the patient’s guide to hand and wrist pain · because the incisions made were small, recovery...

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The paTienT’s guide To

HAND AND WRIST PAIN

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HAND AND WRIST PAIN

Table of ContentsIntroduction ...........................................................................3

The Anatomy of the Hand and Wrist .......................................4

Common Hand and Wrist Injuries ..........................................5

Common Hand and Wrist Diseases and Conditions ...............8

Treatment Options ................................................................11

Keeping Your Hands and Wrists Healthy ..............................13

Conclusion ............................................................................13

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The hands and wrists are essential for performing everyday tasks. We utilize them for almost everything we do. Because of the constant stress we put on our hands and wrists, they are very susceptible to injury.

This educational guide will help you understand the way hands and wrists work, explain common injuries, and discuss the treatment options available to help you find relief.


HAND AND WRIST PAIN

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THE ANATOMY OF THE HAND AND WRISTThe hand and wrist is made up of 27 small bones that allow your fingers, hands, and wrists to perform many different movements. Understanding the structure of these body parts will allow you to determine what is causing your hand and wrist pain.

The wrist is made up of eight bones called the carpal bones, plus the two long bones in your forearm – the radius and ulna. The wrist joint is complex and is made up of a collection of bones and joints that allow you to move your hand. The carpal bones are arranged in two rows; one connects to the ends of the radius and ulna and the other row connects to the bones in the palm of the hand.

The structure of the palm consists of five metacarpal bones that span from the thumb across to the pinky finger. The bases of the metacarpal bones connect to the carpal bones in the wrist, and the heads of the metacarpals connect to the finger bones, known as the phalanges, to form the knuckles.

Each finger has three phalanges: proximal (base), middle, and distal (head). The one exception is the thumb which only has two: the proximal and phalanx.


COMMON HANDAND WRIST INJURIESThe hand and wrist are used so frequently that injuries can often occur. Repetitive actions also cause a lot of wear and tear that leads to damage to the cartilage, tendons, muscles, or bones. The most common hand and wrist injuries include the following.

FracturesThe bones in the fingers, wrists, or hand can fracture easily. A finger fracture occurs most often when there’s trauma to the hand. Though the bones in the fingers are small, fracturing them is not a minor injury because it can throw the rest of your hand out of alignment.

Symptoms of a fractured finger include swelling, tenderness, bruising, loss of function, and deformity of the finger.

For moderate finger fractures, your doctor will put your finger in a splint or a cast for a few weeks to protect it while it’s healing properly. Severe finger fractures could require a surgery involving pins or screws to hold the fractured bones together.

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Wrist sprainsThe many ligaments in the wrist can become stretched or torn, causing a wrist sprain. This often happens as a result of a forceful bend of the wrist, such as falling on an outstretched hand.

A sprained wrist is given a grade based on the severity of the injury. Grade 1 is a mild sprain where the ligaments are stretched, but haven’t torn. Grade 2 is a moderate sprain where the ligaments are partially torn, so the range of motion may be limited. Grade 3 is a severe sprain and the ligaments have been completely torn.

Symptoms of a sprained wrist include swelling, pain when moving the wrist, bruising around the wrist, a popping or tearing feeling in the wrist, tenderness, and warm skin at the wrist.

Moderate sprains will need to be splinted for a couple of weeks, while severe sprains may require surgery to repair the

torn ligaments.


Flexor Tendon injuriesFlexor tendons are the tissues that connect the muscles to your bone to help control movement in your hand. The muscles that move the fingers are located in the forearm, and long tendons extend from the muscles to the bones in the fingers. The flexor tendons run along the palm side of the fingers and work to bend them. If you tear or damage your flexor tendons, you may not be able to bend your fingers.

Flexor tendons are located very close to the surface of the skin, so a deep cut could sever the tendon into two pieces. Partial tears or cuts are also possible, making it possible to bend the finger slightly but not completely.

Symptoms of a flexor tendon tear include an open cut on the palm, inability to bend one or more joints in the finger, pain when bending the finger, tenderness of the finger, and numbness in the fingertip.

If the tendon has been completely torn, it can’t heal on its own, so surgery will be necessary. The surgery is typically an outpatient procedure, so you’ll be able to go home the same day. Your hand will be splinted to ensure that it the tendon heals properly.

For partial tears that don’t require surgery, splinting will be effective in healing the tendon.

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COMMON HAND AND WRIST DISEASES AND CONDITIONSarthritisArthritis can affect the hand, wrist, and thumb specifically. There are many joints that make up the hand and wrist, so there are many opportunities for arthritis to cause painful symptoms. Arthritis is the swelling and inflammation of joints. Cartilage covers the ends of bones and creates a smooth surface for the joint, but this cartilage wears down and causes pain in a joint affected by arthritis.

Carpal Tunnel syndromeCarpal tunnel syndrome is a condition that causes numbness and pain in the hands. The carpal tunnel is a narrow, tube-like structure made up of bones and ligaments in the wrist. Inside this tunnel is the median nerve which runs from the forearm to the hand. The median nerve is responsible for the feeling in the palm side of the thumb, base of the thumb, index finger, and long fingers. Symptoms include numbness, tingling, pain, and a shock-like feeling that travels up the arm.

