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Although wrist pain is clearly an overly general description and carpal tunnel syndrome (CTS) is a specific diagnosis, we discuss these together because of the various interrelated factors involved in them. Wrist pain almost invariably extends beyond the wrist, especially into the hand, and even when it does not, its cause can derive from factors extrinsic to the wrist itself. The pain can also manifest in different parts of the wrist, offering some clues as to the cause. CTS occurs when the median nerve is entrapped in the small passageway on the palmar side of the wrist joint through which several tendons and the medial nerve pass. Inflammation of the tendons places pressure on the nerve, causing pain or discomfort in the wrist, outer fingers (thumb, index finger, and middle finger), and sometimes up the forearm. Wrist and hand pain can also manifest in the fourth and fifth fingers due to pressure on the ulnar nerve.
Healing depends on the condition and its cause. Persistent wrist tenderness or strain usually benefits from ice, splints worn during sleep (due to the ways we tend to flex the wrist and otherwise place pressure on it during natural movement while sleeping), and anti-inflammatory agents (including turmeric and ginger). Repetitive stress injuries invite one to reduce or stop the repetitive actions and to assess the dynamics of posture and movement that are involved. In practicing yoga, there are several ways to play with slight modification of position and energetic action to variably affect pressure in the wrists, while props minimize the pressure from wrist extension. Acute injuries often require medical attention, and many chronic conditions also indicate receiving medical attention.
Basic Wrist Therapy
Students and clients experiencing mild wrist pain can benefit from warming up their fingers, hands, arms, and shoulders before beginning their practice. Wrist and forearm massage are also effective in helping reduce pain. So long as the pain is mild, the following exercises can be healing.
Tadasana Wrist Therapy
Gently rotate the wrists through their full range of circular motion, repeatedly changing direction, then gently shake out the wrists for around 30 seconds. This can be incorporated in brief form into every Sun Salutation.
Uttanasana Wrist Pratikriyasana
Whenever folding into Uttanasana amid Sun Salutations, place the backs of the wrists toward or onto the floor and make an easy fist. This is less intense on the wrists than Pada Hastasana (also, more students can do it and it can be easily done with the exhale into Uttanasana).
Holding the fingers of one hand with the fingers of the other hand, move the wrist forward and back while resisting the movement with the opposing hand. Repeat for 1–2 minutes if pain-free.
Anjali Mudra (aka Reverse Phalen’s Test)
Press the palms and fingers (from the knuckles to the fingertips) firmly together at the chest in a prayer position for 1–2 minutes. This is Anjali Mudra, but also known as reverse Phalen’s test; if there is a burning sensation inside the wrist joint within 30 seconds, this could indicate CTS.
Reverse the position of the hands, placing the backs of the wrists and hands together, and press firmly for up to a minute (Phalen’s test).
See also Hands-Free Flow for Wrist Pain
Kneeling comfortably, place the hands down on the floor with the fingers pointed forward, then turn the palms up, then down with the fingers out, up with the fingers in, down with the fingers back, up with the fingers back, continuing in this fashion with every permutation of palms up and down with the fingers forward, back, in, and out.
Persistent wrist tenderness or strain usually benefits from ice, splints worn during sleep, anti-inflammatory agents (including turmeric and ginger), acupuncture, and other alternative treatments. Encourage students and clients to explore all possible measures and to consult a doctor for additional guidance.
Excerpted from Yoga Therapy: Foundations, Methods, and Practices for Common Ailments by Mark Stephens, published by North Atlantic Books, copyright © 2017 by Mark Stephens. Reprinted by permission of publisher.