Whether giving someone a “high-five” or a thumbs up or a simple wave, the hand is used to communicate every day. When your hand or wrist don’t function properly or are injured, the pain can be very debilitating, particularly for athletes who depend significantly on hands to perform.
SportsMed-Wheaton Orthopaedics can help alleviate your pain by evaluating your specific medical situation and developing a personalized treatment plan that will restore your hand and wrist’s dexterity and functionality.
How the Hand and Wrist work
The hand has a structure made up of 27 bones: 8 carpal bones, 5 metacarpal bones and 14 finger bones (also called phalanges) – all of which are connected by joints, tendons and ligaments.
The hand and wrist are collaborative. Both have multiple joints supported by blood vessels and nerves that work together to produce motion.
Common Causes for Hand and Wrist Pain
The human hand is an amazing appendage that allows a person to do a wide range of actions from sign language and digging to writing, or simply clapping. While the hand is versatile and strong enough to handle many activities, it is also delicate and prone to injury.
Carpal tunnel syndrome is a disorder of the wrist and hand. It occurs when the tissues surrounding the flexor tendons in the wrist swell and put pressure on the median nerve causing pain and numbness. The carpal tunnel is a space formed by the bones and other tissues of the wrist. Non-surgical treatments for carpal tunnel syndrome may include a few weeks of rest, wrist immobilization, use of anti-inflammatory drugs, gentle hand exercises and physical therapy. Surgery is recommended if symptoms persist after months of home treatment. See below for details on Carpal Tunnel Release Surgery.
Trigger finger is a condition that occurs when one of the fingers becomes stuck in a bent position. When straightening the finger, the joint will lock. Trigger finger occurs when the tendon in the finger becomes irritated and swollen. It is caused by a localized narrowing of the sheath that surrounds the flexor tendons in the finger, and is common in people who perform repetitive gripping actions. Trigger finger causes stiffness, pain and may eventually lead to an inability to completely straighten the finger. It can often be treated through home methods such as rest, finger exercises and avoiding repetitive movements. Severe cases may need anti-inflammatory medication, cortisone injections, or possible surgery.
A sprain is an injury to a ligament. There are many ligaments in the wrist that can be stretched or torn, resulting in a sprain. This occurs when the wrist is bent forcefully. Wrist sprains can range from mild to severe, and are graded depending on the degree of injury to the ligaments. Mild and moderate sprains are typically treated with anti-inflammatory medication, short term immobilization, followed by some mild physical therapy with stretching exercises. More severe cases, may require surgery.
Hand and Wrist Arthritis
The human hand is almost constantly in motion. It is both traumatized and overused and thus prone to both acute damage and chronic wear. Inflammation can be both an instigator and a result of osteoarthritis — the wear-and-tear affects of a life time use and repetitive trauma. Those with a family history of hand arthritis are more likely to develop the condition themselves. The most common, and at times disabling location of osteoarthritis in the hand, is at the base of the thumb — the joint that allows us to grip and manipulate objects.
General Non-Surgical Hand Treatments:
- Supportive Measures using braces or splints to protect from overuse and relieve pressure on the joints
- Occupational Therapy with ergonomic modifications for the way we use our hands and wrists
- Non-steroidal anti-inflammatory medications (NSAIDS)
- Corticosteroid Injections
Surgical Treatments for Specific Hand and Wrist Conditions:
Trigger Finger Release
The goal of this surgery is to release the constricting “pulley” that interferes with the flexion and extension action of the finger on the palmar side of the hand. This allows the flexor tendon to slide easier and precludes it from getting caught in a flexed position and thereby alleviating the pain.
Carpal Tunnel Release
The goal of this surgery is to release the constricting “volar carpal ligament” which crosses the wrist on the palmar side of the hand and thereby relieving the excessive pressures on the medial nerve as it passes directly below this “band”. Once the pressure is removed the symptoms of tingling and numbness should resolve. This procedure can be done through a traditional open approach or an arthroscopic one.
Arthroscopic Surgery of the wrist can be useful in the removal of damaged tissue within certain regions of the wrist joint and frequently it has a role in ligament reconstruction for wrist stabilization procedures.