Dorsal Wrist Pain?

Incorporating Emerging Evidence into Clinical Practice for Patients Experiencing Dorsal Wrist Pain During Weight-Bearing Activities

By: Brittany Day

Supporting Evidence

A randomized control study recently published in the Journal of Hand Therapy found rigid carpal stabilizing taping (CST) to significantly increase passive range of motion, active range of motion, and decrease pain in patients experiencing dorsal wrist pain during weight-bearing extension compared to placebo with elastic tape (Kim et al., 2019). 


Wrist extension takes place at the radiocarpal and midcarpal joint (2 degrees of radiocarpal motion to every 1 degree of midcarpal motion) and occurs as the proximal carpal row rolls dorsally while gliding volarly on the radius which may lead to gapping within the proximal carpal row during end-range movements (Foumani et al., 2009). When weight-bearing in extension, the scaphoid supinates while the lunate pronates effectively spreading the carpal bones further apart limiting extension potential (Kobayashi et al., 1997). The idea behind CST is to restrict the midcarpal joint, scaphoid supination, and lunate pronation to increase wrist extension potential with reduction in pain (Kim et al., 2019).

Who is Right for Carpal Stabilizing Taping?

CST may used for patients with dorsal wrist pain caused by various diagnoses such as:

  • Distal Radius Physical Stress Injuries
  • Scaphoid Impaction Syndrome
  • Dorsal Impingement Syndrome
  • Wrist Hypomobility without Ligament Instability

CST may not be appropriate for:

  • Allergies to adhesives
  • Tenosynovitis
  • Dorsal Wrist Ganglion Cyst
  • Scapholunate Injury or Instability
  • Carpal Tunnel Syndrome

Dorsal impaction hand therapyHow to Apply Tape

  1. Use rigid athletic tape that is 1-2 cm in width.
  2. Use a marker to indicate four bony landmarks on the wrist: Dorsal ridge of scaphoid, listers tubercle, triquetrum, pisiform
  3. Connect the indicated marks with tape circumferentially while patient’s hand is resting at 45 degrees of flexion.
dorsal wrist pain

Carpal Stabilizing Taping Intervention Ideas (dorsal wrist impingement exercises)

The following is a list of interventions that may be completed with CST and are a progression from mild to moderate difficulty. Clinical reasoning must be used when progressing patient. 

Ball Rolling – Place hand firmly on ball. Roll forward into flexion and back into extension without lifting hand. Complete exercise for 3 minutes.

Tray Balancing – Balance a tray or plate in palm. Hold without dropping for 3 minutes.

dorsal wrist pain

Wrist Extension with PowerWeb – Hold PowerWeb in lap or on a table. Press wrist into extension. Hold 10 seconds and repeat 10 times.

dorsal wrist pain

Wall Slides with Towel – Begin with towel in hand resting on wall. Shoulder should be flexed over 90 degrees. Slowly lower arm to increase demand on wrist extension. Sustain stretch for ten seconds just before the point of pain is reached. Repeat 10 times.

dorsal wrist pain

Wall Push-Ups– Place hands on wall with shoulders at 90 degrees and elbows extended. Complete 3 sets of 10 push-ups on the wall. 


Foumani, M., Strackee, S.D., Jonges, R., Blankevoort, L., Zwinderman, A.H., Carelsen, B., & Streekstra, G.J. (2009). In-vivo three-dimensional carpal bone kinematics during flexion–extension and radio–ulnar deviation of the wrist: Dynamic motion versus step-wise static wrist positions. Journal of Biomechanics, 42(16), 2664-2671.

Kim, G., Weon, J., Kim, M., Koh, E., & Jung, D. (2019). Effect of weight-bearing wrist movement with carpal-stabilizing taping on pain and range of motion in subjects with dorsal wrist pain: A randomized controlled trial. Journal of Hand Therapy, 33(1), 25-33.

Kobayashi, M., Berger, R., Nagy, L., Linscheid, R., Uchiyama, S., Ritt, M., & An, K. (1997). Normal kinematics of carpal bones: A three-dimensional analysis of carpal bone motion relative to the radius. Journal of Biomechanics, 30(8), 787-793.


  1. Kylie on August 17, 2020 at 9:57 pm

    Is there a video on finding the bony prominences and application? How much pull (if any) is there to secure it?

  2. Aaron Kubistek, CHT on August 19, 2020 at 10:10 am

    It works
    I have taped my wrists for years while lifting…Subsequently i have no hair on my wrists..
    It limits, to some degree, the combined motion of supination and flexion helping to avoid a TFCC issue while bearing weight

Leave a Comment

More To Read

5+ Common Mallet Finger Splints

September 1, 2019

Finger orthoses can be tough, and the mallet finger orthosis is no exception. The protocol for 15 degrees of DIP extension with mallet fingers is tricky to manage while making a splint. Small splints on little fingers are also tricky to get sized just right and with strapping in the right places. Ask any experienced…

Read More

Outcomes of Dorsal Bridging Plates

April 25, 2021

Outcomes of Dorsal Bridging Plates  Fares, A. B., Childs, B. R., Polmear, M. M., Clark, D. M., Nesti, L. J., & Dunn, J. C. (2021). Dorsal Bridge Plate for Distal Radius Fractures: A Systematic Review. The Journal of Hand Surgery. The Skinny Distal radius fractures (DRF) are a common injury that we see in…

Read More

Mechanism of Interneural Edema in Carpal and Cubital Tunnel

May 17, 2020

Mechanism of Interneural Edema Over the last few weeks I have been learning about ultrasonic imaging and carpal tunnel syndrome.  When reviewing carpal tunnel syndrome, I learned that intraneural edema is a common sign of compression injuries such as carpal tunnel and cubital tunnel.  There are numerous causes of carpal tunnel syndrome, and every scenario…

Read More

Sign-up to Get Updates Straight to Your Inbox!

Sign up with us and we will send you regular blog posts on everything hand therapy, notices every time we upload new videos and tutorials, along with handout, protocols, and other useful information.