Wrist and Hand Pain Treatment, Weybridge

You can rest a sore knee. You cannot rest a hand.

That is what makes wrist and hand problems wearing out of proportion to their size — every jar, door handle, keyboard, steering wheel and shopping bag goes through the painful bit, and there is no obvious way to avoid it.

Pain here can come from the joints, the tendons, the ligaments or the nerves. Where the pain sits, and what sets it off, usually points to which. Symptoms on the thumb side of the wrist mean something different from symptoms on the little-finger side, and numbness or tingling suggests a nerve rather than a joint.

A clinical assessment establishes which, and whether physiotherapy, a scan, an injection or further investigation is the right next step.

Pain on the thumb side of the wrist

De Quervain’s tenosynovitis

De Quervain’s tenosynovitis is a common cause of pain on the thumb side of the wrist.

Two tendons that move the thumb pass through a small tunnel at the wrist. Irritation and thickening around those tendons makes thumb and wrist movement painful — typically gripping, lifting, twisting, or anything repetitive involving the thumb.

Treatment may include activity modification, a thumb or wrist support and rehabilitation. Where symptoms persist, an ultrasound-guided steroid injection into the tendon sheath may be considered.

Thumb base osteoarthritis

Osteoarthritis at the base of the thumb is the other common cause of pain in this area, particularly with age. It is felt where the thumb meets the wrist, and provoked by pinching, gripping, opening jars, turning keys or using scissors.

Treatment may include activity modification, hand therapy, strengthening, a supportive splint and, where symptoms remain significant, a guided steroid injection into the joint.

Pain around the wrist tendons

A number of tendons cross the front and the back of the wrist.

These can become painful or develop tenosynovitis, where the lining around the tendon becomes irritated or inflamed. Symptoms include localised pain, swelling, and sometimes a clicking or creaking sensation as the tendon moves.

Treatment depends on which tendon is involved, and may include modifying what aggravates it, splinting and rehabilitation. In selected cases an ultrasound-guided steroid injection into the tendon sheath is considered.

Pain on the little-finger side of the wrist

Pain on the ulnar side of the wrist has several possible causes, including the extensor carpi ulnaris (ECU) tendon, the joints on that side of the wrist, and the triangular fibrocartilage complex (TFCC).

It is typically aggravated by gripping, twisting the forearm, or loading through the hand.

Some of these structures can be assessed with ultrasound. Suspected deeper ligament or TFCC injuries usually need an X-ray or MRI instead.

Carpal tunnel syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through a narrow tunnel at the wrist.

It does not usually present as wrist pain. The typical picture is pins and needles, numbness or burning in the thumb, index and middle fingers and part of the ring finger — often worst at night, and people frequently wake needing to shake the hand out. More advanced compression causes weakness or difficulty with fine movements.

Treatment depends on how severe the compression is, and may include a night splint, activity modification, a guided steroid injection, or referral for surgical decompression.

Persistent numbness, weakness or any wasting of the muscle at the base of the thumb needs proper medical assessment rather than watchful waiting.

Ganglion cysts

A ganglion is a fluid-filled swelling that commonly appears around the wrist or hand.

Many are harmless and need nothing done. Some become uncomfortable or get in the way of wrist movement.

Ultrasound confirms that a lump is cystic rather than solid, and shows its relationship to the structures around it — which matters, because ganglions often sit close to tendons, vessels and nerves.

Treatment depends on symptoms: observation, ultrasound-guided aspiration in selected cases, or referral for a surgical opinion.

Do I need an ultrasound scan?

Not everybody with wrist or hand pain needs a scan. Many of these conditions are identified from the history and examination alone.

Diagnostic ultrasound is particularly useful for:

tendons and tendon sheaths
De Quervain’s tenosynovitis
other forms of tenosynovitis
ganglion cysts and other superficial lumps
inflammation around joints
the median nerve in suspected carpal tunnel syndrome
certain ligament and soft-tissue injuries

It also allows a dynamic examination — tendons and other structures assessed while the wrist and fingers move, which in a hand is often where the problem reveals itself.

Ultrasound cannot assess everything. X-rays suit suspected arthritis or bone injury; MRI is needed for deeper ligament, cartilage or bone problems.

How is wrist and hand pain treated?

Physiotherapy and hand rehabilitation

For most wrist and hand conditions, conservative treatment is the starting point.

That may mean temporarily modifying what aggravates it, appropriate splinting or support, restoring movement, and progressively strengthening the wrist, hand and forearm.

What the programme looks like depends on the structure involved and on your work, hobbies and sport. Physiotherapy here is as much about finding another way to do the painful task as it is about exercises.

Steroid injections

A steroid injection, sometimes called a cortisone injection, is useful for selected conditions — De Quervain’s tenosynovitis, some other tendon sheath problems, symptomatic thumb base osteoarthritis, and carpal tunnel syndrome.

Accuracy matters more in the hand than almost anywhere, because the targets are small and the structures around them are not. At Meyer Physio these are performed under ultrasound guidance, so the tendon, joint or nerve is visualised and the needle guided into the intended target.

An injection is not right for every wrist or hand condition, and where it is used it forms part of a wider plan rather than the whole of one.

What does it cost?

Every appointment lasts a full hour. Where a diagnostic scan is needed, that appointment is charged at the scan rate, which replaces the standard consultation fee rather than being added to it. Current prices are on our prices page.

Wrist and hand pain assessment in Weybridge

Pain at the thumb base, pain along a tendon, and numbness from carpal tunnel syndrome can all occur within an area a few centimetres across, and all need entirely different treatment. Getting that distinction right is most of the job.

Meyer Physio assesses and treats wrist and hand problems at its clinic on Baker Street in Weybridge, Surrey, combining clinical examination, diagnostic ultrasound, ultrasound-guided injection and rehabilitation in one place. The clinician who examines your hand is the one who scans it, performs any procedure and manages the rehabilitation afterwards.

Where ultrasound is not the right investigation, we will say so and recommend an X-ray, MRI, nerve conduction study or a specialist hand opinion instead.

You can come to us directly — no GP referral is needed to book, and there is no waiting list.

Written by Suegnet Meyer, Advanced Practice Musculoskeletal Physiotherapist and MSK Sonographer. HCPC registered [PH55635]. Chartered Society of Physiotherapy member [66175]. Last reviewed: 29 October 2026.

Wrist and Hand Pain