Precision care for pain, instability, and conditions affecting the wrist, hand, fingers, and surrounding joints. Interventional Orthopedics of Washington provides non-surgical, regenerative medicine treatments focused on restoring function, improving stability, and addressing the source of pain.
The wrist and hand contain many small joints, bones, ligaments, tendons, tendon sheaths, nerves, and cartilage surfaces that work together for grip, pinch, dexterity, and load-bearing. Pain may follow an acute injury, repetitive loading, arthritis, tendon or pulley dysfunction, ligament instability, nerve compression, or changes after a fracture or surgery. Because several structures can produce similar symptoms, treatment should begin with an accurate diagnosis rather than a one-size-fits-all approach.
Falls, twisting injuries, sports, or repetitive loading can injure the scapholunate, lunotriquetral, thumb collateral, finger collateral, or TFCC stabilizers. Symptoms may include clicking, weakness, pain with gripping or weight-bearing, and a sense that the wrist or joint is unreliable.
Flexor and extensor tendons may become irritated, overloaded, partially torn, or restricted within a tendon sheath or pulley. De Quervain tenosynovitis and trigger finger are examples that can cause pain, swelling, catching, or reduced motion.
Osteoarthritis, inflammatory arthritis, post-traumatic changes, cartilage injury, fracture-related problems, and bone stress can lead to aching, stiffness, swelling, reduced grip strength, and pain during daily tasks.
Median, ulnar, or radial nerve compression may cause numbness, tingling, burning, pain, clumsiness, or weakness. Repetitive gripping, prolonged wrist positions, vibration, and high-load activity can aggravate symptoms but are not the only possible causes.
At Interventional Orthopedics of Washington, care begins by identifying the specific joint, ligament, tendon, tendon sheath, pulley, cartilage surface, bone, cyst, or nerve most likely contributing to the symptoms. Recommendations are then matched to the diagnosis, examination, imaging findings, functional goals, previous care, and overall health of the patient.
We evaluate a wide range of wrist, hand, thumb, and finger problems and provide non-surgical treatment when it is clinically appropriate. Some conditions are best managed with hand therapy, splinting, activity modification, medication, observation, or surgical referral rather than an injection-based procedure.
Similar symptoms can arise from different structures. Numbness may come from nerve compression at the wrist, forearm, elbow, or neck, while wrist pain may originate from a ligament, tendon, joint, cartilage surface, fracture, cyst, or the TFCC. Recommendations are made only after the history, examination, imaging, previous care, and treatment goals are reviewed.
Precise care requires a detailed understanding of the small joints and closely connected soft tissues responsible for motion, grip, pinch, sensation, and fine motor control.
Ultrasound can evaluate many superficial tendons, tendon sheaths, ligaments, cysts, nerves, and soft tissues in real time. Radiographs are commonly the initial imaging study for chronic wrist or hand pain. MRI, CT, electrodiagnostic testing, or other studies may be recommended when the suspected problem requires additional information.
Treatment starts with understanding the full pattern of wrist or hand symptoms and identifying the structure or combination of structures most likely responsible.
No single test answers every question. The diagnosis is based on how the symptom pattern, examination, function, imaging, and any electrodiagnostic findings fit together.
The treatment plan depends on the diagnosis, severity, tissue involved, nerve function, previous care, occupational and activity demands, overall health, and strength of the available evidence. Care may include one or more of the following:
Many wrist and hand conditions are initially treated non-surgically, but surgery may be the safer or more effective option when delaying treatment could cause permanent loss of motion, tendon function, sensation, strength, alignment, or joint stability.
When surgical evaluation is appropriate, we can explain the findings and coordinate referral to a qualified hand and upper-extremity surgeon.
Patients choose IOW for physician-led, diagnosis-first care that considers the specific tissue involved, the complete upper-extremity examination, the patient's goals, and the most appropriate path back to function.
The goal is not to inject every painful structure. It is to identify the most likely pain generator and recommend the least invasive reasonable option for that diagnosis.
A physician-led process that combines a detailed diagnostic evaluation with an individualized treatment plan based on the condition, anatomy, imaging, activity demands, and overall health of the patient.
Identifies the structure or combination of structures most likely contributing to your symptoms
Matches treatment to the diagnosis rather than simply treating the location of pain
Precise diagnosis. Individualized treatment.
