Q&A: Wrist and Chronic Back Pain

Don’t Wrist It

Question: I saw a GP recently because of pain in my right wrist. He diagnosed it as De Quervain’s tenosynovitis and prescribed a topical anti-inflammatory cream. However, the pain still persists. When can I expect my wrist to recover? Is the pain due to the nature of my job, which involves lots of computer work? I am a 36-year-old woman.

Answer: De Quervain’s tenosynovitis (also known as de Quervain’s disease or de Quervain’s syndrome) is the inflammation of the two tendons that move the thumb. This painful condition can be caused by a number of factors including:

• Medical problems, such as rheumatoid arthritis, or a wrist injury where scar tissue can restrict the movement of the wrist
• Set-up of your workstation (i.e. how your wrist is positioned when using the keyboard or mouse
• Activities that require repetitive movement of the hand and wrist, such as tennis, golfing, computer gaming, or typing for long periods

Recovery time varies among individuals, but typically, treatment involves wearing a brace for about four to six weeks to keep the thumb and wrist in a neutral position. This reduces swelling and limits hand movement.

You should also modify those daily activities that caused your condition, to minimise aggravating it, and to prevent its recurrence.

Get a referral from your doctor to see an Occupational Therapist who can assist you in managing the discomfort.

Ms Teo Sing Hwee
Principal Occupational Therapist
Occupational Therapy
Tan Tock Seng Hospital

 

Aching To Fly

Question: I’m 44 years old and have chronic back pain. To attend an upcoming family function, I would soon need to take a non-stop 16-hour flight to Los Angeles, US. I am concerned that being seated for so long will result in unbearable pain. What can I do to help myself?

Answer: We recommend that you undergo a proper evaluation at the Spine Clinic to determine the cause of your chronic back pain. Treatment options will depend on the cause, and may include physiotherapy, medication, injection, and surgery.

If there is no need for surgical intervention but the pain still persists, or if you are not keen on surgery, you may be referred to the Pain Clinic. Doctors will assess your suitability for interventions, such as injections or the use of radiofrequency to eliminate the nerves that are causing pain. Once your pain control has improved, you should be able to tolerate the long distance flight better. However, this may not necessarily be achieved within a one-month window. Meanwhile, it would be better if you can break up such a long flight into two legs to better manage the pain.

If you can’t, here is what you can do on board the long-haul flight:
 

• Leave your seat and take intermittent walks up and down the aisle to break up the long period of sitting.
• Take some analgesia before you board, to help with the stiffness and make your journey more comfortable.
• Request a seat at the first row (which usually has more leg room) so you can move around and stretch. Otherwise, request an aisle seat so you can get in and out of the seat easily.

Dr Bin Wern Hsien
Senior Consultant
Khoo Teck Puat Hospital

Dr Aravind Kumar
Consultant
Orthopaedic Surgery
Khoo Teck Puat Hospital

Ms Ng Lih Yen
Senior Principal Physiotherapist
Physiotherapy
Khoo Teck Puat Hospital
 

Read these next:

• Chronic Back Pain
• Q&A: Calf Cramps and Lower Back Aches
• In Good Hands