Hand & Wrist Pain

Common causes of hand and wrist injuries include impact during sports or recreational activities, accidental falls and ageing wear and tear. Most minor injuries like cuts and bruises heal on their own, but certain injuries may lead to serious conditions that can affect hand function in the long run. In this section, we look at the common hand injuries that require prompt medical attention and care.

Arthritis

Arthritis occurs when there is inflammation in the joint area. Arthritis tends to occur in older patients or those who have previously injured their hand. Osteoarthritis in the hands is common. Osteoarthritis is mostly due to ageing wear and tear of the cartilage between the joints, reducing the protective cushioning and resulting in pain. Other causes include joint instability, genetic factors, or injury. Some patients may have other forms of inflammatory arthritis such as rheumatoid arthritis or gouty arthritis.

The symptoms of arthritis include pain, stiffness, limited motion, swelling at the joint area and at times a grinding sensation upon moving the joint. People with rheumatoid (inflammatory) arthritis may have longer morning stiffness and more swelling of the joints than those with osteoarthritis.

Depending on the severity of the condition, your doctor may prescribe medications or physiotherapy to alleviate the pain and swelling. Should symptoms persist, surgery may be needed to fuse the joint or replace it with an artificial one. Talk to your orthopaedic specialist to understand the treatment options available

Fracture

Trauma from falls or sports injuries may fracture the bones in the hand. If the bones are broken or displaced from its original position, prompt surgical attention is recommended.

Symptoms of bone fracture in the hand include pain, tenderness, swelling, deformity at the area of the fracture and limitation in movement. If you experience any of these symptoms, seek medical help promptly.

For minor cases, treatment usually requires immobilisation with cast support until the bone heals, which can take about 6 – 8 weeks. Surgery may be required to align and stabilise badly deformed fractures. Consult your orthopaedic specialist to understand the treatment options available

Trigger finger occurs when a finger becomes locked in a bent position. It is usually caused by the swelling or inflammation of one of the tendons flexing the finger. Common symptoms include a noticeable nodule in the palm or a popping sensation felt when trying to straighten the finger. Risk factors for trigger finger include repetitive use of the hands, and certain medical conditions such as diabetes or rheumatoid arthritis.

Signs & Symptoms

Common signs of trigger finger include:

• A painful snapping or popping sensation upon bending and straightening the finger
• A tender bump on the palm of the hand, near the base of the affected finger
• Finger stiffness or becoming locked at a bent position

If trigger finger is not treated promptly, the affected finger may become permanently stuck in a certain position, resulting in difficulty performing everyday tasks.

Diagnosis

Your doctor may check your medical history and perform a physical examination of the hand. Further diagnostic tests may be prescribed for a full assessment.

Treatment

Treatment for trigger finger depends on the severity and duration of the symptoms. In certain cases of early diagnosis, non-surgical methods such as splinting may help improve the condition. Your doctor may also prescribe medications to help alleviate the pain. Should symptoms persist, surgery may be recommended to release the affected sheath in order for the tendon to move freely again.  Talk to your orthopaedic specialist to understand more.

The median nerve controls sensation and movement in hands. Carpal tunnel syndrome occurs when the median nerve in the wrist is compressed. Common signs include numbness, a tingling sensation, weakness and occasional pain in the hand and wrist area. Causes of carpel tunnel syndrome include repetitive hand movements, pregnancy or arthritis.

Signs & Symptoms

In the early stages, gradual numbness, an occasional tingling sensation in the fingers (thumb, index and middle fingers) with some feeling of pain, are usually felt. Other common symptoms include:

• Weakness of the muscles at the base of the thumb
• Reduced dexterity and being prone to dropping objects
• Burning, prickling sensation in the hand similar to pins and needles
• Less sensitivity in the touch
• Discomfort in the hand

If you experience any of the above symptoms, it is important to seek medical help from an orthopaedic specialist promptly as carpal tunnel syndrome may lead to permanent nerve and muscle damage.

Diagnosis

Your doctor may check your medical history and perform a physical examination. The following diagnostic tests may be prescribed to further assess the condition.

• X-ray
• Nerve conduction study to observe the electrical activity in affected nerves

Treatment

Upon early diagnosis, non-surgical methods such as wrist splinting may help improve the condition. Your doctor may also prescribe medication to help alleviate the swelling that may be causing nerve compression and numbness. Should symptoms persist, surgery in the form of minimally invasive surgery may be required to help to relieve pressure on the impinged median nerve. Minimally invasive surgery causes less scarring and allows for a quicker return to function.  Consult your orthopaedic specialist to find out more.

De Quervain’s tenosynovitis is an inflammation of the tendon sheath (called the synovium) at the base of the thumb. The tendons that move the thumb become constricted in a tight tunnel. The inflammation comes from the friction created as the tendon glides along the thumb with repeated movements. The usual cause of De Quervain’s tenosynovitis is overuse of the wrist.

Signs & Symptoms

The main symptom of De Quervain’s tenosynovitis is pain over the wrist joint near the base of the thumb. Other symptoms include:

• Pain after increased activity involving the wrist and hand
• Pain beginning as an aching sensation and progressing to a sharp pain in the affected area
• Swelling in the affected area

If you experience any of the above symptoms, talk to your hand surgeon to find out more.

Diagnosis

Your doctor may check your medical history and perform a physical examination of the hand. Further diagnostic tests may be prescribed for a full assessment.

Treatment

Treatment usually includes:

• Non-steroidal anti-inflammatory drugs to relieve pain
• Steroid injection
• Wearing a splint to rest the area

If the symptoms persist without improvement, day surgery may be offered. The success rate of surgery is high and you will regain normal use of your hand upon recovery.  Talk to your hand surgeon to understand more.