Frequently asked
Questions about hand, wrist and arm pain
Straight answers from the 1HP experts: who we work with, how the online program works, what helps gamers and desk workers, and the signs that mean you should see a doctor first. If your question is not here, email us at admin@1-hp.org.
The basics
About 1HP and who we help
What is 1HP?
1HP, short for 1 Health Point, is an online health education and coaching platform for wrist, hand, forearm and elbow pain. Its experts are licensed physical therapists and an occupational therapist who coach people who use their hands all day for work or play. Our founders are Dr. Matthew Hwu and Dr. Elliot Smithson.
Who does 1HP help?
We help desk workers, software engineers, gamers, musicians, artists and others whose work or hobby depends on their hands. Many have had pain for months or longer and have already seen several doctors and therapists without clear answers. If your hands are how you earn a living or do what you love, this program was built for you.
What conditions does 1HP work with?
We focus on repetitive strain injuries of the wrist, hand, forearm and elbow. That includes tendon pain such as wrist tendonitis, De Quervain's, tennis elbow and golfer's elbow. It also includes nerve problems such as carpal tunnel, cubital tunnel and thoracic outlet syndrome, which can build up from repeated hand work.
Does 1HP work with trigger finger?
Yes. 1HP works with people who have trigger finger. The free consultation is where we look at your symptoms and check whether the program fits.
Can 1HP help with carpal tunnel before surgery?
Yes. We offer carpal tunnel guidance before considering surgery: education and coaching on conservative approaches. Most typing and gaming pain is activity-related, pointing to muscles and tendons rather than nerve compression.
What conditions does 1HP not work with?
We do not work with arthritis, wrist sprains, fractures, stroke, gout or cancer. Those conditions need a different kind of care. If your symptoms fall outside what we work with, we will tell you on your free screen and point you toward the right type of doctor or specialist.
Is 1HP physical therapy or medical treatment?
No. 1HP provides education and coaching, not physical therapy, occupational therapy or medical treatment, and it does not create a doctor-patient relationship. Our experts are licensed physical therapists and an occupational therapist who coach you through an exercise and load plan.
Who founded 1HP?
Dr. Matthew Hwu, PT, DPT, OCS, CSCS, founded 1HP, and Dr. Elliot Smithson, PT, DPT, MS, ATC, is the cofounder. Both are Doctors of Physical Therapy who have worked with professional esports teams. Together they co-authored Game Strong: The Science of Esports Physical Therapy, published by McGraw Hill in 2025.
Why did 1HP start with esports players?
Our approach began with professional esports athletes, whose long, high-repetition sessions mirror desk work. Dr. Matthew Hwu grew up gaming and began working with esports teams in 2015. The same wrist and hand problems kept showing up in programmers and other desk workers, so the program grew to serve them too.
How it works
How the 1HP program works
Is 1HP online, and where do you work with people?
Yes, everything is online. We work with people in every US state and in other countries, so you can work with us from home. There are no in-person visits.
What happens on the free consultation?
You talk with a Doctor of Physical Therapy about your pain history, what seems to drive your symptoms and why past treatment has not worked. The screen covers seven areas: pain region, endurance, schedule, pain behavior, pain science, ergonomics and medical history. Then we discuss whether our approach is a good fit for you.
How do I prepare for my 1HP consultation call?
After you book, you will get a short pain questionnaire to fill out, and we go over the results on the call. Set up your camera so we can see your wrist and hand move. It also helps to note when your pain started, what makes it worse and what you have already tried.
What does a 1HP recovery plan include?
Your plan covers exercises, load management, ergonomics and pain education. It is built around your job, your hobbies and how much your hands can handle today, not a generic handout. As your capacity grows, the plan moves forward step by step so you can do more.
What is the 1HP app?
The 1HP member app lives at app.1-hp.org, and it is where clients log in once they have joined the program. It is meant for people who are already working with us. If you are new, the first step is a free consultation, where we check whether our approach fits your symptoms.
