Manual therapy for work-related wrist pain in a manual physical therapist

Introduction: The wrist is a common site for work-related musculoskeletal disorders (WMSD) among physical therapists (PTs), often due to manual therapy. There are limited data on management of wrist injury in PTs. The purpose of this case is to describe the management of a PT with wrist pain. Case Description: The patient was a 28-year-old female with a 6-month history of right ulnar-sided wrist pain, aggravated by performing thoracic/lumbar posterior to anterior (PA) glides. The patient reported 7/10 on the Numeric Pain Rating Scale and 6.5/10 on the Patient-Specific Functional Scale (PSFS). Symptoms were reproduced at the lunotriquetral joint. Outcomes: The patient was seen for two visits. Following anterior to posterior non-thrust mobilization at the triquetrum on lunate, the patient improved inability to perform thoracic/lumbar PA glides. The patient was educated on manual therapy modifications, isometrics, and self-mobilization. At 2-month follow-up, the patient reported 0/10 pain, scored 10/10 on the PSFS, and +7 on the Global Rating of Change. Discussion: This case demonstrates the successful use of education, manual therapy, and exercise in the management of a PT with a wrist-related WMSD. Future research should focus on the prevention/treatment of wrist-related WMSDs in PTs who perform manual therapy.