The Most Common Forms of Hand Pain

As we age our bodies become less resilient and more susceptible to the wear and tear from our daily activities.  Our hands, fingers, and wrists are as just as likely to exhibit issues as our knees, hips, and backs.  Inflammation, fraying of tendons, autoimmune responses, degenerations of cartilage, reduced density of bone, deconditioning of support muscles, all can be contributing factors leading to aches, pains, and debilitations that can manifest as a wide spectrum of disorders.  When hand pain, finger pain, or wrist pain hits it can make day to day life tough.  Here are some of the common causes:

Osteoarthritis

• Osteoarthritis is the erosion of the smooth cartilage padding at one or both ends of the bones that meet in any joint.  This causes the eventual rubbing of two bones together which can cause inflammation and pain.  Rheumatoid arthritis could be a possible autoimmune cause for deterioration of the cartilage in the hand.  Other causes could be from anatomical imbalances or repetitive motion.  Osteoarthritis in the hand, such as Basal Joint Osteoarthritis can cause hand pain, finger pain, joint swelling, and even joint deformation.

Carpal tunnel syndrome

• The carpal tunnel is a passageway for the nerves and tendons to travel through your wrist and into your palm to your fingers.  Carpal tunnel syndrome is where the passageway narrows for a variety of reasons both genetic and activity based causing numbness, tingling, or hand pain.  Repetitive motions or vibrations can cause irritation that leads to inflammation of the passageway putting pressure on the median nerve which is responsible for the control and feeling of the thumb, pointer, and middle fingers.  In cases where the inflammation cannot be controlled by activity modification, physical therapies, or drug therapies, surgical intervention may be necessary to prevent possible or further damage to the median nerve.

Cubital tunnel syndrome

• The cubital tunnel is a passageway for the ulnar nerve to pass from your upper arm through your elbow and into your forearm.  Ulnar nerve entrapment can give symptoms of ” falling asleep ” in the ring finger and little finger, especially when the elbow is bent. There may be an aching pain on the inside of the elbow. In some cases, it may be difficult moving the fingers in and out or manipulating objects. Numbness and tingling in the ring finger and little finger are common symptoms of ulnar nerve entrapment. Often, these symptoms come and go. They happen more often when the elbow is bent, such as when driving or holding the phone. Some people wake up at night because their fingers are numb.
• Weakness of grip and difficulty with finger coordination (such as typing or playing an instrument) may occur.
• If the nerve is very compressed or has been compressed for a long time, muscle wasting in the hand can occur. Once this happens, muscle wasting cannot be reversed. For this reason, it is important to see the doctor as soon as any of the symptoms are noticed.

Trigger finger

• This is caused by swelling in the sheath around the flexor tendon’s in your hand as well as the tendon itself.  If you try to straighten your hand from a fist and a finger catches resistance in the bent position and then pops through the rest of the motion quickly to the straight position you may have trigger finger.
• Symptoms of trigger finger usually start without any injury, although they may follow a period of heavy hand use. Symptoms may include: A tender lump in your palm, swelling catching or popping sensation in your finger or thumb joints, pain when bending or straightening your finger. Stiffness and catching tend to be worse after inactivity, such as when you wake in the morning. Your fingers will often loosen up as you move them. Sometimes, when the tendon breaks free, it may feel like your finger joint is dislocating. In severe cases of trigger finger, the finger cannot be straightened, even with help. Sometimes, one or more fingers are affected.

DeQuervain’s tendinosis 

• A condition causing hand pain in the tendons located on the thumb side of your wrist.
• DeQuervain’s Tenosynovitis usually occurs from overusing your thumb or wrist, especially in activities that move your thumb directly away from your wrist such as skiing or hammering.  Like trigger finger in that it is caused by swelling in the sheath around the tendon, DeQuervain’s tendinosis separates itself from trigger finger in that the swelling does not include the tendon itself and it only affects the thumb.

Dupuytren’s contracture 

• an abnormal thickening of the tissue just beneath the skin in the palm and can extend into the fingers. Firm pits, nodules, and cords may develop that can cause the fingers to bend into the palm, which is a condition described as Dupuytren’s contracture. Although the skin may become involved in the process, the deeper structures—such as the tendons—are not directly involved. Occasionally, the disease will cause thickening on top of the finger knuckles (knuckle pads), or lumps or cords within the soles of the feet (plantar fibromatosis).
• The initial lumps may produce discomfort that usually resolves, but Dupuytren’s disease is not typically painful. The disease may first be noticed because of difficulty placing the hand flat on an even surface, such as a tabletop. As the tissue thickens and fingers are drawn into the palm, one may notice increasing difficulty with activities such as washing, wearing gloves, shaking hands, and putting hands into pockets.
• While surgical correction used to be the likely treatment available, due to advances in technology a collagenase called Xiaflex can now be used to release your finger without surgery.

Fracture

• Hand deformity after a trauma is an obvious sign of a fracture, but less obvious fractures can present with swelling, tenderness, bruising, the inability to move fingers, or hand pain that worsens when in use.  If you suspect a fracture go ahead and book an appointment with an orthopedic specialist immediately and let them know that you suspect a fracture.  Bones begin to heal, sometimes incorrectly, in as little as 5-7 days so the easiest option is to be seen quickly before treatment becomes more complicated and expensive.

Ganglion cysts
A cyst is a fluid-filled sac. Ganglion cysts arise from the capsule of a joint or the sheath of a tendon. They can be found at different places on the wrist. A ganglion cyst that grows on the top of the wrist is called a dorsal ganglion. Others are found on the underside of the wrist between the thumb and your pulse point, at the end joint of a finger, or at the base of a finger. Most of the time, these are harmless and can disappear in time.

• Because the fluid-filled sac puts pressure on the nerves that pass through the joint, some ganglion cysts may be painful. Large ganglia, even if they are not painful, are unattractive. Smaller ganglions that remain hidden under the skin (occult ganglions) may be quite painful. A ganglion grows out of a joint, like a balloon on a stalk. It rises out of the connective tissues between bones and muscles. Usually, the more active the wrist, the larger the cyst becomes. With rest, the lump can decrease in size.

Nerve injury

• While most nerve injuries of the hand are traumatic in nature, if you are experiencing tingling, numbness, radiating pain or aching, or loss of hand strength it is time to come and see an orthopedist to rule out nerve impingement just in case to avoid nerve compression becoming permanent damage.

Jammed Finger

• For many of us a familiar type of hand pain caused by the finger being forcibly pushed back into the hand.  Technically a jammed finger is just a sprain of the finger, but with possible pain, bruising, tenderness, and swelling it is hard to tell the difference between a sprain and a minor fracture.  If you are ever in doubt it is the safer route to go ahead a see a physician for an x-ray to rule out a fracture.

Mallet finger

• Caused usually by traumatic damage to the tendon that straightens the finger.  This causes a deformation with the end of the finger uncontrollably bent down.  After a finger fracture is ruled out most mallet fingers can be healed simply with a splint and time.

Tumors

• While most hand tumors are luckily benign it is always important to see a physician to rule out other possibilities as early as possible.

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