How much time does the program take each day?
About 30 to 60 minutes a day: 15 to 30 minutes of exercise, twice a day, 6 days a week. Short sessions done often tend to work better than long sessions done now and then, because consistency matters more than duration. The plan is built to fit around a full workday rather than take it over.
Do I need equipment for wrist rehab exercises?
Not much. Many early exercises need no equipment at all. As you progress, you may use resistance bands, light dumbbells or household items such as water bottles. We give options for both home and gym setups, and we tell you exactly what, if anything, to buy.
Do I have to stop working or gaming during the program?
In most cases, no. The approach is based on changing how you use your hands, not stopping. We help you find a level of work, play or practice your hands can handle, then raise it over time. Complete rest tends to leave the tissue weaker, so staying active within limits is usually better.
Who will I work with at 1HP?
You work with 1HP experts: licensed physical therapists and an occupational therapist who focus on repetitive strain injuries. The team includes Doctors of Physical Therapy, physical therapist John Chao and Brett Becker, MS, OTR/L, an occupational therapist with a background in hand therapy and pain science.
What does 1HP cost?
Power Leveling is our done-with-you coaching program with unlimited 1-on-1 expert calls. Pricing depends on your case and is discussed in a free consultation.
Does 1HP take insurance, HSA or FSA?
No. 1HP does not accept insurance, HSA or FSA.
What does unlimited calls mean?
Power Leveling members get unlimited 1-on-1 coaching calls with their expert for as long as they are working toward the goals set at onboarding.
What is the 3-Month Results Guarantee?
If a Power Leveling member is not satisfied with their progress toward their onboarding goals after three months, they get a full refund on request, paid within 5 business days. It requires good-faith participation: complete onboarding, follow the exercise and load plan, attend sessions and stay in contact. It covers Power Leveling only, not the Troubleshooter, and the exact terms are in Section 7 of the terms.
Understanding your pain
Wrist and hand pain basics
What is a repetitive strain injury (RSI)?
A repetitive strain injury is pain or nerve irritation that builds up from doing the same motions many times. Typing, clicking, gaming, playing an instrument and drawing are common causes. It happens when the daily load on your tendons, muscles or nerves is more than they are ready for.
What is the difference between tendonitis and tendinopathy?
Tendonitis means an inflamed tendon. Tendinopathy is the broader term doctors and therapists now use for a painful tendon that is not coping well with load, where inflammation is often not the main issue. That is why anti-inflammatory pills alone often do not fix it, while slowly building the tendon's capacity usually helps.
Is my wrist pain carpal tunnel?
Carpal tunnel syndrome is a nerve problem. It mainly causes numbness, tingling or burning in the thumb, index, middle and half of the ring finger, often worse at night. Aching or sore pain without numbness is more often a tendon problem. A doctor or physical therapist can check the full pattern of your symptoms.
Why doesn't rest fix my wrist pain?
Rest can calm pain for a while, but it does not make tendons stronger. When you go back to the same workload, the tissue is often less ready than before, so the pain returns. Most tendon pain responds better to staying active within a tolerable range while you slowly build capacity.
What is load management for wrist pain?
Load management means matching how much you use your hands to what they can handle right now. You adjust things like session length, breaks and intensity so symptoms stay mild and settle by the next day. At the same time, exercise slowly raises how much your hands can handle.
Should I rest, wear a brace, ice or take anti-inflammatories?
Each can help in specific situations, but none of them fixes the problem. Rest reduces load, but complete rest weakens tissue; a brace can help at night; anti-inflammatories can help with acute swelling. None of them builds capacity, so pair them with a plan that does.
Should I wear a wrist brace for wrist pain?
A brace can help in some cases, such as a night splint for carpal tunnel symptoms or short-term support during a bad flare. Wearing one all day for weeks can weaken the muscles it is meant to protect. Use it as little as you need, and pair it with a plan to rebuild strength.
