Hand Conditions

What are some common hand conditions?

Arthritis

Arthritis is joint inflammation and can occur in multiple areas of the hand and wrist. Arthritis of the hand can be very painful.

Osteoarthritis

Osteoarthritis is one of the most common forms of arthritis in the hands and may be caused by normal use of the hand or it may develop after an injury. Osteoarthritis usually develops in one of 3 places: the base of the thumb, at the end joint closest to the finger tip, or at the middle joint of a finger.

Signs and symptoms of osteoarthritis include: 

• Stiffness
• Swelling and pain
• Bony nodules at the middle or end joints of the finger
• Pain and possibly swelling at the base of the thumb
• Loss of strength in the fingers and the grip of the hand

Treatment for osteoarthritis includes:

• Nonsteroidal anti-inflammatory drugs
• Resting  the affected hand
• Wearing splints at night
• Using heat to soothe the pain
• Using ice to reduce swelling
• Possible cortisone injections
• Possible surgery when no other treatments work 

Carpal tunnel syndrome

Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through the carpal tunnel in the wrist, a narrow confined space. Since the median nerve provides sensory and motor functions to the thumb and 3 middle fingers, many symptoms may result.

The following are the most common symptoms for carpal tunnel syndrome. Symptoms may include:

• Trouble gripping objects with the hand(s)
• Pain or numbness in the hand(s)
• “Pins and needles” feeling in the fingers
• Swollen feeling in the fingers
• Burning or tingling in the fingers, especially the thumb and the index and middle fingers

The symptoms of carpal tunnel syndrome may look like other conditions such as tendonitis, bursitis, or rheumatoid arthritis. Always see your healthcare provider for a diagnosis.

Treatment may include:

• Splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel)
• Oral or injected (into the carpal tunnel space) anti-inflammatory medicines (to reduce the swelling)
• Surgery (to relieve compression on the nerves in the carpal tunnel)
• Changing position of a computer keyboard, or other ergonomic changes

Ganglion cysts

Soft, fluid-filled cysts can develop on the front or back of the hand for no apparent reason. These are called ganglion cysts — the most common, benign (noncancerous), soft-tissue tumor of the hand and wrist.

The following are the most common symptoms for ganglion cysts include:

• Wrist pain that is aggravated with repeated use or irritation
• A slow growing, localized swelling, with mild aching and weakness in the wrist
• An apparent cyst that is smooth, firm, rounded, or tender

The symptoms of ganglion cysts may look like other medical conditions or problems. Always see your healthcare provider for a diagnosis.

Initially, when the cyst is small and painless, treatment is usually not needed. Only when the cyst begins to grow and interferes with the functionality of the hand is treatment usually necessary. Treatment may include:

• Rest
• Splinting
• Nonsteroidal anti-inflammatory medicines
• Aspiration
• Cortisone injections
• Surgery

Tendon problems

Two major problems associated with tendons include tendonitis and tenosynovitis. Tendonitis, inflammation of a tendon (the tough cords of tissue that connect muscles to bones) can affect any tendon, but is most commonly seen in the wrist and fingers. When the tendons become irritated, swelling, pain, and discomfort will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. The tendon sheath is usually the site which becomes inflamed, but both the sheath and the tendon can become inflamed simultaneously. The cause of tenosynovitis is often unknown, but usually strain, overuse, injury, or excessive exercise may be implicated. Tendonitis may also be related to disease (such as, diabetes or rheumatoid arthritis).

Common tendon disorders include the following:

• DeQuervain’s tenosynovitis. The most common type of tenosynovitis disorder characterized by the tendon sheath swelling in the tendons of the thumb.
• Trigger finger/trigger thumb. A tenosynovitis condition in which the tendon sheath becomes inflamed and thickened, thus preventing the smooth extension or flexion of the finger/thumb. The finger/thumb may lock or “trigger” suddenly.
• Lateral epicondylitis (commonly known as tennis elbow). A condition characterized by pain in the back side of the elbow and forearm, along the thumb side when the arm is alongside the body with the thumb turned away. The pain is caused by damage to the tendons that bend the wrist backward away from the palm.
• Medial epicondylitis (commonly known as golfer’s or baseball elbow). A condition characterized by pain from the elbow to the wrist on the palm side of the forearm. The pain is caused by damage to the tendons that bend the wrist toward the palm.