Assessment
A detailed history, then a thorough examination of movement, strength and the affected area. You leave with a working diagnosis you understand and a plan agreed with you, not handed to you.
What We Treat
Hand & Wrist Pain Treatment in London
Carpal tunnel, RSI, wrist sprains, post-surgical hands: hand and wrist pain usually means a small structure is being loaded faster than it can take. We combine specialist hand therapy with graded loading to settle the symptoms and rebuild the capacity your work and sport demand of it.
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- Self-referral; no GP letter needed.
Our hand and wrist team
Overview
Understanding hand & wrist pain
Hand and wrist pain, in desk-based and active people alike, usually comes down to load applied faster than the tissue can take it. Get the diagnosis right and the rehabilitation works; guess at it and it stalls.
The common problems each behave differently:
- Carpal tunnel syndrome: compression of the median nerve at the wrist. NHS guidance recommends conservative measures first, such as night wrist splints and activity modification, with steroid injection or a surgical opinion considered when symptoms persist or worsen.
- RSI and wrist sprains: overload from sustained typing and gripping, or a strain after a fall on an outstretched hand, both of which respond to graded, structured rehabilitation.
- Post-operative hands: recovery after hand or wrist surgery or a fracture, where stiffness and reduced strength need a staged plan.
At Kaizen our hand-therapy assessment identifies the specific tissue and the overload behind it, then builds a loading plan around how you actually type, train and lift. We refer for nerve studies, imaging or a hand-surgery opinion when that is the right next step. Self-referral; no GP referral needed.
Excellent
From 6 five-star Google reviews
Source: Google
David helped me when I started to have a strong tibia pain only 5 weeks before the marathon. I genuinely thought at some point that I wasn’t going to be able to do it and I did my PB!
After suffering with terrible back pain, Gus has helped me make huge improvements. Very professional and happy to explain the processes and treatments. Many thanks
Couldn’t recommend this physio team enough! They helped me recover from a knee injury 3 weeks before the London Marathon which I thought was going to prevent me from running it! Everyone was really friendly, supportive and genuinely cared about helping me reach my goal. Special thanks to Charlie, Gus, Brad and Stef!
I came to Dave with an ongoing injury that I’ve been struggling with for months! He helped sort it out straight away, also giving me some exercises to help target the area to get back to full strength. I’m now back to running pain-free already and training properly — I’ll definitely be recommending Kaizen Physiotherapy to my clients!
Gus worked miracles to get me running a marathon after being injured 6 weeks out. He worked out the issue really quickly and provided a clear and actionable plan to deal with it. The sports massages were the best I’ve ever had too — thanks Peggy! Can’t recommend Gus and Peggy enough.
I had such a positive experience working with Brad at Kaizen. He supported me through a meniscus tear and got me all the way back to running a half marathon and HYROX training. Everything was structured, progressive, and easy to follow, and I always felt like I was in safe hands.
Hand therapy for hand and wrist pain can help to:
Pin down the exact diagnosis
Tendon, nerve, joint and ligament problems in the hand and wrist behave differently and need different plans. Our specialist assessment identifies the tissue and the load behind it, and we refer for nerve studies or a hand-surgery opinion when that is the right step.
Ease carpal tunnel conservatively
NHS guidance puts conservative care first: night wrist splints, activity changes and graded rehabilitation help many people avoid injections or surgery altogether. If symptoms persist or worsen, we say so early and route you to the right opinion promptly.
Splint what needs protecting
Custom splinting from our hand therapist protects healing ligaments, tendon repairs and irritable joints while you keep using the rest of the hand. Splints are made and adjusted for your anatomy and your job, then weaned as the tissue recovers.
Recover from a wrist sprain
A fall on an outstretched hand can leave the wrist swollen, stiff and weak. We protect the healing ligaments early, then restore movement and grip in stages so the wrist copes with pressing, lifting and weight-bearing again.
Rebuild grip and forearm capacity
Typing, gripping and lifting all day load small structures faster than they adapt. Graded strengthening of the forearm, wrist and shoulder rebuilds the capacity behind everyday tasks, from opening jars and carrying bags to racket sports and climbing.
Guide recovery after surgery
After hand or wrist surgery or a fracture, structured rehabilitation restores movement, strength and confidence. We manage scars, swelling and stiffness within your surgeon's guidance, and stage the load week by week so the repair stays protected while everyday function returns.
Why it happens
What causes hand & wrist pain?
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Repetitive or sustained gripping, typing and mouse use that loads the wrist faster than it can adapt, a common driver of RSI
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Median-nerve compression at the wrist (carpal tunnel syndrome), often aggravated by sustained wrist postures, repetitive load, pregnancy, or certain health conditions
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An acute wrist sprain or fall on an outstretched hand, straining the ligaments and soft tissue of the wrist (after a fall we first check for a possible fracture, and refer for an X-ray if needed)
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A rapid increase in gym, racquet, or climbing load that overloads the wrist without adequate recovery
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Strength and capacity deficits in the forearm, wrist, and shoulder, so the smaller structures absorb load they are not conditioned for
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Recovery after hand or wrist surgery or a fracture, where stiffness and reduced strength need structured, graded rehabilitation
At your first appointment we work out what is really holding you back, then agree the plan with you before you leave.
