Dr. Emily Warren, DPT treats wrist and hand conditions one-on-one at Mindful Movement Physical Therapies in Holladay and Salt Lake City. No referral needed in Utah.

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Quick Answer

Wrist and hand pain has many different causes — carpal tunnel syndrome, De Quervain’s tenosynovitis, TFCC tears, trigger finger, thumb arthritis, and others — and each responds to different treatment. Physical therapy accurately diagnoses the source of your pain and provides targeted treatment: nerve gliding, tendon loading, joint mobilization, splinting guidance, and activity modification. Most wrist and hand conditions respond well to conservative care before surgery is considered. Dr. Emily Warren treats wrist and hand conditions at Mindful Movement Physical Therapies in Salt Lake City.

Common Wrist & Hand Conditions Treated at MMPT

Carpal Tunnel Syndrome (CTS)

Carpal tunnel syndrome is the most common peripheral nerve entrapment in the body, affecting approximately 3–6% of the general population. It occurs when the median nerve is compressed as it passes through the carpal tunnel — a narrow passageway on the palm side of the wrist formed by the carpal bones and the transverse carpal ligament.

Symptoms: Numbness, tingling, and burning in the thumb, index, middle, and part of the ring finger — especially at night and with sustained gripping. Severe cases involve weakness of the thenar muscles (the thumb pad) and dropping objects.

PT treatment: Nerve gliding exercises (median nerve neurodynamic mobilizations), wrist splinting in neutral position (especially at night), ergonomic modifications, soft tissue work to the carpal tunnel and forearm flexors, and cervical assessment (C6 nerve root pathology can mimic CTS). Research shows PT is as effective as surgery for mild-moderate CTS at 1-year follow-up.

De Quervain’s Tenosynovitis

De Quervain’s is inflammation of the tendons on the thumb side of the wrist — the abductor pollicis longus and extensor pollicis brevis — as they pass through their tendon sheath at the radial styloid. It’s especially common in new mothers (from repetitive lifting of infants with the wrist in ulnar deviation) and among people who text extensively.

Symptoms: Pain and tenderness on the thumb side of the wrist, often radiating into the thumb or forearm. The Finkelstein test (folding the thumb into the palm and bending the wrist toward the little finger) reproduces the pain strongly.

PT treatment: Activity modification to reduce ulnar deviation under load, thumb spica splinting to rest the tendons, progressive loading program for the wrist extensor tendons, and soft tissue work. Most cases resolve within 4–8 weeks of consistent treatment. Cortisone injection is effective if PT doesn’t resolve the condition.

TFCC (Triangular Fibrocartilage Complex) Injuries

The TFCC is a complex of cartilage and ligaments on the ulnar (little finger) side of the wrist that stabilizes the distal radioulnar joint and cushions load. TFCC injuries are common in tennis players, gymnasts, rock climbers, and anyone who falls on an outstretched hand or performs repetitive forearm rotation under load.

Symptoms: Pain on the ulnar side of the wrist (opposite side from the thumb), often worse with forearm rotation (turning a key or doorknob), gripping, and weight-bearing through the wrist. May have a clunking or clicking sensation.

PT treatment: TFCC injuries are classified as traumatic (acute tears) or degenerative. Traumatic peripheral tears have good healing potential with appropriate immobilization and progressive rehabilitation. Central tears and degenerative lesions are less likely to heal but respond well to functional rehabilitation — restoring strength and proprioception to minimize symptoms. Dr. Warren will coordinate with your orthopedic surgeon if imaging has confirmed a significant structural tear.

Trigger Finger (Stenosing Tenosynovitis)

Trigger finger occurs when the tendon sheath around a flexor tendon becomes thickened and inflamed, causing the finger to catch, lock, or “trigger” when bending. It’s most common in the ring finger and thumb, and is associated with repetitive gripping, diabetes, and rheumatoid arthritis.