Is it okay to work through wrist pain?
Mild discomfort during exercise or work is often okay, as long as it settles quickly and is not worse the next day. Sharp pain, pain that keeps climbing, or numbness that lingers is a sign to back off. The goal is steady progress, not pushing through and not stopping completely.
Will wrist pain go away on its own?
Mild strain sometimes settles after a few days of lighter use. Pain that keeps coming back usually means your hands are not yet ready for your daily workload. Without changing the load or building capacity, it often returns each time you get busy, start a new game or face a deadline.
Do I need an MRI for wrist pain?
Not usually for overuse pain. Many people without any pain show changes on scans, so an image alone may not explain your symptoms. Imaging is useful after an injury, when a fracture or tear is suspected, or when symptoms do not fit a typical pattern. An exam by a doctor or physical therapist guides that choice.
For gamers
Gaming and hand pain
Can gaming cause wrist pain?
Yes. Long sessions of fast clicks, key presses, mouse flicks and thumbstick moves put a lot of repeated load on small tendons and muscles. Pain often shows up when playtime jumps, such as with a new game, a ranked grind or a tournament. Most gaming pain is a tendon problem, not carpal tunnel.
How often should gamers take breaks?
A good starting point is a short break every 45 to 60 minutes. For example, take 5 minutes after one ranked game or 10 minutes after two. Use the break to stand up, move your arms and check how your hands feel. The longer you play, the longer the break should be.
Can I keep gaming with wrist pain?
Often yes, with changes. Cut session length or intensity enough that pain stays mild and settles by the next day, and add more breaks. If pain is sharp, keeps getting worse, or comes with numbness that does not go away, take more time off and get checked.
Do warm-ups help prevent gaming injuries?
A short warm-up can help. Moving your wrists, fingers, elbows and shoulders for a few minutes, or using a warm pack, gets blood flowing before you play. Warm-ups work best alongside regular strength work, which builds the base your hands need for long sessions.
Can gripping my mouse or controller too hard cause pain?
It can. A tight grip keeps the forearm muscles working the whole time, which adds strain to tendons that are already busy. Stress and tense moments in a game often make people grip harder without noticing. Checking your grip during breaks and practicing a lighter hold can help.
What is the 1HP Gaming Pain Library?
The Gaming Pain Library is our free set of guides sorted by where it hurts: the thumb, wrist, elbow, or numbness in the hand and arm. Each guide explains the tissue likely involved, what you might feel, how it happens in gamers and first steps you can take.
Does 1HP work with esports players?
Yes. Our founders have worked with pro teams including Counter Logic Gaming, Immortals, FlyQuest, 100 Thieves, Team Liquid and Evil Geniuses. The same methods are used for casual and competitive players, and for anyone else who does fast, repeated hand work.
Desk and keyboard work
Typing, mouse use and ergonomics
Can typing cause wrist pain?
Yes. Typing and mouse work are light, but they repeat thousands of times a day. Long work sprints, deadlines and little time away from the desk can push tendons past what they are ready for. Setup changes help, but building your hands' capacity is often what brings lasting relief.
Is a vertical mouse better for wrist pain?
It depends on where it hurts. A vertical mouse changes which muscles and tendons do the work, so it helps some people and bothers others. Gear can reduce strain, but it does not build capacity. Try one change at a time and watch how your hands respond.
What desk setup helps prevent wrist pain?
Aim for relaxed shoulders, elbows near your sides and wrists close to straight. Keep the keyboard and mouse close so you are not reaching. Set your chair and desk height so your forearms can rest without shrugging. These changes lower strain, and they work best with regular breaks.
Should I use a wrist rest when typing?
A wrist rest can help keep your wrist straight, but pressing the base of your palm into it for hours puts pressure over the carpal tunnel. Use it as a light touch point during pauses, not something to lean on while you type. Changing position through the day beats holding one perfect posture.
