Evidence-based care at Vantage Point
Wrist and Hand Physiotherapy in Bondi Junction
Assessment and treatment for wrist and hand pain, from wrist injuries and thumb pain to finger injuries and pins and needles, with a clear explanation of what is going on and a plan built around strength, grip and the tasks that matter to you.
- APA Musculoskeletal Physiotherapists
- Grip strength testing with VALD dynamometry
- Rehabilitation after hand and wrist surgery
Symptom profiles
Which best describes your symptoms?
Wrist and hand pain presents in distinct ways, and where you feel it and how it started point to different structures and a different starting point for treatment. Select the one closest to yours.
Wrist Pain and Wrist Injuries
Pain in the wrist after a fall onto an outstretched hand, or pain that builds with weight-bearing through the hands, lifting or twisting.
You might notice
- Pain on the thumb side of the wrist after a fall
- Pain on the little finger side of the wrist when twisting, gripping or doing push-ups
- Clicking, weakness or pain when taking weight through your hand
What is usually happening
Wrist pain after a fall needs careful assessment, as some fractures, particularly of the scaphoid, may not show on the first X-ray. Most wrist sprains and many fractures recover well with the right period of protection followed by graded strengthening. In a trial of 439 adults with a scaphoid waist fracture, function at 12 months was similar with surgery or a cast (Dias et al., 2020).
Common causes
Scaphoid fracture
A break in a small wrist bone near the thumb, which can be missed on early X-rays.
Distal radius fracture
A break at the end of the forearm bone, the most common wrist fracture.
TFCC injury
A strain or tear of the cartilage and ligaments on the little finger side of the wrist.
Wrist ligament sprain
A sprain of the ligaments between the wrist bones, often after a fall.
What we look at in your assessment
How the injury happened, where the wrist is tender, wrist range and stability tests, and grip strength with VALD dynamometry. If a fracture or ligament tear is suspected, we arrange imaging through your GP or a sports physician and a specialist opinion when needed.
How treatment usually starts
Protection with a brace or cast when needed, then restoring movement, graded loading, and grip and forearm strengthening, with a return to weight-bearing through the hands based on milestones.
Related services
Thumb Pain
Pain at the base of the thumb or along the thumb side of the wrist, often worse with gripping, pinching, lifting a baby or using your phone.
You might notice
- Pain on the thumb side of the wrist when lifting or gripping
- Aching at the base of the thumb when pinching, writing or opening jars
- Swelling or a bump at the base of the thumb
What is usually happening
Thumb pain usually comes from the tendons on the thumb side of the wrist, as in De Quervain's tenosynovitis, which is common in new parents, or from wear in the joint at the base of the thumb. Both often settle with changes to how you load the thumb, a brace or splint, and strengthening. Across trials, exercise for hand osteoarthritis gave small improvements in pain, function and stiffness (Østerås et al., 2017).
Common causes
De Quervain's tenosynovitis
Irritation of the two tendons on the thumb side of the wrist, often with lifting and gripping.
Thumb base arthritis
Wear in the joint where the thumb meets the wrist, common after 50.
Thumb ligament sprain
A sprain of the ligament on the inside of the thumb, also called skier's thumb, often from a fall or ball sport.
What we look at in your assessment
Where the pain sits, tendon and joint tests, thumb and grip strength with VALD dynamometry, and the tasks that aggravate it, from lifting a baby to work and sport.
How treatment usually starts
Changes to how you grip and lift, a brace, or a custom splint through a hand therapist, then progressive thumb and hand strengthening. If pain persists, we work with your GP on options such as an injection.
Related services
Finger and Hand Pain
Pain, stiffness or catching in the fingers, from an injury in sport, a finger that locks or clicks, or aching, stiff hands.
You might notice
- A finger that catches, clicks or locks when you bend it
- A swollen, stiff finger joint after a ball or fall injury
- Stiff, aching finger joints, especially in the morning
What is usually happening
Finger injuries in sport are common and often treated as minor, but some tendon and ligament injuries need early splinting to heal well. Trigger finger comes from a thickened tendon catching in its sheath. Aching, stiff hands are often due to osteoarthritis, where a hand exercise program can ease pain and stiffness.
Common causes
Trigger finger
A finger tendon catching in its sheath, causing clicking or locking.
Finger sprain or dislocation
A ligament injury to a finger joint, common in ball sports.
Mallet finger
An injury to the tendon that straightens the fingertip, needing a splint for several weeks.
Hand osteoarthritis
Wear in the finger joints, causing aching, stiffness and swelling.
What we look at in your assessment
Finger and hand range, joint stability, tendon function, and grip strength with VALD dynamometry. If a fracture, tendon or ligament injury is suspected, we arrange imaging and a specialist opinion when needed.
How treatment usually starts
Early protection with buddy taping, or a custom splint through a hand therapist, then restoring movement and strength. For stiff, aching hands, a hand exercise program and advice on protecting your joints.
