Wrist Drop – Causes, Symptoms, Diagnosis & Treatment
Wrist drop, also known as radial nerve palsy, is a condition where a person cannot extend their wrist and fingers due to weakness or paralysis of the extensor muscles. It significantly affects daily activities such as gripping objects, writing, and lifting. Understanding the causes, symptoms, and treatment options is essential for effective recovery
What is Wrist Drop?
Wrist drop is a neurological condition caused by dysfunction of the radial nerve, which controls the extension of the wrist and fingers. When this nerve is damaged, it leads to an inability to lift the hand, causing a characteristic drooping appearance
Causes of Wrist Drop
There are several potential causes of wrist drop, including:
Radial Nerve Injury:
- Direct trauma to the radial nerve
- Fractures of the humerus bone
- Compression due to prolonged pressure (e.g., sleeping with the arm in an awkward position)
Neurological Disorders:
- Peripheral neuropathy due to diabetes or other conditions
- Stroke or brain injury affecting nerve function
Poisoning & Toxins:
- Lead poisoning
- Alcohol-related nerve damage
Medical Procedures:
- Improper use of crutches
- Surgical complications involving the arm or shoulder
Symptoms of Wrist Drop
- Inability to extend the wrist and fingers
- Weak grip strength
- Numbness or tingling along the back of the hand
- Difficulty performing fine motor tasks
- Drooping appearance of the hand when attempting to lift it
Diagnosis of Wrist Drop
Medical History & Physical Examination
- Assessing muscle strength and nerve function
- Checking for recent trauma or medical conditions
Electromyography (EMG) & Nerve Conduction Studies
- Identifying nerve damage and the extent of impairment
Imaging Tests (X-ray, MRI, CT Scan)
- Detecting fractures or nerve compression
Physiotherapy Treatment for Wrist Drop
Physiotherapy plays a crucial role in restoring wrist function. Effective treatment options include:
1. Strengthening Exercises
- Wrist Extension with Resistance Band: Strengthens the extensor muscles
- Finger Lifts: Improves finger mobility and grip strength
- Ball Squeezing Exercise: Enhances hand coordination
2. Stretching Exercises
- Radial Nerve Gliding: Helps improve nerve mobility
- Wrist Flexor Stretch: Prevents stiffness in the wrist and hand
3. Splinting & Bracing
Wearing a wrist splint to support hand function and prevent contractures
4. Electrical Stimulation
Helps activate weak muscles and improve nerve function
5. Manual Therapy & Massage
Improves circulation and reduces muscle tightness
Other Treatment Options
- Medications: NSAIDs for pain relief
- Surgical Intervention: In severe cases, nerve grafting or tendon transfer may be needed
Recovery & Prognosis
Recovery from wrist drop depends on the severity of nerve damage. Mild cases recover within a few weeks to months with physiotherapy, while severe cases may require surgical intervention. Early treatment improves the chances of full recovery.
Exercises for Wrist drop
1. Wrist extension stretch: Hold the affected arm straight out in front of you with the palm
down. Use your other hand to gently pull your hand back and up, stretching your wrist. Hold
for 15-30 seconds and repeat 3-5 times.
2. Wrist extension strengthening: Hold a light weight (less than 1 pound) in the affected
hand with the palm down. Slowly lift your wrist up, keeping your forearm still, and then
lower it back down. Repeat 10-15 times and 3-5 sets.
3. Finger extension stretch: Place your affected hand flat on a table or other flat surface
with your fingers extended. Use your other hand to gently pull your fingers back and up,
stretching your fingers. Hold for 15-30 seconds and repeat 3-5 times.
4. Finger extension strengthening: Place a small weight (less than 1 pound) on the back of
your affected hand. Slowly lift each finger one at a time, keeping the others still, and then
lower it back down. Repeat 10-15 times and 3-5 sets.