Activity Related Hand and Wrist Pain

It is normal for some people to have hand & wrist pain during or after certain types repetitive or strenuous activities.

STRENUOUS ACTIVITIES may cause discomfort because very strenuous activities result in microscopic muscle and tendon damage.  The body’s response is inflammation – pain and swelling.

Symptoms from strenuous activities are often made more tolerable by heat and stretching before activity, icing down the sore area after activity, and a short course (1-2 weeks) of over the counter anti-inflammatory medications.

Without adequate prior conditioning, prolonged periods of unusually strenuous activity may trigger a variety of inflammatory musculoskeletal conditions that generally self-resolve within 2-3 weeks.

REPETITIVE ACTIVITIES such as typing, texting, or assembly work use may also cause activity related discomfort.  The symptoms can become recurrent and can be flared up by the repetitive activity.

Symptoms from repetitive light activities are usually due to muscle fatigue due to steady muscle contraction without full relaxation.

Long term repetitive activities may be related to chronic muscle, tendon, and nerve changes in the hand that manifest as certain specific conditions.

There is no scientific evidence that short term repetitive activities cause any permanent damage or lingering problems with the hands, despite popular opinions to the contrary.

Hands are designed to perform continuous activities. Muscles may ache from fatigue of continuous use, depending on the activity, muscle conditioning, and individual factors. Individual factors appear to be the primary contributing factor in symptoms attributed to repetitive activities. The most common individual factors to precipitate symptoms are the effects of age, certain medical conditions, problems with the body’s normal chemistry or hormone levels, and stress in the workplace.


There are normal degenerative changes to the health, structure, function, and activity related tolerances of muscles, tendons, and joints.  These changes are collectively called tendinopathies (ligaments and tendons) and enthesopathies (joints).  Tendinopathies and Enthesopathies are a part of the natural aging process.  Genetic factors and personal history factors likely affect age related presentation of symptoms.


Specific medical conditions are known to be associated with causing hand conditions that can aggravate activity related hand discomfort.  Controlling the medical condition can help reduce symptoms.  Examples of such medical conditions include:

  • Diabetes
  • Thyroid Disease
  • Gout
  • Pregnancy and Post-partum periods
  • Cancer Treatments
  • Inflammatory Arthritis
  • Irritable Bowel Diseases
  • Cardiac Disease
  • Kidney Disease


It has been shown that for some people, the body’s natural reaction to prolonged mental stress affects their normal automatic pattern of muscle action and relaxation. Stress results in poor muscle relaxation – both in muscles performing obvious actions and in those maintaining the body’s posture. Routine activities in a stressful environment may be associated with muscle tension or muscle fatigue symptoms. Because stress is difficult to either measure or treat, the current focus of management is on the physical aspects of the workplace according to ergonomic recommendations.  Additionally, seeking avenues to reduce life stressors has shown to have a positive impact on reducing musculoskeletal pain.

ERGONOMICS refers to the way posture and body position affects comfort during and after work.

Typical ergonomic recommendations include:

  • being well supported in your chair at workstation
  • allowing relaxation while maintaining a neutral posture
  • frequent brief breaks to avoid repetitive overuse
  • performing stretching exercises

Specific physical aspects of the individual workstation are taken into consideration when making specific recommendations. These recommendations are generally made by an occupational therapist.

Because the field of ergonomics is an emerging science, many ergonomic guidelines are based on theory.  There is little documentation of their effectiveness in symptom reduction with regards to work related repetitive activities.

Ergonomics, therapy, nor surgery will solve problems relating to job dissatisfaction, stress, secondary gain, or other individual factors.