Hand & Wrist Pain – Common Causes & Treatments
ARTHRITIS – BASE OF THE THUMB
In a normal joint, cartilage covers the end of the bones and serves as a shock absorber to allow smooth, pain-free movement. In osteoarthritis (OA, or “degenerative arthritis”) the cartilage layer wears out, resulting in direct contact between the bones producing pain and deformity. One of the most common joints to develop OA in the hand is the base of the thumb. Read More.
ARTHRITIS – OSTEOARTHRITIS
Arthritis literally means “inflamed joint.” Normally a joint consists of two smooth, cartilage-covered bone surfaces that fit together as a matched set and that move smoothly against one other. Arthritis results when these smooth surfaces become irregular and don’t fit together well anymore and essentially “wear out.” Arthritis can affect any joint in the body, but it is most noticeable when it affects the hands and fingers, causing hand and wrist pain. Read More.
ARTHRITIS – RHEUMATOID
There are many types of arthritis. Rheumatoid arthritis is just one type. Wear and tear arthritis (osteoarthritis), gouty arthritis, and psoriatic arthritis are three other common types. Rheumatoid Arthritis is considered a systemic disease. That is, it can affect many parts of the body. Patients often awaken with stiff and swollen joints. Early on, many patients feel tired. Two thirds of patients with rheumatoid arthritis have hand and wrist pain. Read More.
CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome (CTS) is a condition brought on by increased pressure on the median nerve at the wrist. In effect, it is a pinched nerve at the wrist. Symptoms may include numbness, tingling, and pain in the arm, hand, and fingers. Read More.
COMPLEX REGIONAL PAIN SYNDROME – CRPS
Formerly Known as Reflex Sympathetic Dystrophy (RSD) Complex regional pain syndrome (CRPS) is a pain condition that is constant over a long period of time that is believed to be the result of dysfunction in the central or peripheral nervous systems. CRPS is characterized by pain, swelling or stiffness in the affected hand or extremity.
CUBITAL TUNNEL SYNDROME
There is a bump of bone on the inner portion of the elbow (medial epicondyle) under which the ulnar nerve passes. When the pressure on the nerve becomes great enough to disturb the way the nerve works, then numbness, tingling, and pain may be felt in the elbow, forearm, hand, and/or fingers. Read More.
DE QUERVAIN SYNDROME
Patients with de Quervain syndrome have painful tendons on the thumb side of the wrist. In de Quervain syndrome, the tunnel where the tendons run narrows due to the thickening of the soft tissues that make up the tunnel. Hand and thumb motion cause pain, especially with forceful grasping or twisting. Read More.
EXTENSOR TENDON INJURIES
Extensor tendons, located on the back of the hand and fingers, allow you to straighten your fingers and thumb. These tendons are attached to muscles in the forearm. As the tendons continue into the fingers, they become flat and thin. In the fingers, smaller tendons from small muscles in the hand join these tendons. It is these small-muscle tendons that allow delicate finger motions and coordination.
FLEXOR TENDON INJURIES
The muscles that bend (flex) the fingers are called flexor muscles. These flexor muscles move the fingers through cord-like extensions called tendons, which connect the muscles to bone. The flexor muscles start at the elbow and forearm regions, turn into tendons just past the middle of the forearm, and attach to the bones of the fingers.
Ganglion cysts are very common lumps within the hand and wrist that occur adjacent to joints or tendons. The most common locations are the top of the wrist, the palm side of the wrist, the base of the finger on the palm side, and the top of the end joint of the finger. The ganglion cyst often resembles a water balloon on a stalk, and is filled with clear fluid or gel. They will cause hand and wrist pain, although not necessarily all the time.
GOUT AND PSEUDOGOUT
Gout and pseudogout-calcium pyrophosphate deposition disease (CPPD)-are two types of crystalline arthropathies which are disease processes that cause sore joints because salt crystals have formed in the joint. The crystals irritate the joints and sometimes surrounding tendons, causing the body to release chemicals that make the joints swollen and red.
Kienbock’s disease, or avascular necrosis of the lunate, is a condition in which the lunate bone, one of eight small carpal bones in the wrist, loses its blood supply, leading to death of the bone. The lunate is a central bone in the wrist, important for proper movement and support of the joint. The lunate, along with the adjacent bones on either side of it, the scaphoid and triquetrum, make up the proximal carpal row.
Nerves are the “telephone wiring” system that carries messages from the brain to the rest of the body. A nerve is like a telephone cable wrapped in insulation. An outer layer of tissue forms a cover to protect the nerve, just like the insulation surrounding a telephone cable. A nerve contains millions of individual fibers grouped in bundles within the “insulated cable.”
Psoriasis is a skin disease in which patients have dry, red and scaly skin rashes that can occur on any part of the body. Between 5-20% of patients with psoriasis may develop an associated arthritis. Read More.
The scaphoid bone is unique in that it links the two rows together. This puts it at extra risk for injury, which accounts for it being the most commonly fractured carpal bone.
The scaphoid is one of the eight small bones in the wrist. These small bones are arranged into two rows. During normal wrist motion, the wrist bones move in concert with one another to allow the flexibility and wide variety of positions that we take for granted. The scaphoid spans these two rows and is an important link for maintaining coordinated and stable movement of the wrist.
Vascular disorders of the upper-extremity are uncommon, but ones that may have lasting implications. Arteries bring oxygenated blood from the heart to the fingertips and veins return the used blood back to the heart and lungs. Read More.
The wrist is made up of eight small bones and the two forearm bones, the radius and ulna. A wrist fracture may occur in any of these bones when enough force is applied to the wrist, such as when falling down onto an outstretched hand. Read More.
The most common ligament to be injured in the wrist is the scapho-lunate ligament. It is the ligament between two of the small bones in the wrist, the scaphoid bone and the lunate bone. There are many other ligaments in the wrist, but they are less frequently injured. Read More.
Material modified from the American Society for Surgery of the Hand.