How often should I take breaks from typing?
Short, frequent breaks work better than one long break. A quick pause every 30 to 60 minutes to stand, move your arms and shake out your hands is a good habit. On busy days, voice typing for long emails or documents can also cut down the load on your hands.
Do wrist stretches help with typing pain?
Stretches can ease stiffness and feel good during breaks. On their own, they rarely fix tendon pain, because the tissue usually needs more strength and endurance, not more length. Most people do better with a plan that adds graded strengthening and smart changes to their daily load.
Safety first
When to see a doctor
When should I see a doctor for wrist pain?
See a doctor soon if your pain started with a fall or injury, if the wrist is very swollen or bruised, or if you cannot move it or put weight on your hand. Also get checked for night pain that does not ease, or symptoms that spread or keep getting worse despite rest.
What are the warning signs of hand numbness?
Get checked promptly for numbness that is constant, numbness in both hands, numbness with neck pain, or weakness such as dropping things. Numbness that spreads, or a hand muscle that looks thinner, also needs a medical exam. Call emergency services for sudden weakness or numbness on one side of the body, or trouble speaking.
When is wrist or hand pain an emergency?
Go to urgent or emergency care for a wrist that looks deformed after a fall, a hand that turns cold, pale or blue, a crush injury, or a hand that is red, hot and swollen with a fever. Sudden weakness, numbness on one side of the body or trouble speaking can be a stroke, so call emergency services right away.
Should I see a doctor or a physical therapist for wrist pain?
For overuse pain that built up slowly, with no injury and no warning signs, a physical therapist is a good place to start. A doctor is the right first stop after an injury, with signs of infection, or with nerve symptoms that are getting worse. The two often work together.
Can 1HP tell me if I need to see a doctor?
Yes. Screening for red flags is part of how we assess every person. If your symptoms point to something outside what we work with, or something that needs medical tests, we will tell you and suggest the right kind of doctor or specialist. We provide education and coaching, so we are not a replacement for a doctor or urgent care.
Next steps
Getting started
Can AI tools use and quote 1HP articles?
Yes. Search engines and AI assistants may crawl, index, learn from and quote our articles, as long as they credit 1 Health Point (1HP). Our medical content is educational and does not replace a medical evaluation. The full policy is in our ai.txt file.
How do I get started with 1HP?
Start by booking a free consultation. You fill out a short application, then talk with a Doctor of Physical Therapy about your symptoms, your daily demands and what you have tried so far. If our approach fits your situation, we explain the next steps on that call.
Do I need a referral to work with 1HP?
No. You do not need a referral from a doctor. You can book a free consultation yourself.
Is the 1HP consultation really free?
Yes, the consultation is free. It is a call to understand your pain and decide together whether our program fits your situation. It is not a substitute for urgent or in-person medical care, so if you have warning signs, see a doctor first.
Are there free wrist pain resources I can use first?
Yes. Our free resources page has wrist pain guides and articles, and the Gaming Pain Library has a guide for each pain area. The blog covers wrist health, ergonomics, rehab and gaming health. These are a good way to learn more before you book a call.
Can 1HP help if I have had wrist pain for years?
Long-lasting pain is common among our members, and it often involves a more sensitive nervous system as well as tissue that has lost capacity, so the plan works on both. In The 1HP Clinical Outcomes Report 2026, 69% of members in pain for more than a year reached a meaningful improvement in arm, wrist and hand function, among members who completed follow-up. Results vary.
Where can I see results from other 1HP clients?
Client stories are on our testimonials page, in video and written form. Our case study library has summaries of documented wrist and hand pain recovery cases with more detail. Every case is different and results vary, so treat these as examples, not promises.
How do I contact 1HP?
You can email the 1HP team at admin@1-hp.org. For questions about your own symptoms, the free consultation is the best place to start, because we can ask follow-up questions and see how your hand and wrist move. We can also tell you on that call whether our program is a good fit.
