In Case of hand pain, conservative treatments can include:
- splints
- injections anti-inflammatory
- medicines
- creams
- therapy depending on the problem.
Doctors will work to determine the cause of the hand pain and the best treatments to help patients regain strength in their hands.
Common Hand Pain and Problems
- Carpal tunnel syndrome
pressure on the median nerve causes pain over the wrist and fingers.
-compression of the median nerve at the wrist.
-can lead to numbness, tingling or weakness in the hand and
fingers.
-these symptoms are found in, index, middle and half of the ring fingers.
-can lead to atrophy of the hand and finger muscles. - Cubital Tunnel Syndrome
pain at the small finger and half of the ring finger.
pain originates at the medial elbow.
-increased pressure on the ulnar nerve at the elbow where the nerve passes on under the medial epicondyle or “funny bone”.
-the connective tissue over the nerve will sometimes thicken, causing the patient to have numbness and tingling along the little finger and ulnar half of the ring finger.
-ulnar nerve compression below the elbow that can cause a “claw hand”. - Osteoarthritis
Pain typically affects the interphalangeal joints of the fingers and thumb.
-the degenerative joint disease causes the gradual deterioration of the cartilage forming the joint of the hand fingers. - Rheumatoid Arthritis
Pain is located at the knuckles of the fingers and the wrist bone on the side of the small finger.
-inflammation or irritation causing pain, swelling, weakness and over
time, loss of the normal shape and alignment of joints.
-the joints between the hand and fingers swell and move upward (dorsal subluxation).
-tendons over the joint slip and cause the fingers to bend towards the little finger (ulnar drift). - Flexor Tendonitis (trigger finger)
Pain may be located in the palm at the base of the finger.
the condition that affects a tendon to remain in the bent position when attempting to straighten it.
-The flexor tendon becomes thick and irritated as it slides through the tendon Pulley causing a thickened nodule and triggering of the tendon. - De Quervain syndrome
Pain is located over the radial (thumb) side of the wrist.
pain and swelling over the thumb side of the wrist that may cause difficulty in gripping with the thumb.
– inflammation of the sheath or tunnel that surrounds the two tendons that control the movement of the thumb. - Basal Thumb Joint Arthritis
Pain is located at the base of the thumb (CMC joint).
-arthritis of the basal joint or thumb CMC (carpometacarpal) joint.
-basal joint arthritis results in pain with restricted movement of the thumb across the palm.
Wrist pain has a lot of possible causes
Finklestein's Test
It is hard to differentiate between Finklestein’s test (Basal Thumb Arthritis).
The test is conducted by having the patient make a fist with the fingers closed over the thumb and the wrist is bent towards the little finger.
The hand is pulled so that the involved tendons are stretched, causing sharp, local hand pain in injury and inflammation is present.
Grind Test (Basal Thumb Arthritis)
By axial loading, pushing and rotating the thumb metacarpal bone, grinding may be felt within the joint.
Hand Pain & Problems
Flexor Tenosynovitis (Kanavel’s signs)
Pain is located in the finger at the flexor tendon sheath.
Kanavel’s Four cardinal signs
1. Uniform swelling of the entire finger.
2. The finger is flexed.
3. Intense pain when attempting to straighten the finger. it occurs early.
4. Tenderness along the course of the tendon sheath.
Trigger Finger
A trigger finger is a type of tendinitis on the hand one of the most common that we see and what happens is that tendon typically has to glide in the palm through a series of ligaments or almost like tunnels which we refer to medically as pulleys and with the inflammation that comes with the tendinitis that tendon swells and every time it tries to glide into these small tunnels it gets trapped and the motion of moving your finger it kind of goes click clunk rather than having a smooth motion.
It can be quite tender quite uncomfortable and, sometimes that the parts that are inflamed get trapped in a bent position so, it’s hard to straighten your finger unless you take your other hand and straighten it so, the trigger finger when it’s interfering with your quality of life so if you are finding it’s annoying because you go to you know if you go to hold a glass and your finger kind of gets stuck and you can’t let go or, you have something smaller like a hotpot you can’t put it down because the fingers are stuck in a bent position more commonly people come. After all, it’s sore, and the soreness is what they’re looking for the treatment of not so much the actual locking treatment for trigger finger, you can try conservative management with taking Motrin Advil occasionally. We’ll have people try splinting the finger straight people report that in the morning they’ll often wake up with their finger bent, and so we find if they sleep with the finger straight at night, the tendon is not as likely to get caught but, this doesn’t have a very high success rate. The doctor then the options that he has been injecting and trying to do the procedure through the skin with a needle or doing surgery the percentage of these different treatments are number one is to try to control the inflammation around the tendon and number two is to make more space for the tendon to glide so with a cortisone injection, that’s direct trying to control the amount of inflammation in the tendon which then usually allows it to float more smoothly. When a doctor does a what’s called the percutaneous approach through the skin with a needle he’s injecting cortisone to control the inflammation but, also he’s trying to cut with the edge of the needle to open up the tunnel a little bit this we can only offer for certain fingers usually the middle two fingers your middle and your ring finger other fingers it’s a little bit trickier a little bit more dangerous because of nerves that are there when we do the project the goal is simply to open the tunnel where the tendon is most likely trapped and give it free rein to – to glide without getting trapped recurrence following treatment. If you go the injection route then, we find that with one dose we can cure about 70% of people so, there will be some people who come back so, we can offer them a section ii injection. If we go the surgery’s approach the cure rate is closer to 99. You know 0.5% in terms of risk with the surgery doctor’s opening the skin there’s a certainly a slightly greater chance of infection with that approach than with the injection but, I mean the risk of getting infected with this type of an elective procedure is pretty small so that shouldn’t be the main deterrent with the surgery your recovery time is a little longer you have some soreness in your palm can’t get your hand wet so, there’s some downtime in terms of frequency we would see easily you know ten to 15 trigger fingers a month that ends up choosing the injection route against maybe one or possibly two that would pick the surgery route. The decision about what to do is the patient’s decision, and we think that’s one of the things that we pride ourselves on here at Sports & Spinal Solutions Clinic is that we very much will have a good discussion and let people know what the different treatments are. What the maybe the cost differences are the what the differences are on complications and recovery and success rate and help people make the decision that’s best for them given their demands in life their preferences and their values and make a decision that way.