The level of pain will differ based on the grade of the sprain. A sprain is graded from mild to severe based on how far out of range the ligament has been stretched. A mild sprain only requires rest and stabilization from an ACE bandage, while a severe sprain may require immobilization or casting.


Flexor TendonsTissues responsible for bending the fingers and thumb also run through the carpal tunnel. When the tissues around the flexor tendons become inflamed due to injury or repetitive use, they put pressure on the median nerve which results in numbness and pain.

TendonitisTendonitis occurs when the thick cords of tissue that connect muscle to bone become inflamed. Inflammation is caused when the tendons are overused by repetitive actions. As a result, patients experience pain in the tendon area and loss of motion.

dupuytren’s ContractureThis condition causes the tissue in the palm of the hand to become thicker and shorter over time. As a result, the fingers bend inward. Symptoms of this condition include a hard lump at the base of the ring and pinky fingers, a cord across the palm, and limited motion when bending fingers or flattening your hand.

Mallet FingerThis condition occurs when the tendon on the top of the finger is torn or injured. Symptoms of mallet finger include pain, tenderness, swelling, and loss of motion. It can be treated with ice, immobilization, and anti-inflammatory medication. When the tear is severe, surgery may be necessary.

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gout Gout is a condition where patients experience sudden bouts of intense pain, swelling, and redness in the joints. Gout typically occurs in the joints of the big toe, but it can also affect the small joints in the finger.

This disorder is the result of an excess of uric acid accumulating in the bloodstream. The uric acid leaves the bloodstream and develops into painful, spike-like crystals that accumulate in the joints. The body reacts to the uric acid as foreign bodies and sends fighting cells to the area which causes inflammation. Treatment options include ice, rest, elevation, and anti-inflammatory medication. If needed, your doctor may also prescribe a stronger medication to help reduce the inflammation.

Trigger FingerTrigger finger is a condition where the tendons in the forefinger or thumb become stuck in a bent position. Symptoms of trigger finger include pain, stiffness, and a popping sensation when moving. Treatment options include rest, ice, compression, anti-inflammatory medication, corticosteroid injections, or surgery in severe cases.


TREATMENT OPTIONSnon-surgicalWhen injuries are not very severe, they can typically be treated with non-surgical methods.

MedicationAnti-inflammatory medications like ibuprofen are used to treat the symptoms of hand and wrist injuries and disorders. This medication will decrease inflammation and provide relief.

injectionsIf medication is not helping to relieve your pain, your doctor may suggest corticosteroid injections. Injecting the joint with a corticosteroid can typically decrease the swelling and the effects should last between a few weeks to a few months.

splintingSplinting the injured finger, hand, or wrist will immobilize the injured area so that you can perform activities without causing more harm to the injury. However, a splint shouldn’t be worn for long periods of time because this could result in loss of motion.

surgicalIf non-surgical methods have not been effective in treating the injury or providing pain relief, it may be too severe and could require a surgical procedure for repair.

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Wrist arthroscopy Wrist arthroscopy is a procedure that involves putting an arthroscope, or small camera, inside the joint to get a closer look at the damage or injury. The camera within the joint projects images onto a monitor. The surgeon watches the monitor as he or she guides small instruments to perform the surgery or just to get a better look inside the joint.

Because the incisions made were small, recovery will only take a few days or weeks. Be sure to keep the bandage clean and dry, apply ice, and elevate the wrist.

Wrist Joint ReplacementHaving a wrist joint replacement is less common than a knee or hip replacement because the surgery is a little more complicated. This option is typically performed on patients who are dealing with severe arthritis and a joint that is so damaged that it must be replaced.

During a wrist joint replacement, the damaged ends of the bones are removed and replaced with artificial joints. This will improve the range of motion in the wrist and allow you to perform daily activities without pain. In some cases, it can be done as an outpatient procedure.

Protecting your hands and wrists is crucial to prevent these overuse injuries from occurring. It’s especially necessary when you’ve had a hand or wrist injury in the past.


KEEPING YOUR HANDS AND WRISTS HEALTHYYou rely on your hands and wrists for almost everything, so make sure you protect them as much as you can. Take these few tips into consideration to keep your hands and wrists healthy and to prevent injuries.

Take Frequent BreaksOne of the main causes of wrist injuries and wrist conditions is performing repetitive activities for long periods of time such as typing on the computer, working on an assembly line, or swinging a tennis racquet. Be sure to take breaks while performing these activities to allow your wrists to recuperate.

Treat any injuriesIf you’re dealing with pain in your fingers, hands, or wrists, it’s important to see your doctor at the first sign of injury. Your injury could get worse if left untreated, so it’s crucial that you seek treatment right away.

extra supportConsider wearing a supportive brace while performing repetitive activities. This is particularly important during recovery in order to reduce the risk of reinjury. A brace can also prevent conditions from developing in the future.

CONCLUSIONWrist injuries and conditions are common, but if you’re dealing with pain, there are many options available to you that will provide relief and allow you to participate in normal activities again. It’s also important that you protect your wrists as much as possible, especially if you regularly perform tasks that are particularly damaging.

the patient’s guide to hand and wrist pain · because the incisions made were small, recovery...

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