Hand, Finger & Wrist Pain

Dr. Shreedhar Archik

A closer look at hand anatomy & injury

The human hand consists of several small bones called phalanges, metacarpals and carpals.  The wrist is where the radius and the ulna (the two bones of the lower arm) meet at the hand.

An area of cartilage between the radius and the ulna separates the radioulnar joint from the rest of the wrist, which is contained within a capsule of cartilage, synovial membrane, and ligaments.  Radiocarpal ligaments carry the hand along with the forearm in rotational movements, and intercarpal ligaments strengthen the small wrist bones.

From performing minor repetitive tasks (like clicking a mouse) to suddenly stopping the force of the body during a fall, the hands and wrists are susceptible to pain and injury at all stages in life.

The carpal tunnel is an area where several tendons and nerves pass through the wrist.   In carpal tunnel syndrome, a narrowing of this opening compresses the nerves and tendons.

Another common problem is pain at the base of the thumb, usually later in life, from arthritis.  This can be treated with splints, injections, and possible reconstructive surgery, if needed.

Other common wrist problems include bone fractures dislocations of the various component joints, and inflamed tendons and ligaments from overuse.

Symptoms of hand, finger and wrist pain

 Pain in the fingers, hand, or wrist is usually caused by overuse, repetitive motion, or underlying conditions like arthritis or ganglion cysts Hand, finger and wrist injuries such as fractures, dislocations, or torn ligaments are often caused by falls or blows during sports or work activities.  Injuries can also occur during accidents or activities.

Symptoms of hand, finger or wrist pain depend on the type of injury or condition, but commonly include pain during use, swelling, and difficulty moving the affected area.

Treatment for hand, finger and wrist pain includes over-the-counter pain medication, rest, ice, and elevation.   In more severe injuries, immobilization or surgery may be necessary.  Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.

 Common causes of hand, finger and wrist pain treated at MOS

 Arthritis

Arthritis is painful inflammation and stiffness of the joints, which can be caused by many types of degenerative joint conditions.  There are over 100 types of arthritis, including osteoarthritis, rheumatoid, gout, psoriatic, septic, post-traumatic, and lupus. Arthritis symptoms can include swelling, tenderness, sharp pain, stiffness, and sometimes fever and chills.

Basal joint (thumb) arthritis is a common type of osteoarthritis that occurs as a result of the degeneration of the cartilage that surrounds the thumb joint. Symptoms include pain, swelling, and difficulty with gripping or pinching motions (such as turning a key or opening a jar). Treatment includes anti- inflammatory medicines, splinting the thumb, and corticosteroid injections. Surgery is also a treatment option for severe cases of basal joint arthritis.

Carpal tunnel syndrome

Carpal tunnel syndrome is a painful condition caused by a pinched nerve in the wrist that leads to radiating pain, weakness, or numbness in the palm side of the hand, wrist or fingers.  Treatment includes anti-inflammatory medicine, splinting the wrist, or corticosteroid injections.   If symptoms do not improve with this treatment, surgery may be necessary to relieve the symptoms and restore functionality.

Finger or wrist dislocation

Finger or wrist dislocation occurs when the bones in a joint are forced out of their natural position.  Another common name for a dislocated finger is a finger jam. Sports activities or falls often cause finger or wrist dislocations. Symptoms include obvious deformity of the affected area, swelling, pain, and difficulty or inability to move the joint.

Dislocations are serious injuries that require immediate medical attention. First aid treatment includes removing any rings or other jewelry, applying an ice pack, and elevating the area higher than your heart.

 

Sprains & strains

 Aligament injury, or sprain is damage that occurs to a ligament, the tissue that connects two bones. In a ligament injury, the tissue can become overstretched, incur small tears, or tear completely.  Symptoms of a ligament injury include swelling, pain, and a feeling of instability in the joint.

 A tendon injury, or strain is damage that occurs to a tendon the connective tissue that connects a muscle to a bone and allows for flexible motion of the limbs.  In a tendon injury, the tissue can become overstretched, develop micro-tears, or rupture.  Symptoms of a tendon injury include inflammation, tenderness, and pain that gets worse during use of the affected area.

 Fractures

 A fracture is a break in a bone. Broken bone symptoms include pain (intensified when the area is moved or pressure is applied), swelling, bruising, and loss of function.  Fractures may also cause the area around the bone to appear distorted or deformed, especially in open fractures where the bone protrudes from the skin.

