Health & Fitness Bulletins

February 18, 2025

Elbow, Wrist, and Hand Pain: Rest or Stay Active?

Chronic pain conditions of the elbow, wrist, and hand are common. This includes tennis elbow, thumb osteoarthritis, and tenosynovitis (inflammation of the tendon sheath). Treatment guidelines recommend rest, so the “injury” can heal, but the scientific evidence may not support that advice.

Decades ago, it was common to tell people with back pain to rest so it can heal. We now know that advice made the problems worse. Could the same be true for chronic pain conditions of the arm, wrist, and hand? A study recently published in the British Medical Journal says “yes.”

Gareth Jones and colleagues performed a randomized, controlled, multi-site trial involving 538 patients. All patients received physical therapy. Some patients were advised to stay active within tolerable limits. Others were advised to rest and protect the painful area and to not aggravate it. Patients advised to stay active proved 40% more likely to achieve full recovery at 26 weeks.

Patients in the stay-active group received advice to stay active to recover quickly. Patients were told that distal arm pain is common, lasting damage is rare, and that recovery can be expected with physical therapy. They were advised that early return to work with gradually increasing activity was helpful.