oriented doctor or therapist is so important.

Only when the odds are stacked in your favor can treatment for the adhesion take hold and get you out of pain.

Treatment to Remove Adhesion Causing Wrist Pain

To get your adhesion removed, your doctor or therapist must:

• Test your range of motion and flexibility (tells the doctor how much adhesion you have)
• Treat you to remove your adhesion
• Re-test your range of motion and flexibility (tells the doctor if the primary problem causing your pain was removed)

Below is an example of how we treat in our office at Barefoot Rehab.

The cool thing about getting your adhesion removed is that you’ll know if it’s REALLY helping you the first visit.

You’ll know if you’re permanently improved in 5 visits or less. In fact, it’s a rule.

So you can get fixed and not be worried about wasting your time, energy, or money.

When it comes to pain:

• Fix the problem … and your pain will go away.
• Don’t fix the problem … and your pain will stay and get worse.

Isn’t it common sense?

What have you tried for your wrist pain? Did it work? Not work?