Related services
Pins and Needles and Numbness in the Hand
Tingling, numbness or burning in the hand and fingers, often worse at night or when holding a phone or steering wheel, sometimes with a weaker grip.
You might notice
- Tingling in the thumb, index and middle fingers, often waking you at night
- Dropping things or a weaker grip
- Symptoms that ease when you shake out your hand
What is usually happening
Carpal tunnel syndrome, from pressure on the median nerve at the wrist, is the most common cause, but similar symptoms can come from the neck or elbow. In a trial of 120 women with carpal tunnel syndrome, manual therapy gave similar results to surgery at 1 and 4 years. Surgery remains the right choice for some people, particularly with constant numbness or muscle weakness (Fernández-de-las-Peñas et al., 2020).
Common causes
Carpal tunnel syndrome
Pressure on the median nerve at the wrist, affecting the thumb, index and middle fingers.
Cubital tunnel syndrome
Irritation of the ulnar nerve at the elbow, affecting the ring and little fingers.
Nerve irritation from the neck
A nerve root in the neck causing symptoms down the arm and into the hand.
What we look at in your assessment
Where your symptoms are and what brings them on, nerve tests at the neck, elbow and wrist, and grip and pinch strength with VALD dynamometry. If nerve studies are needed, we organise them with your GP and work with a neurologist or hand surgeon.
How treatment usually starts
Night splinting, nerve and tendon gliding exercises, hands-on treatment and changes to aggravating tasks. If symptoms are severe or not improving, we arrange a surgical opinion.
Related services
Wrist and Hand Pain in Sport
Wrist and hand pain that builds with training, common in gymnastics, climbing, CrossFit, racquet sports and lifting.
You might notice
- Pain on the back of the wrist with push-ups, handstands or front squats
- Pain on the little finger side of the wrist with twisting or racquet sports
- Finger pain with hard gripping, such as in climbing
What is usually happening
Repeated weight-bearing and gripping can load the wrist and finger tissues faster than they can adapt, especially after a jump in training. Most settle with load management, technique changes and progressive strengthening, without needing to stop completely.
Common causes
Wrist impingement
Pain on the back of the wrist when it is bent back under load.
TFCC irritation
Pain on the little finger side of the wrist with twisting and gripping.
Finger pulley injury
A strain of the bands that hold the finger tendons in place, common in climbers.
Tendon pain
Irritation of the wrist and forearm tendons from repetitive gripping.
What we look at in your assessment
Your training load and technique, wrist and finger tests, and grip and forearm strength with VALD dynamometry to compare sides.
How treatment usually starts
Modified training and technique, taping or a brace where it helps, progressive wrist, grip and forearm strengthening, and a graded return to full training.
Related services
Recovery After Hand or Wrist Surgery
Rehabilitation after hand and wrist surgery, from fracture fixation to carpal tunnel release and tendon or ligament repair, following your surgeon's protocol.
You might notice
- Stiffness and swelling after your operation
- A weak grip and difficulty with everyday tasks
- Wanting to get back to work, the gym or sport
What is usually happening
After hand and wrist surgery, swelling, stiffness and a weaker grip are common. A staged plan within your surgeon's limits restores movement first, then strength, and we measure your grip strength to guide your return to work and sport.
Common surgeries
Wrist fracture fixation
A plate or screws to hold a broken wrist, such as a distal radius or scaphoid fracture.
Carpal tunnel release
Releasing the ligament over the median nerve at the wrist.
Tendon repair
Repair of a cut or ruptured finger or thumb tendon, usually with a custom splint from a hand therapist.
Ligament repair
Repair or reconstruction of a wrist or thumb ligament.
What we look at in your assessment
Your surgeon's protocol, swelling, scar and range of movement, and grip strength with VALD dynamometry once it is safe to test.
How treatment usually starts
Settling swelling and restoring movement first, then graded strengthening and a return to work, the gym and sport. We work with your surgeon and hand therapist, who provides any custom splints.
Related services
Pain on the outside or inside of the elbow? See elbow physiotherapy.
The research
What the Research Tells Us
For wrist fractures and carpal tunnel syndrome, research has compared surgery with nonsurgical care.
The results show why we often start with a structured plan, and why surgery is the right choice for some people. When it is, we work with your surgeon and hand therapist before and after the operation.
Scaphoid waist fracture: surgery or a cast
Wrist function at 12 months
Similar in both groups.
Potentially serious complications
Went on to have surgery
11% of people in the cast group later had surgery, for example when the bone was slow to heal.
439 adults with a scaphoid waist fracture. Complications after surgery included infection, nerve problems and complex regional pain syndrome (Dias et al., 2020).
Carpal tunnel syndrome
Manual therapy and surgery gave similar results
In 120 women with carpal tunnel syndrome, manual therapy and surgery gave similar pain and function at 1 and 4 years (Fernández-de-las-Peñas et al., 2020).
