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Wrist-Hand Evidence

Support for Wrist-Hand Manual Therapy Techniques

Summary:

Manual therapy interventions for the wrist have been associated with improvements in pain and function in individuals with lateral epicondylalgia (LE) and carpal tunnel syndrome (CTS).

Lateral Epicondylalgia (le):

There is one low-powered trial that investigated the effectiveness of wrist joint manipulation for individuals with LE. Struijs et al compared the effects of manipulation of the wrist to a combined treatment program of ultrasound, friction massage and muscle stretching and strengthening in patients with tennis elbow. Subjects in the wrist manipulation group attended regular treatment sessions consisting of repeated applications of a wrist/scaphoid manipulation. Subjects receiving manipulation demonstrated greater improvement in the primary outcome measure, which was “global measure of improvement”, at initial three week follow up. However at the six-week mark no differences between groups were found for this primary outcome or the majority of secondary outcome measures. Although the results and methodological shortcomings of this study limit the ability to draw firm conclusions regarding the efficacy of this technique, the work by Struijs et al. does suggest there may be a role for wrist manipulation in the management of LE.

Other Clinical Evidence:

 

Other Relevant Evidence:

Goetz, 2010, Clin Biomech

 

Techniques

  • Carpal-Metacarpal (CMC) Glides - Flexion and Extension
  • Distal Radioulnar Joint (DRUJ) Posterior to Anterior and Anterior to Posterior Mobilization
  • Distal Radioulnar Joint (DRUJ) Pronation
  • Distal Radioulnar Joint (DRUJ) Supination
  • Extensor Pollicis Brevis / Abductor Pollicis Longus Longitudinal Stretch
  • Intercarpal Horizontal Flexion
  • Intercarpal Anterior-Posterior and Posterior-Anterior Mobilization
  • Radial Deviation
  • Radiocarpal Anterior to Posterior Mobilization
  • Radiocarpal Lateral Transverse Glide
  • Radiocarpal Medial Transverse Glide
  • Radiocarpal Posterior to Anterior Mobilization
  • Wrist / Scaphoid Extension Thrust Manipulation
  • Ulnar Deviation
  • Wrist Extension Mobilization
  • Wrist Flexion Mobilization