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Pain the in the hand can be caused by several conditions, including carpal tunnel syndrome, cubital tunnel syndrome, trigger finger, DeQuervain’s Syndrome, and osteoarthritis. Each of these conditions has unique characteristics yet what connects them is their origin – pain in the hand or the arm, or both.
Wengjing Zeng, MD, a hand surgeon with the TriHealth Hand Surgery Specialists and the TriHealth Orthopedic & Sports Institute, explains a few of these common hand conditions and potential treatment options.
Carpal tunnel syndrome is a pinched nerve in the wrist, which can be associated with diabetes, rheumatoid arthritis, some thyroid conditions, pregnancy, and gout, said Dr. Zeng. Symptoms of carpal tunnel syndrome include pain, numbness and tingling (which is sometimes worse at night), a weak grip, and tendency to drop things.
Nonsurgical treatment involves splinting and steroid injections, while surgical treatment is an outpatient procedure in which the ligament at the top of the “tunnel” is cut, relieving pressure on the nerve. No formal rehabilitation is required, and the patient can go back to light tasks immediately, though Dr. Zeng advises taking one month off heavy labor.
Cubital tunnel syndrome is a pinched nerve at the elbow – more specifically, at the “funny bone.” Symptoms include pain, numbness and tingling (which is sometimes worse at night in the small and ring fingers), a weak grip, and muscle wasting in the hand.
Nonsurgical treatment includes nighttime splinting and avoiding leaning on the elbows, while surgery releases pressure on the nerve. The time to recovery from cubital tunnel surgery can vary.
Trigger finger is a common hand condition where patients describe discomfort at the base of the finger or thumb, a lump in the palm, pain, popping, a catching feeling, or finger stiffness. It can occur with certain medical conditions like rheumatoid arthritis, gout, and diabetes, or strong and repeated gripping, but in most cases, the cause of the trigger finger is not known.
Nonsurgical treatment options include anti-inflammatory medication such as ibuprofen, activity modification, or steroid injections. Surgery for trigger finger opens the pulley at the base of the finger so that the tendon can glide more freely. Postoperatively, there is often no formal therapy, no splinting or casting, and the patient can often return to light work quickly.
DeQuervain’s Syndrome is tendinitis on the thumb side of the wrist. It can be caused by repetitive movements, changes in hormones, or swelling, though the cause is often unknown. Symptoms include pain and swelling at the base of the thumb or wrist.
Nonsurgical treatment generally involves a splint, anti-inflammatory medications, or steroid injections. Surgery releases the tunnel, and postoperatively, there is often no formal physical therapy, no splinting or casting, and the patient can return quickly to light work.
Osteoarthritis occurs when the joint space narrows, the cartilage buffer is lost and bone rubs on bone. Nonsurgical treatment includes anti-inflammatory medications, the use of heat or ice, bracing, ergonomic adjustments, such as fat pens or jar grippers, avoidance of irritating activities, or steroid injections. Surgery involves removing the arthritic bone and replacing it with a tendon. Postoperatively, there is generally six weeks of full-time splinting and a total three months of formal therapy.
These conditions are best treated by a hand surgeon. Hand surgeons evaluate and treat the entire arm, including the skin, muscles and tendons, bones and joints, arteries and veins, and nerves. Other conditions they treat and procedures they perform include lacerations, amputations, fractures, and overuse syndromes.
If you feel any pain that matches with these common hand symptoms, please make an appointment with your primary care physician, who will evaluate your symptoms and refer you to a hand surgeon if necessary.