Carpal tunnel syndrome
Surgery helped more than a night splint alone
In 176 people, 90% improved with surgery and 75% with a night splint at 18 months, and 41% of the splint group went on to have surgery (Gerritsen et al., 2002).
Hand osteoarthritis
Exercise gave small benefits
Across trials, hand exercise gave small improvements in pain, function and finger stiffness straight after a program, which were not sustained at longer follow-up (Østerås et al., 2017).
Most wrist and hand problems recover with the right protection at the right time, followed by graded strength work. That is why we measure your grip strength and build your plan around the tasks that matter to you.
Your treatment
Five Steps, Each With a Clear Goal
Every consultation is 45 minutes. Your plan is built around what matters to you, whether that is picking up your child, a full day at the keyboard or getting back to the gym.
- 1
Assess
A detailed history and examination of your wrist, hand, elbow and neck, including grip strength testing with VALD dynamometry.
Goal: A clear diagnosis
- 2
Explain
What is causing your pain, what to expect, and which activities are safe to keep doing.
Goal: Confidence to keep using your hand
- 3
Settle
Hands-on treatment, dry needling where it helps, taping or a brace, and changes to how you grip and load your hand to calm pain.
Goal: Pain under control
- 4
Strengthen
Progressive wrist, grip and forearm strength, with VALD dynamometry to compare sides and track change.
Goal: Strength targets met
- 5
Stay well
A return to work, the gym or sport based on milestones, and a plan to keep your wrists and hands strong.
Goal: Back to what matters to you
Fees and funding
Consultations and Rebates
Every consultation is 45 minutes. The number of consultations you need depends on your wrist or hand and your goals, so we discuss your plan with you at your first visit.
Book an AppointmentWays to claim
- Private health: rebates claimed on the spot with HICAPS
- Medicare: rebates with a GP referral
- Workers compensation: fees set by SIRA, with approvals coordinated with your case manager
- CTP: fees set by SIRA
Common Questions
Do I need an X-ray after a wrist injury?
Often, yes. After a fall onto an outstretched hand, pain on the thumb side of the wrist needs assessment for a scaphoid fracture, which may not show on the first X-ray. We arrange imaging through your GP or a sports physician, and a repeat scan or specialist review when needed.
Do I need a splint?
Sometimes. Some injuries, such as a mallet finger or certain fractures, need a splint for a set time, and night splints often help carpal tunnel symptoms. We can advise on an off-the-shelf brace, and refer you to a hand therapist for a personalised splint.
Do I need surgery for carpal tunnel syndrome?
Not always. In a trial of 120 women, manual therapy gave similar results to surgery at 1 and 4 years (Fernández-de-las-Peñas et al., 2020). In another trial, surgery helped more than a night splint alone, and 41% of people in the splint group went on to have surgery (Gerritsen et al., 2002). We help you weigh up the options, and arrange a surgical opinion when it is the right step.
Should I see a physiotherapist or a hand therapist?
Both have a role. We assess and treat wrist and hand pain and injuries, and rehabilitate you after surgery. For personalised splints, and some early care after tendon repair, we work with a hand therapist.
When should I see a doctor urgently?
Seek urgent medical care if your wrist or finger looks deformed, if you cannot bend or straighten a finger after a cut, if your hand is cold, pale or numb after an injury, or if a hand wound is red, hot and swollen.
How many sessions will I need?
It depends on your wrist or hand, how long you have had symptoms and your goals. We give you an estimate at your first visit and review it as you meet each step's goal.
Can I claim my physio through private health?
Yes. Rebates are claimed on the spot with HICAPS. Medicare rebates are available with a GP referral, and workers compensation and CTP claims are accepted once approved.
What research is this page based on?
The studies referenced on this page are listed below.
- Dias JJ, Brealey SD, Fairhurst C, Amirfeyz R, Bhowal B, Blewitt N, et al. Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial. Lancet. 2020;396(10248):390–401.
- Fernández-de-las-Peñas C, Arias-Buría JL, Cleland JA, Pareja JA, Plaza-Manzano G, Ortega-Santiago R. Manual therapy versus surgery for carpal tunnel syndrome: 4-year follow-up from a randomized controlled trial. Phys Ther. 2020;100(11):1987–1996.
- Gerritsen AAM, de Vet HCW, Scholten RJPM, Bertelsmann FW, de Krom MCTFM, Bouter LM. Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA. 2002;288(10):1245–1251.
- Østerås N, Kjeken I, Smedslund G, Moe RH, Slatkowsky-Christensen B, Uhlig T, Hagen KB. Exercise for hand osteoarthritis. Cochrane Database Syst Rev. 2017;(1):CD010388.
- Clinically reviewed by David Cohen and Zachary Ehrenfeld, APA Musculoskeletal Physiotherapists and Directors of Vantage Point Physiotherapy. Last reviewed October 2026.