PT treatment: Tendon gliding exercises, activity modification, splinting to rest the A1 pulley, and soft tissue massage. In early cases, PT can resolve trigger finger before cortisone or surgery becomes necessary.

Thumb CMC (Basal Joint) Arthritis

Arthritis at the carpometacarpal joint at the base of the thumb is among the most common hand arthritis presentations — especially in women over 40. It causes pain with pinching, gripping, and opening jars, and may cause visible deformity of the thumb base.

PT treatment: Thumb stabilization splinting (reduces joint stress during activity), strengthening of the intrinsic thumb muscles, joint protection education, adaptive equipment guidance, and pain management. Many patients with CMC arthritis remain fully functional for years with conservative management.

Wrist Sprains and Instability

Wrist sprains range from minor ligament strains to significant disruptions of the scapholunate or lunotriquetral ligaments. Unaddressed wrist instability can progress to degenerative arthritis. PT restores strength, proprioception, and movement patterns to support the healing ligament and prevent recurrence.

Why the Cervical Spine Matters for Hand and Wrist Symptoms

One of the most common diagnostic errors in wrist and hand pain is failing to assess the neck. The C6 nerve root exits the cervical spine and supplies sensation to the thumb and index finger — the same distribution as carpal tunnel syndrome. The C7 root supplies the middle finger. Cervical radiculopathy from a disc herniation or foraminal stenosis can produce hand numbness, tingling, and weakness that is indistinguishable from peripheral nerve entrapment on symptom report alone.

Dr. Warren performs a thorough cervical and upper extremity neurological assessment at MMPT to determine whether your wrist/hand symptoms have a neck component. Many patients with “treatment-resistant” carpal tunnel syndrome actually have a cervical driver that hasn’t been addressed.

What to Expect at Mindful Movement Physical Therapies

Your initial evaluation covers a detailed history of symptom onset and behavior, cervical and thoracic spine screening, upper extremity neurological examination (sensation, reflexes, strength), specific orthopedic tests for the suspected diagnosis (Phalen’s, Tinel’s, Finkelstein, Watson’s scaphoid shift, etc.), grip and pinch strength measurement, and functional assessment of your work and activity demands.

Treatment is individualized and may include:

Nerve gliding exercises for nerve entrapment conditions
Progressive tendon loading programs for tendinopathies
Joint mobilizations for restricted wrist or finger joints
Custom splinting recommendations and instruction
Ergonomic assessment and activity modification
Cervical treatment when indicated
Dry needling for trigger points contributing to symptoms

Common Questions

Do I need an MRI before starting PT?

Usually not. Most common wrist and hand conditions are diagnosed clinically — through history, physical examination, and orthopedic tests. Imaging is valuable when a TFCC tear, scaphoid fracture, or other structural pathology is suspected, or when symptoms don’t respond to conservative care as expected. Dr. Warren will recommend imaging if it’s clinically indicated.

I’ve been told I need carpal tunnel surgery. Should I try PT first?

For mild to moderate carpal tunnel syndrome, PT (nerve gliding, splinting, ergonomics) is as effective as surgery at 1-year follow-up in randomized trials. Surgery is clearly more effective for severe CTS with significant thenar muscle weakness or denervation. For most patients without severe weakness, a 6–8 week trial of PT before committing to surgery is evidence-based and reasonable.

My wrist has been hurting for 6 months. Is it too late for PT?

No. Chronic wrist and hand conditions often respond well to PT even after months of symptoms. The assessment will determine whether there’s a reversible mechanical driver, and treatment is designed accordingly.

Wrist & Hand Pain Treatment in Salt Lake City

If wrist or hand pain is limiting your work, hobbies, or daily activities — targeted physical therapy is the most effective first step before considering injections or surgery.

Dr. Emily Warren treats wrist and hand conditions one-on-one at Mindful Movement Physical Therapies in Holladay and Salt Lake City. No referral needed in Utah.