Your initial visit runs 45–60 minutes: a detailed history, then a thorough examination of movement, strength and the affected area. We explain what we find in plain English and agree a working diagnosis together.
Treatment starts the same day, and you leave with the first exercises of a plan built around your goal.
Better than yesterday. Kaizen means continuous improvement: small, repeatable gains, built session by session, until you are back to what you love and no longer need us.
- One team across five London clinics: Soho, Liverpool Street, Marylebone, Canary Wharf and Wimbledon Village, plus online appointments.
- Rated 5.0 on Google across 218 reviews.
- Founded in 2022 by David Thomas and Gus Hadonou. You see the same physiotherapist at every visit, so each session builds on the last.
Fees and insurance
Book online through Jane and self-refer, with no GP letter needed. If you are using private health insurance, check your policy first: some insurers ask for a GP referral before your first session.
- Initial assessment and treatment: £155 for a full 45–60 minutes
- Follow-up treatment: £93, with your plan progressed at each visit
- Massage (sports, pregnancy and Swedish): £75 for 30 minutes, £130 for 60 minutes, £160 for 90 minutes
- Lomi Lomi massage: £170 for 90 minutes, £220 for 2 hours
- Performance MOT & Screening: £300 for a 90-minute screen with force-plate testing and a written report
- Recognised by Bupa, AXA Health, Aviva, Cigna, WPA and Allianz
Your journey
with Kaizen
Everything starts with a proper assessment. We find what is driving the problem, treat it, and build the strength that keeps it fixed, so you finish performing, not just pain-free.
Treatment
Hands-on care to settle symptoms and restore movement: manual therapy, with acupuncture, shockwave or soft-tissue work where they genuinely help. The first home exercises go with you the same day.
Rebuild
Progressive exercise that returns strength, control and load tolerance, from Reformer Pilates to strength and conditioning. Each follow-up reassesses against your baseline, so progress is measured rather than guessed.
Perform
Criteria-based milestones return you to work, sport and training. Discharge happens by mutual agreement once you can manage independently, with a Performance MOT available to catch the next weak link early.
We specialise in:
- Musculoskeletal and sports physiotherapy
- Western medical acupuncture (AACP)
- Physiotherapy-led Reformer Pilates
- Specialist hand therapy and splinting
- Shockwave therapy for stubborn tendons
- Strength and conditioning for rehabilitation
- Running and gait analysis
- Performance MOT and movement screening
Treatment approach
How do we treat hand & wrist pain?
Hand Therapy
Specialist hand-therapy assessment identifies the affected tissue, whether tendon, nerve, joint or ligament, and combines splinting, activity modification, manual techniques and a graded exercise plan, the core approach for wrist and post-surgical hand conditions.
See treatment detail →Physiotherapy
Hands-on physiotherapy addresses the wider chain of forearm, wrist and shoulder strength and control, and delivers the progressive loading that rebuilds tissue capacity rather than only settling symptoms.
See treatment detail →FAQ
Frequently asked
questions
Do I need surgery for carpal tunnel syndrome?
Not usually as a first step. NHS guidance recommends conservative measures first, such as a night wrist splint and modifying aggravating activities, which help many people. A steroid injection may be offered if splinting does not work. Surgery is considered only when symptoms are severe, persistent or worsening, and we refer appropriately when a surgical opinion is warranted.
Will I need a splint?
Sometimes. Custom splinting from our hand therapist protects healing ligaments, tendon repairs and irritable joints while you keep using the rest of the hand. For carpal tunnel syndrome, a night wrist splint is one of the first conservative measures. Splints are made and adjusted for your anatomy and your job, then weaned as the tissue recovers.
Do I need a GP referral to see a hand therapist?
No. You can book a hand-therapy assessment directly, with no GP referral needed. We assess the hand and wrist, explain what is going on and agree a plan with you. If you need nerve studies, imaging or a hand-surgery opinion, we refer you for those when that is the right next step.
When should I worry about hand or wrist pain?
Seek urgent care if you have severe pain after trauma, an obvious deformity, you cannot move or use the hand, or there is rapidly spreading redness, fever, or numbness with significant weakness. Persistent night-time numbness, wasting of the thumb muscles, or symptoms that steadily worsen also warrant prompt assessment and possible nerve studies.
Related What We Treat
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Kaizen Physiotherapy & Performance • 111 Charing Cross Road, Soho, London WC2H 0DT
Book OnlineAppointments typically available within 1–2 weeks