Not every wrist or hand condition requires an injection. When a procedure is recommended, ultrasound or fluoroscopy is selected according to the treatment target and clinical need. Benefits, risks, alternatives, recovery expectations, and limitations are reviewed before treatment, and outcomes vary by condition and patient.
An evaluation may be helpful when wrist or hand pain continues despite a reasonable trial of rehabilitation, activity modification, splinting or bracing, ergonomic changes, medication, or other appropriate first-line care.
This includes people with unresolved pain, weakness, stiffness, clicking, loss of grip strength, or instability after a fall, sprain, overuse injury, or other wrist or hand trauma.
A detailed assessment may help when symptoms suggest arthritis, tendon injury, tendinopathy, ligament damage, cartilage or joint problems, carpal tunnel syndrome, trigger finger, or other peripheral nerve irritation.
Patients considering surgery may benefit from reviewing the diagnosis, imaging, rehabilitation options, and reasonable non-surgical treatments before deciding on the next step. Some conditions still require prompt surgical care.
The best candidates understand that recovery often requires progressive strengthening, mobility work, activity modification, bracing or splinting when appropriate, and follow-up care. A procedure, when appropriate, is usually one part of a broader treatment plan.
The evaluation determines candidacy: not every wrist or hand condition is appropriate for an injection or regenerative procedure. Acute fractures, complete tendon ruptures, infection, progressive neurologic deficit, vascular compromise, severe deformity, advanced joint destruction, and other urgent or clearly surgical problems may require different care or specialist referral.
Schedule an evaluation to review your symptoms, examination findings, hand use demands, previous treatment, and imaging. In-person care is recommended when a hands-on examination or diagnostic ultrasound is needed. Telemedicine may be available for an initial records and imaging review.
Many wrist and hand conditions are treated non-surgically first, while certain structural problems require surgical care. The right sequence depends on the diagnosis, severity, function, imaging findings, and response to appropriate prior treatment.
Your visit begins with a diagnosis-focused evaluation rather than assuming that every wrist or hand problem should receive the same treatment.
Recommendations are explained in plain language, including expected benefits, limitations, alternatives, risks, recovery considerations, and when a procedure is not appropriate.
Treatment planning considers rehabilitation, mobility, grip and pinch demands, splinting or bracing, activity goals, and follow-up instead of relying on a procedure alone.
These cards describe the care process and are not patient testimonials or promises of treatment outcome. Verified wrist and hand reviews can be added here later without changing the section layout.
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Read ArticleClear answers about wrist and hand pain, how we identify the true source, and the regenerative treatment options available at IOW.
Wrist and hand pain often results from overuse, repetitive motions, nerve compression, or injuries to tendons, joints, or ligaments. Even activities like typing, gripping, or lifting can strain delicate structures and lead to chronic pain or stiffness.
Common causes include carpal tunnel syndrome, osteoarthritis, trigger finger, ligament sprains, or nerve entrapments. Pain may also arise from previous injuries or post-surgical complications that haven’t fully healed.
We use a combination of physical exams, musculoskeletal ultrasound, and diagnostic injections to pinpoint the exact tissue or nerve involved. This ensures your treatment targets the true root, not just the symptoms.
Yes. Most patients benefit from non-surgical regenerative therapies like PRP, prolotherapy, and nerve hydrodissection. These treatments stimulate your body’s healing process and can restore function without the risks or downtime of surgery.
Depending on your diagnosis, we may recommend PRP injections, bone marrow concentrate (BMC), prolotherapy, or hydrodissection for nerve release. We also treat ganglion cysts and joint pain using image-guided precision injections.
Yes. Ultrasound-guided nerve hydrodissection can relieve median nerve compression in carpal tunnel syndrome without surgery. It’s a powerful alternative with less risk, no scarring, and no recovery downtime.
We often help patients manage post-surgical pain, scar tissue, and residual nerve or tendon issues. Regenerative care can support healing, reduce inflammation, and improve long-term outcomes even after prior procedures.
You might be a candidate. Schedule your free discovery call and let’s explore your options.
Medically reviewed by Dr. Otoño Silva, M.D.
Board Certified in Physical Medicine & Rehabilitation · Fellowship-Trained in Interventional Orthopedics, Centeno-Schultz Clinic
Last reviewed