Wrist Drop - Potential Causes and Physiotherapy Treatment

Wrist drop, medically known as radial nerve palsy, is a condition where a person is unable to lift or extend their wrist and fingers. This happens when the radial nerve—a major nerve responsible for wrist and finger extension—becomes compressed, irritated, or injured. Because this nerve plays a crucial role in hand and arm movement, wrist drop can interfere with daily activities such as holding objects, writing, or lifting the hand.

This article explains the causes, symptoms, treatment options, and physiotherapy exercises that support recovery from wrist drop.

What Causes Wrist Drop?

Wrist drop can result from several factors, ranging from mild nerve compression to severe trauma.

1. Radial Nerve Injury

Injuries like upper-arm fractures, shoulder dislocations, or direct blows can damage the radial nerve. This is one of the most common causes of wrist drop.

2. Prolonged Pressure on the Nerve

Long periods of leaning on the arm—such as resting the arm over a chair or using poorly fitted crutches—can compress the nerve and affect its function.

3. Radial Tunnel Syndrome

When the radial nerve becomes compressed in a narrow space within the forearm (the radial tunnel), it may trigger pain, weakness, and eventually wrist drop.

4. Saturday Night Palsy

Falling asleep with the arm draped awkwardly over a hard surface can compress the radial nerve. This temporary compression often leads to wrist weakness upon waking.

5. Inflammatory or Medical Conditions

Inflammation due to rheumatoid arthritis, infections, or systemic diseases may also affect the radial nerve, resulting in limited wrist movement.

Symptoms of Wrist Drop

People with wrist drop may experience:

• Inability to lift or extend the wrist

• Drooping of the hand

• Weak or impaired grip strength

• Numbness or tingling on the back of the hand

• Difficulty performing daily tasks like holding a cup or typing

Symptoms vary depending on the severity and location of the nerve involvement.

Physiotherapy Treatment for Wrist Drop

Physiotherapy is the cornerstone of wrist drop rehabilitation. Treatment focuses on restoring movement, reducing pain, and retraining the affected muscles.

1. Range of Motion Exercises

These gentle movements prevent joint stiffness and maintain the flexibility of the wrist, fingers, and forearm.

2. Strengthening Exercises

Targeted strengthening helps rebuild muscles that extend the wrist and fingers. A physiotherapist gradually increases intensity based on progress.

3. Therapeutic Modalities

Depending on symptoms, the therapist may use:

• Heat therapy

• Ice application

• Ultrasound

• Electrical stimulation (TENS or NMES)

These techniques help reduce pain, stimulate muscles, and promote healing.

4. Neuromuscular Re-Education

Special exercises and sensory training help the brain re-establish communication with weakened muscles. Techniques may include mirror therapy and tactile stimulation.

5. Functional Training

Therapists guide patients through activities such as gripping, writing, picking up objects, and other daily tasks to improve real-life hand function.

6. Bracing or Splinting

A customised wrist splint supports the hand in a neutral position, prevents contractures, and allows healing while maintaining proper alignment.

7. Patient Education

Learning proper ergonomics, safe arm positioning, and avoiding pressure on the radial nerve is crucial for preventing recurrence.

Expected Recovery Timeline

Recovery depends on the severity of nerve involvement:

• Mild compression: 3–6 weeks

• Moderate nerve irritation: 2–3 months

• Severe nerve damage: 6 months or longer

• Post-surgical cases: Varies depending on the nerve repair procedure

Consistent physiotherapy and adherence to a home exercise program significantly improve outcomes.

Helpful Exercises for Wrist Drop

(Performed under the supervision of a physiotherapist)

1. Passive Wrist Extension Stretch

Use the opposite hand to gently lift the affected wrist upward until a mild stretch is felt.

2. Finger Flexion and Extension

Slowly open and close the fingers to improve mobility and circulation.

3. Wrist Flexion and Extension with Light Weight

Hold a light object and move the wrist up and down to activate wrist muscles.

4. Grip Strengthening

Squeeze a soft ball to improve hand strength and endurance.

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Conclusion

Wrist drop is a challenging condition that affects both hand function and daily activities. However, with timely diagnosis, proper physiotherapy, and consistent exercise, most individuals experience significant improvement. A well-designed treatment plan—centred on mobility, strengthening, nerve stimulation, and functional training—can restore wrist movement and enhance overall quality of life.

If you experience symptoms of wrist drop, consulting a physiotherapist or healthcare provider is essential for accurate assessment and recovery.

People Also Ask

What is the main cause of wrist drop?

Radial nerve injury or compression is the primary cause. Trauma, prolonged pressure, or nerve inflammation are common triggers.

What does wrist drop weakness look like?

The wrist hangs downward, and lifting the hand or fingers becomes difficult due to weakness in the extensor muscles.

Is wrist drop permanent?

Most cases recover with physiotherapy, but severe nerve damage may require longer treatment or surgical intervention.

“This content is for informational purposes only and not a substitute for medical advice.”