North Texas Musculoskeletal Medicine

Enhancing the body's innate ability to heal

Regenerative Orthopedics Osteopathic Manipulation


The wrist is made up of eight small bones called carpals. The carpal bones are arranged in 2 interrelated rows. One row connects with the ends of the bones in the forearm-radius and ulna. The other row of carpal bones connects with the bones of the palm of the hand. The synovial joints between the carpal bones and the wrist are covered with articular cartilage that facilitates movement.

These bones are held together by ligaments, which are tough bands of fibrous tissue. Six major ligaments give stability to the wrist by joining the radius to the carpal bones and binding the 2 rows of carpal bones together. These ligaments join with others to link the wrist to the hand.

The muscles in the forearm and palm, called thenar muscles, help keep the wrist and hand moving, stable, and aligned. They are joined to the bones by tendons, which are white, flexible fibrous cords. When the muscles contract, they pull on the tendons to move the bone. The tendons that run down our fingers are held in place by a series of ligaments called pulleys that cross over the tendons forming a tunnel-like sheath. In healthy joints, these tendons glide easily through the tunnel.


  • Osteopathic Manipulative Medicine focuses on improving joint restriction and misalignment. It improves blood flow to nourish tissue and reduce inflammation, reducing joint pain. It also helps to reduce strain on surrounding body tissue that causes further pain and structural dysfunction.
  • Platelet Rich Plasma Therapy (PRP), promotes and accelerates the natural healing process of soft tissue injuries and osteoarthritis by stimulating the release of adult stem cells that already exist in tissue. A concentrated solution of the patient's blood platelets containing healing cells called alpha-granules and plasma is injected into damaged tissue resulting in new cell growth and increased blood flow.
  • Dextrose Prolotherapy accelerates the healing process through the injection of a solution that includes dextrose. The dextrose acts as an irritant, deliberately causing inflammation. The controlled, localized inflammation triggers a healing cascade, resulting in the deposition of new collagen, the natural material of ligaments and tendons, onto the damaged tissue.

Common hand and wrist conditions include.

Carpal tunnel syndrome: Repetitive motion can damage the transverse carpal ligaments supporting the tunnel containing the tendons and nerves. It is generally characterized by numbness or pain in the thumb and first 2 fingers and occurs when the median nerve is compressed at the wrist. Carpal tunnel syndrome is often a common complaint in individuals who use their hands for prolonged periods of time in a particular occupation such as computer work.

Sprains and strains: Sprains and strains are the 2 most common types of injuries affecting the hand and wrist. A sprain refers to an injury to a ligament and a strain refers to a muscle injury. Sprains and strains occur due to excessive force applied during a stretching, twisting, or thrusting action.

Ligamentous injuries: Ligaments are tissues that connect bones to other bones. They are made up of several fibers and one or all of the fibers may be involved. A ligament injury may cause pain and swelling and limit the movement of hand and wrist joints.

Other common hand and wrist conditions include:

  • Muscle tear
  • Tendinitis
  • De Quervain's Tenosynovitis
  • Trigger finger
  • Jammed finger
  • Arthritis

For more information on treatments for hand and wrist conditions please visit Our Services page.