A distal radius fracture is a break in the arm bone (radius) that connects to the hand at the wrist joint.  Falls or other accidental trauma from sports or car accidents can cause this type of fracture.   Symptoms include pain, deformity, swelling, and inability to move the joint.  Treatment includes immobilization in a splint or cast, pain medication, and in some cases, surgery.

A scaphoid fracture is a break in the scaphoid, one of the small bones of the wrist.  Scaphoid fractures are commonly caused by accidents in which the arms are thrust out to break the fall.  Symptoms include swelling and pain that worsens when gripping an object.  Treatment depends on where the fracture occurs on the scaphoid bone.  If the injury occurs closer to the thumb, immobilization will likely be the best course of treatment.  However, if the break is closer to the arm bone, surgery may be necessary, since the lower portion of the bone does not have a good blood supply.

Ganglion cysts

 Ganglion cysts are fluid-filled, benign tumors (cysts) that develop on the outside of a joint or tendon.  These cysts develop under the skin as small sacs filled with a clear, jelly-like substance that may feel spongy or firm to the touch, depending on size.

Dupuytren’s contracture

Dupuytren’s contracture  is a condition in which the tissue in the palm of the hand becomes thicker and shorter over time, causing the fingers to bend inward.  Symptoms include a hard lump at the base of the ring and pinky fingers, a fibrous cord across the palm, and difficulty bending the fingers or flattening the hand.  Treatment includes physical therapy, immobilization, or corticosteroid injections, as well as procedures to separate the cord in the palm (needle aponeurotomy) or surgery.

Nerve injury

A nerve injury can occur when the finger, hand, or wrist is cut, overstretched, crushed, or burned.  Motor vehicle accidents, work injuries, and falls are common causes of nerve injury.  Symptoms include numbness and difficulty moving the affected area.  Treatment depends on the severity of the injury, and may include rest, immobilization, physical therapy, and in some cases, surgery.

Tendonitis

Tendonitis (also known as tendinitis) is inflammation of the tendons the thick, rope-like cords of tissue that connect muscle to bone.  Tendonitis is caused by overuse (repetitive motion) or sudden injury.   Tendonitis symptoms include pain in the tendon area, and sometimes loss of motion.

De Quervain’s tendonitis is a form of tendonitis that affects the tendons in the thumb side of the wrist.  Symptoms include pain, swelling, and difficulty gripping with the hand.  Treatment includes rest, ice, compression, and anti-inflammatory medication.  In some cases, corticosteroid injections or surgery may be advised.

Trigger finger

Trigger finger is a condition in which the tendons in the forefinger or thumb catch or become stuck in a bent position.  Symptoms include pain, a popping sensation when using the affected finger(s), and stiffness.  Treatment includes immobilization, anti-inflammatory medication, restricting the activities that caused the repetitive stress, and in some cases corticosteroid injections.  Surgery may be necessary in serious or debilitating cases.

Kienbock’s disease

Kienbock’s disease is a bone disorder similar to avascular necrosis, in which the lunate bone of the wrist loses its blood supply and begins to break down.  The exact cause is unknown, but Kienbock’s disease frequently occurs following an injury to the wrist.  Symptoms include pain, stiffness, swelling, and restricted range of motion of the wrist joint.  Surgery is often necessary to treat the symptoms of Kienbock’s disease.  No cure is currently known for this rare disorder.

Baseball/Mallet finger

Baseball or mallet finger occurs when the tendon that runs along the top of a finger is injured or torn.  Symptoms include pain, tenderness, swelling, and inability to move the finger joint.  Treatment for mallet finger includes ice, immobilization with a splint, and anti-inflammatory pain medication.  In servere tears, surgery may be necessary.

Writer’s cramps

Writer’s cramps are a type of repetitive stress injury that is caused by writing or typing.  Symptoms include spasms or cramps, and pain that becomes more severe with continued use.  Treatment includes rest, behavioral retraining therapy, or injections of medication.

 Repetitive motion/stress syndrome

 Repetitive motion syndrome or repetitive stress syndrome is a general term that describes pain, weakness, numbness, or tingling in an affected body part due to frequent use.  Treatment includes rest, alternating heat and ice, and anti-inflammatory medication.
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Disclaimer: The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The information is provided solely for educational purpose and should not be considered a substitute for medical advice.