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Main causes of wrist pain
Carpal tunnel syndrome
Median nerve compression in the carpal canal. Nighttime numbness of fingers 1–3, a "dropping" hand, weak grip. The most common cause. Confirmed by EMG and ultrasound of the nerve.
De Quervain's tenosynovitis
Inflammation of the first extensor compartment — tendons at the base of the thumb. Pain on thumb abduction, positive Finkelstein test. Common in young mothers and after unusual loading.
Rhizarthrosis
Arthrosis of the first carpometacarpal joint of the thumb. Pain with grip, opening jars, pinch. "Shifting" joint deformity. Affects up to 20% of women over 50.
Ganglion (hygroma)
A cystic formation on the dorsal or palmar surface of the wrist. Often painless but may compress a nerve or limit motion. Treated by ultrasound-guided aspiration or injection.
Trigger finger
Stenosing tenosynovitis of the finger flexors. Click on flexion, sometimes finger locking in flexion. Treated by injection into the A1 pulley under ultrasound guidance.
Post-traumatic conditions
Sequelae of scaphoid fractures, TFCC tears, instability of the distal radioulnar joint. Combination of regenerative treatment with orthopedic care.
Carpal tunnel syndrome
How to recognize it
Nighttime numbness of the thumb, index and middle fingers. Patient wakes up and shakes the hand. Daytime numbness when holding a phone, steering wheel, book. Weak grip, dropping objects.
Diagnosis
Positive Tinel's and Phalen's tests. EMG (nerve conduction study) — gold standard, determines compression severity. Ultrasound of the nerve — cross-sectional area and hypervascularization.
Regenerative treatment
Median nerve hydrodissection: precise PRP/CGF injection into the canal around the nerve under ultrasound guidance. Cells and growth factors mainly reduce inflammation and may support tissue healing; how much the tissue recovers cannot be predicted in advance. 2–3 sessions. Surgical release is only needed for severe thenar atrophy.
Rhizarthrosis and de Quervain's
Rhizarthrosis — cartilage regeneration
CGF or MFAT injections into the first carpometacarpal joint under ultrasound navigation. 2–3 sessions. An alternative to trapeziectomy and endoprosthesis.
De Quervain's — tendon restoration
CGF into the first extensor compartment under ultrasound guidance. Cells and growth factors mainly reduce inflammation and may support tissue healing; how much the tissue recovers cannot be predicted in advance. 2 sessions 3–4 weeks apart.
Trigger finger
Targeted injection into the A1 pulley zone. Results vary from patient to patient: they depend on the stage and type of damage, and a doctor assesses the outlook after reviewing the MRI. Especially effective in fresh forms.
How it is treated: the cause comes first
Treatment depends on the cause of the pain, so it starts with an examination and, if needed, imaging — X-ray, ultrasound or MRI. The same pain can be caused by osteoarthritis or by a tendon, nerve or disc problem.
Most patients are helped by conservative treatment: exercise therapy, load management, short courses of painkillers and sometimes injections. Regenerative methods (PRP, cell preparations) are discussed once the diagnosis is known and there is at least limited evidence for it; no method guarantees a result.
We send a description of your case and your images to several partner clinics. The clinic doctors give a preliminary opinion, suggest a plan and quote a price, and we help you compare the options.
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- A complete tendon or ligament rupture with loss of function — surgical repair is usually needed.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Catapano M et al. Effectiveness of Platelet-Rich Plasma Injections for Nonsurgical Management of Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil, 2020.
- Sheth U et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am, 2012.
Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised
Frequently asked questions
Numbness of the thumb, index and middle fingers at night is a classic sign of carpal tunnel syndrome. A night splint and a corticosteroid injection help; with marked nerve compression on nerve conduction studies or muscle weakness, a small operation releases the ligament.
This is inflammation of the tendons at the base of the thumb, which hurts when gripping and moving the thumb outwards. A splint for 3–6 weeks and reduced load help; a corticosteroid injection works in most patients, and a small operation is done if it fails.
No. In mild and moderate cases a night splint and a corticosteroid injection are often enough. Surgery is recommended for constant numbness, muscle weakness and wasting, or marked nerve compression on nerve conduction studies.
Thumb base arthritis cannot be cured, but in early stages a splint, exercise, painkillers and injections help many people for years. With severe pain and deformity, surgery is discussed — removal of the trapezium bone or joint replacement.
If pain lasts more than 2 weeks, fingers go numb at night, grip weakens or the wrist swells after an injury. After a fall on the hand with pain in the “anatomical snuffbox”, an X-ray is needed so as not to miss a scaphoid fracture.