Hand & Wrist Pain

Wrist Ganglion

These are small “bumps” located on the fingers, wrist, or other joints of the hand. These are very common and are small hernias of the joint involved. They do not require treatment unless they become unsightly or painful. Occasionally, they may press on important structures and cause symptoms. Treatment usually involves an injection, or if symptoms persist, a minor operation.

Trigger Fingers

This condition is a result of a nodule developing on a finger tendon which may get caught in small pulleys which occur naturally in the hand. These can be quite painful and first begin as a popping in the finger and then may progress causing the finger to remain bent all the time. These are usually treated with an injection, but a minor operation is occasionally necessary if this does not resolve.

deQuervain’s Tendontitis

This disorder is a tendonitis on the thumb side of the wrist which is very tender and painful with activities. It is diagnosed by doing a special maneuver which mimics the pain. This problem usually responds to injections, but occasionally a minor operation is necessary.

Carpal Tunnel Syndrome (CTS)

This is a very common disorder which causes pain, numbness, and weakness in the hand. This is often localized to the thumb, index, and middle fingers, but in many patients, it is present in the arm and can even radiate into the neck. It is generally worse with activities and causes awakening from sleep, which may occur many times per night. Many patients notice weakness in their hands and drop objects. CTS is very common and occurs in one person out of ten in this country.

CTS is a result of minor, though repeated, injury to the carpal ligament which stretches across the wrist. This ligament then thickens, causing pressure on the median nerve beneath it. This causes the numbness and tingling and can lead to permanent loss of grip strength.

Patients can often diagnose themselves by placing their wrist in a bent position. If numbness or pain occur within one minute, then often Carpal Tunnel Syndrome is present. (However, not every person with CTS will develop pain during this test). If left untreated, CTS can result in severe nerve damage which may become permanent, causing numbness and weakness.

CTS is usually treated with injections and splinting. If these are unsuccessful, a small operation, the “mini” carpal tunnel release, is available. Please refer to the Carpal Tunnel Brochure (in this office) for more information on this condition.

Dupuytren’s Contracture

Dupuytren’s Contracture is a disorder caused by the overgrowth of scar tissue in the hand. This can result in a finger being drawn into the palm. This is most common in the ring or little fingers. Generally, it does not cause pain, but can be troublesome if left untreated. When the fingers contract far enough toward the palm, it is treated by removal of the scar tissue. If left too long, they may not be treatable.

Osteoarthritis or Degenerative Arthritis

This disorder is seen in many people as they age, and may be quite painful, in its early stages, before deformity develops. When the disease matures, a specific pattern is seen. Osteoarthritis is generally not disabling but may cause deformity. When it is tender, it usually responds to physical therapy, splinting, and/or injections, and rarely requires surgery. Various joint replacements and other procedures are available for patients who do need surgery.

Basal Joint Arthritis

This is a special form of arthritis that is seen generally in women in their forties or above. The pain is located where the thumb and wrist meet. It can cause weakness in the hand and difficulty doing daily activities. It can be quite symptomatic and awaken patients at night. It is generally diagnosed by tenderness when pushing on this area and rarely requires surgery. Most of the time, it responds readily to injections and splinting, and then becomes non-painful. Surgery is generally quite successful when needed.

Rheumatoid Arthritis

This disorder is a disease of the lining of joints and is usually seen in women in their twenties, thirties, and forties and men after age sixty-five. It may progress to a disabling disorder and may cause the hand to lose strength and function due to deformed fingers. This disorder should be evaluated early because it may respond to splinting which may prevent some of the ultimate deformity. When symptoms become severe enough, an operation is necessary to replace the arthritic joints.