Hand and Wrist Pain Diagnosis Guide Hand and wrist injuries are common following a fall onto an outstretched hand or in individuals involved in ball and contact sports or upper limb weight bearing sports (such as gymnastics). Patients suffering from hand and wrist pain are often seen in physiotherapy practice. Pain may be caused by local structures within or around the wrist or hand or occasionally, may be referred from other sources (such as the neck, upper back, shoulder or elbow). One common clinical presentation is the patient suffering from sudden onset wrist pain typically as a result of a fall onto an outstretched hand, the cause of which is often torn ligaments or connective tissue around the wrist, such as a Sprained Wrist (figure 1) or occasionally a fracture such as a Radius Fracture (figure 1) or Scaphoid Fracture (figure 2). In patients who experience finger trauma in ball or contact sports, a Sprained Finger or Thumb is often the result (figure 3). Gradual onset hand and wrist pain often develops as a result of overuse particularly in gripping activities such as racquet sports or manual work such as carpentry. One of the more common overuse wrist injuries is Wrist Tendonitis which involves gradual degeneration and inflammation of one or more wrist tendons. In those patients with associated neck, upper back, shoulder, elbow or forearm pain, Referred Pain (frequently from the neck, upper back, shoulder or elbow) is often the cause of symptoms. In older patients with gradual onset