Assessment of Injection Site Injury Resolution
Based on your description of improved wrist tenderness when flat and restored middle finger function, the injury appears to be resolving but requires continued functional rehabilitation to address residual wrist weakness. 1
Current Clinical Status
Your symptoms suggest incomplete recovery with persistent proximal weakness despite distal improvement—a pattern that requires specific management:
- Injection site pain resolution: Local injection site reactions typically resolve within days to weeks, with most symptoms (redness, swelling, tenderness) improving significantly by 2-4 weeks 2, 3
- Improved distal function: The fact that your middle finger "no longer falls" indicates recovery of finger flexor/extensor function 1
- Persistent wrist weakness: The pattern of distal recovery with ongoing proximal weakness suggests either learned non-use from prolonged disuse during the injury period, or incomplete nerve recovery 1
Primary Management Strategy: Task-Oriented Functional Therapy
You should immediately begin functional activities that promote normal wrist movement patterns rather than protecting or splinting the wrist. 1
Specific Functional Activities to Implement Daily
- Weight-bearing through the wrist: Place your affected hand flat on kitchen counters or tables while standing during meal preparation, using the wrist to stabilize objects 1
- Bilateral functional tasks: Engage both hands in activities requiring wrist stability, such as personal care tasks or kitchen work where both wrists must support and stabilize 1
- Progressive loading: Gradually increase the time and weight that your wrist bears during these functional movements 1
Exercise Protocol Components
- Stretching: Perform wrist flexor and extensor stretches multiple times daily 1
- Active strengthening: Progress from gross movements (large wrist circles, flexion/extension) to fine motor control (gripping, manipulating small objects) 1
- Avoid splinting: Do not use wrist braces or splints, as these prevent restoration of normal movement and worsen outcomes 1
Critical Pitfalls to Avoid
- Do not "nurse" the affected limb: Avoid cradling or excessively protecting your wrist—this perpetuates weakness 1
- Do not rely on passive rest: While you can use pillows or furniture for comfortable resting positions, emphasize active use during all functional activities 1
- Do not delay functional use: The longer you avoid using the wrist normally, the more deconditioning occurs 1
When to Seek Further Evaluation
If wrist weakness persists despite 4-6 weeks of appropriate functional therapy, consider:
- Electrodiagnostic studies: To reassess nerve function and identify incomplete nerve recovery or residual compression 1
- Advanced imaging: Ultrasound or MRI to identify structural causes such as tendon pathology or persistent nerve compression 1
- Specialist referral: Neurology or hand surgery consultation if structural pathology is suspected 1
Expected Timeline
- Reassessment interval: Monitor wrist strength, range of motion, and functional use every 2-4 weeks 1
- Supervised therapy: Initial supervised physical or occupational therapy is recommended, as benefits diminish without ongoing supervision 1
- Anxiety management: Use distraction techniques and relaxation strategies during tasks, as anxiety can impair motor performance 1