Hand and Wrist Pain: A Holistic Diagnostic and Treatment Approach to Local and Referred Internal…

The hand and wrist are a unique anatomical structure in terms of functionality, standing out in human evolution for their fine motor skills. Over the course of evolution, the hand developed in a way that allowed it to perform many tasks, such as grasping, writing, manipulation, and lifting weights. The fact that the hand occupies a large area on the homunculus map shows the importance and complexity of this structure within the nervous system. Today, our hands are placed under greater strain through activities such as keyboard use, touchscreens, and lifting weights, and as a result of improper use, they become prone to pain, restricted movement, and loss of function.

In this article, the causes of hand and wrist pain, diagnostic methods, and treatment approaches will be addressed within the context of manual medicine, neural therapy, and regulation medicine.

Causes of Hand and Wrist Pain

Local Musculoskeletal Problems

• Carpal Tunnel Syndrome: Pain and numbness in the wrist and fingers resulting from compression of the median nerve at the wrist.
• Trigger Finger: Painful restriction of movement due to inflammation and blockage in the finger tendons.
• De Quervain's Tenosynovitis: Inflammation of the tendons that move the thumb.
• Arthritis: Osteoarthritis or rheumatoid arthritis can cause pain and stiffness in the joints of the hand.
• Ligament Injuries: Excessive stretching or tearing of ligament tissues in the wrist.
• Ganglion Cysts: Fluid-filled cysts that form in the wrist can cause nerve compression and pain.

Referred Internal Organ Problems

Hand and wrist pain can be associated with viscerosomatic reflexes caused by internal organs:

Internal Organs Associated with Hand and Wrist Pain:

• Heart: Pain in the left hand and wrist can be a reflection of heart conditions such as angina or myocardial infarction.
• Lungs: Right-hand pain in particular can originate from lung pathologies.
• Liver and Gallbladder: Pain in the right wrist can be associated with bile duct obstruction or liver dysfunction.
• Digestive System: Esophageal spasms, stomach, and intestinal problems can reflexively refer pain to the hand and wrist.

Neural and Fascial Connections

• Fascial Chains: The wrist carries tension through fascial connections that extend along the upper extremity to the shoulder and neck.
• Brachial Plexus and Median Nerve: Compression or irritation of these nerves can cause pain radiating to the wrist and hand.

Autonomic, Also Known as Vegetative, Nervous System Dysfunction

• Sympathetic Nervous System: Chronic stress and increased sympathetic activity can cause circulatory disturbance and inflammation in the wrist and hand.
• Parasympathetic Nervous System: Insufficient parasympathetic activity delays healing and increases chronic pain.

Diagnostic Methods for Hand and Wrist Pain

Clinical Evaluation

• Taking a History: The duration, severity, triggering factors, and referred pain symptoms are queried.
• Physical Examination:
• Wrist range of motion, strength testing, and nerve function are evaluated.
• Carpal tunnel syndrome is screened for using the Tinel and Phalen tests.

Segmental Evaluation

• The C5-T1 segments associated with the wrist and hand are examined by palpation.

Imaging Techniques

• X-ray: To evaluate joint deformities.
• MRI and CT: To examine soft tissue injuries and nerve compressions.
• Ultrasonography: To evaluate tendon and nerve structures.

Laboratory Tests

• Biochemical analyses and blood tests to detect internal organ dysfunction.

Treatment Approaches for Hand and Wrist Pain

Regulation with Neural Therapy

Neural therapy is an effective method for regulating the autonomic nervous system and viscerosomatic reflexes:

• Disturbance Field Treatment:
• Treating old scars, dental infections, and chronic inflammation foci with local anesthetic injections reduces sympathetic load.
• Segmental Neural Therapy:
• Injections applied to the C5-T1 segments regulate viscerosomatic reflexes.
• Autonomic Nervous System Regulation:
• Stellate ganglion block helps bring sympathetic dysfunction under control.

Manual Medicine Approach

Manual therapy is used to correct mechanical dysfunctions of the wrist and hand:

• Joint Mobilization: Relieves restricted movement in the wrist and fingers.
• Fascial Manipulation: Increases circulation by releasing tension in the fascial chains.
• Muscle Relaxation Techniques: Relaxing the forearm and hand muscles can relieve pain.

Supportive Approaches with Regulation Medicine

• Anti-Inflammatory Nutrition:
• Omega-3 fatty acids, magnesium, zinc, and antioxidants reduce inflammation.
• Gut Health:
• Prebiotic and probiotic supports help bring systemic inflammation under control.
• Lymphatic and Venous Drainage:
• Important for supporting circulation in the hand and wrist.

Exercise and Rehabilitation

• Physical Exercise: Strengthening the wrist and hand muscles and increasing flexibility.
• Postural Training: Instilling correct posture habits during computer and mobile phone use.

Psychological Support and Stress Management

• Stress Management: Meditation and mindfulness techniques to reduce the load on the autonomic nervous system.

Holistic Treatment Protocol

Patient Evaluation:

• Clinical examination, segmental analysis, and evaluation of autonomic nervous system dysfunctions are performed.

Treatment Plan:

• Neural Therapy: Treatment of disturbance fields and segmental regulation.
• Manual Medicine: Joint mobilization, fascial manipulation, and muscle relaxation techniques.

Regulation Medicine: Dietary adjustments and inflammation control. Long-Term Support:

• Exercise, postural training, and stress management programs.

Conclusion

Hand and wrist pain is associated not only with local mechanical problems, but also with internal organ dysfunctions, viscerosomatic reflexes, and autonomic nervous system dysfunctions. Neural therapy, manual medicine, and regulation medicine provide effective treatment by targeting the causes of these complex pains.

Given the critical importance of the hands in human life, early diagnosis and effective treatment of problems in this area both prevent functional loss and improve individuals' quality of life.

Dr. Hüseyin Nazlikul, M.D., PhD.
President of IFMANT, BNR, MTAR
Specialist in General Medicine - Medical Biophysics
President of IFMANT (International Federation of Medical Associations of Neural Therapy)
President of the Turkish Neural Therapy Society
President of the Turkish Manual Medicine - Pain Regulation Association
Hakkı Yeten Cad. Vital Fulya Plaza No:23 Kat:3 D:10 Fulya 34394 Şişli – Istanbul
Tel: 0 (212) 219 19 12 or 219 09 00 Fax: 0 (212) 219 18 38