Although the bones, muscles, tendons, and ligaments of the hand are small, the impact of hand injuries and disorders can be big. Fortunately, there are orthopedic doctors that specialize in hand and upper extremity disorders. There’s a long list of injuries and conditions that affect the hands, but we’re going to look at just five of the most common hand disorders as well as how they can be treated.
1. Carpal Tunnel Syndrome
One of the most common disorders is carpal tunnel syndrome. This condition causes pain, numbness, and tingling in the hand and arm. As the American Society for Surgery of the Hand puts it, carpal tunnel syndrome is essentially a pinched nerve in the wrist.
Carpal tunnel syndrome may be caused by a combination of different factors that can increase pressure on the median nerve and narrow the carpal tunnel:
- Repetitive hand use
- Prolonged extreme flexion or extension of the hand and wrist
- Sex (more common in women)
- Conditions like diabetes, rheumatoid arthritis, and thyroid disease
Carpal tunnel usually worsens over time, making early diagnosis and treatment important.
If carpal tunnel is diagnosed and treated early, patients often see results from nonsurgical treatments including:
- Bracing or splinting
- Activity changes
- Nerve gliding exercises
- Steroid injections
If surgery is required, carpal tunnel release can be performed in an open procedure or endoscopically.
Arthritis is another one of the most common hand disorders. According to the Centers for Disease Control and Prevention (CDC), about 54.4 million adults in the US annually are diagnosed with some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia by a doctor. Arthritis is an inflammation of one or more joints. There are many different types of arthritis with different causes. Two common types of arthritis that affect the joints of the hand and wrist are osteoarthritis and rheumatoid arthritis.
Osteoarthritis is often called “wear-and-tear arthritis” and is caused by the cartilage in joints wearing away over time. Rheumatoid arthritis is a chronic disease that causes the lining of the joints to swell, often starting in the hands or feet.
The primary symptom of arthritis is joint pain. Arthritis pain is often described as dull or burning at first and worsens over time. Nonsurgical treatments include anti-inflammatory medications to reduce pain, injections and splinting. Surgical intervention may be needed for pain relief and joint preservation. If the joint can’t be repaired and preserved, then joint replacement is an option.
3. Trigger Finger
Also called stenosing tenosynovitis, trigger finger is a condition in which one of your fingers feels like it is locking or catching when you try to bend it. The condition causes pain and stiffness in affected fingers. Trigger finger most often affects the ring finger and thumb, but can affect other fingers. Trigger finger is caused by inflammation in the sheath surrounding the finger’s tendon.
Trigger finger may develop after forceful hand use, but the exact cause is unknown. People with diabetes and rheumatoid arthritis are at higher risk of developing trigger finger. There are nonsurgical treatment options including rest, splinting, special exercises, pain medication, and steroid injections. Surgical treatment of trigger is called “tenolysis” or “trigger finger release.”
4. Dupuytren’s Disease
There is a layer of tissue that lies between the skin and muscle of your palms and fingers. This tissue is called the fascia. Dupuytren’s disease causes the fascia to thicken and tighten over time. This causes the fingers to be pulled in towards the palm in what is called Dupuytren’s contracture.
The cause of Dupuytren’s is unknown and there is no evidence that it is related to hand injuries, repetitive motion, or overuse. If the contracture is limiting hand function, a hand specialist can perform surgery to remove the affected tissue. Nonsurgical treatments include steroid injections, enzyme injections, and a procedure called needling.
5. Ganglion Cysts
Ganglion cysts are benign (noncancerous) lumps that develop along the tendons and joints of the hands and wrists. Ganglion cysts range in size from pea-sized to an inch in diameter. These cysts become painful when they press on a nerve in the hand. Depending on the location of the cysts, they may cause difficulty with joint movement.
Immobilizing the affected hand or wrist with a brace or splint may allow a cyst to shrink and relieve pain. Another procedure called aspiration is used to drain the fluid from the cysts. If nonsurgical treatments are unsuccessful, the doctor may recommend a surgery called an excision to remove the ganglion cyst.
If you’re having issues with a hand injury, you should see an orthopedic doctor with expertise in diagnosing and treating hand disorders. South Shore Orthopedics is proud to have three physicians who are fellowship-trained in hand and upper extremity surgery. We’ve recently welcomed Dr. Michael Daly as part of our team. He joins Dr. John Kadzielski and Dr. Glen Seidman in providing comprehensive care for hand and upper extremity conditions. Call (781) 337-5555 to make an appointment.