Hand & Wrist Surgery

What are Common Symptoms?

Hand and wrist pain can arise from various conditions affecting the bones, joints, ligaments, tendons, nerves, or other structures in the hand and wrist. Here are some common symptoms associated with hand and wrist pain:

  • Pain: Persistent or intermittent pain in the hand or wrist is the primary symptom. The pain may vary in intensity and may be dull, aching, sharp, or throbbing in nature.
  • Swelling: Inflammation of the hand or wrist may cause visible swelling or puffiness.
  • Stiffness: Difficulty moving the hand or wrist through its full range of motion. The affected joint may feel stiff and may be accompanied by a feeling of tightness.
  • Weakness: A sense of weakness in the hand or wrist, making it challenging to grip objects firmly or perform certain activities.
  • Tenderness: The affected area may be tender to touch or pressure.
  • Numbness or Tingling: Sensations of pins and needles or loss of sensation in the hand or fingers, indicating possible nerve involvement.
  • Limited Range of Motion: Difficulty flexing or extending the fingers or moving the wrist.
  • Clicking or Snapping: Some individuals may experience clicking or snapping sensations in the hand or wrist during movement.
  • Radiating Pain: Pain that extends from the hand or wrist up the arm or into specific fingers, often following the path of a specific nerve.
  • Locking or Catching: A feeling that the hand or wrist joint “catches” or gets stuck during movement.
  • Discoloration or Bruising: Injuries to the hand or wrist may cause bruising or discoloration of the skin.
  • Joint Deformities: In some cases, chronic conditions like arthritis may lead to visible changes in the shape or alignment of the hand or wrist joints.

Common Causes

Common causes of hand and wrist pain include:

  • Carpal Tunnel Syndrome: Compression of the median nerve as it passes through the carpal tunnel in the wrist, leading to pain, tingling, and numbness in the hand and fingers.
  • De Quervain’s Tenosynovitis: Inflammation of the tendons on the thumb side of the wrist, causing pain and difficulty with thumb and wrist movement.
  • Ganglion Cysts: Noncancerous, fluid-filled lumps that may form near tendons or joints, causing discomfort and limiting movement.
  • Wrist Sprains or Fractures: Injuries to the wrist ligaments or bones due to falls or accidents.
  • Osteoarthritis: Degenerative joint disease that can affect the hand and wrist joints.
  • Rheumatoid Arthritis: An autoimmune condition that can cause inflammation and damage to the hand and wrist joints.
  • Tendinitis: Inflammation of the tendons in the hand or wrist, often due to overuse or repetitive movements.
  • Trigger Finger: A condition in which the finger catches or locks in a bent position due to inflammation of the tendon sheath.
  • Dupuytren’s Contracture: A condition in which the tissue beneath the skin of the palm thickens and tightens, causing the fingers to bend inward.
  • Referred Pain: Pain originating from a different location, such as the neck or forearm, but felt in the hand or wrist.

If you experience persistent or severe hand and wrist pain or any accompanying symptoms, it’s important to seek medical evaluation from a orthopedic specialist. Proper diagnosis is crucial to determine the underlying cause of the pain and develop an appropriate treatment plan. Treatment options may include rest, physical therapy, pain medication, corticosteroid injections, splinting, or in some cases, surgery, depending on the specific condition and individual needs.

Common Treatments

The treatment for hand and wrist pain depends on the underlying cause of the pain. Here are some common treatments that may be used to alleviate hand and wrist pain:

  • Rest and Immobilization: Taking a break from activities that worsen the pain and allowing the hand and wrist to rest can promote healing. In some cases, wearing a splint or brace to immobilize the affected area may be recommended.
  • Physical Therapy: A physical therapist can design exercises and stretches to improve strength, flexibility, and function in the hand and wrist. They may also provide manual therapy techniques to reduce pain and improve mobility.
  • Pain Medication: Over-the-counter pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can help reduce pain and inflammation.
  • Corticosteroid Injections: In cases of severe inflammation or pain, corticosteroid injections may be administered directly into the affected area to provide temporary relief.
  • Cold and Heat Therapy: Applying ice packs to reduce inflammation and swelling or using heat therapy to relax the muscles can be beneficial.
  • Activity Modification: Avoiding or modifying activities that aggravate the pain can aid in the healing process.
  • Hand Exercises: Engaging in hand exercises can help maintain strength and flexibility and may be particularly beneficial for conditions like arthritis.
  • Nerve Gliding Exercises: For conditions like carpal tunnel syndrome, specific nerve gliding exercises can help reduce nerve compression and symptoms.
  • Joint Protection Techniques: Learning proper ergonomics and joint protection techniques can prevent exacerbation of symptoms in conditions like arthritis.
  • Medication for Nerve-related Pain: For conditions involving nerve pain or tingling, medications like gabapentin or pregabalin may be prescribed.
  • Ganglion Cyst Aspiration: For ganglion cysts causing pain or discomfort, aspiration (draining the fluid from the cyst) may be performed.
  • Surgery: In cases of severe injuries, fractures, or conditions that do not respond to conservative treatments, surgery may be considered. Procedures may involve repairing ligaments, removing cysts, or addressing structural issues in the hand and wrist.

There are several surgical procedures for hand and wrist conditions, each designed to address specific issues and provide relief from pain or improve hand and wrist function. Here is a list of common surgical procedures for the hand and wrist:

  • Carpal Tunnel Release: A surgery to relieve pressure on the median nerve by cutting the transverse carpal ligament in the wrist, performed to treat carpal tunnel syndrome.
  • Trigger Finger Release (Trigger Thumb Release): A procedure to release the tendon sheath and allow smooth movement of the flexor tendons, relieving triggering or locking of the finger or thumb.
  • Dupuytren’s Contracture Release (Fasciectomy or Fasciotomy): A surgery to remove the thickened and contracted tissue (fascia) in the palm and fingers to improve hand function.
  • Ganglion Cyst Removal: A procedure to remove a fluid-filled cyst that develops near a joint or tendon in the hand or wrist.
  • De Quervain’s Release (De Quervain’s Tenosynovitis Release): A surgery to release the tendon sheath covering the tendons at the base of the thumb to treat De Quervain’s tenosynovitis.
  • Tendon Repair (Flexor Tendon Repair or Extensor Tendon Repair): A surgery to repair a torn or lacerated flexor or extensor tendon in the hand or wrist.
  • Wrist Arthroscopy: A minimally invasive procedure using a small camera (arthroscope) to visualize and treat various wrist problems, such as ligament tears or cartilage injuries.
  • Wrist Fusion (Wrist Arthrodesis): A surgery to fuse the bones of the wrist joint, often performed to treat severe arthritis or instability.
  • Wrist Ligament Repair or Reconstruction: A surgery to repair or reconstruct damaged ligaments in the wrist, restoring stability.
  • Scaphoid Fracture Fixation: A surgery to stabilize a fractured scaphoid bone in the wrist using screws or other fixation devices.
  • Thumb Basal Joint Arthroplasty (LRTI – Ligament Reconstruction Tendon Interposition): A surgery to treat thumb arthritis by removing the damaged joint and reconstructing it using nearby tendons.
  • Thumb Ulnar Collateral Ligament (UCL) Repair (Gamekeeper’s Thumb Repair): A procedure to repair a torn UCL in the thumb.
  • Metacarpal Fracture Fixation: A surgery to stabilize a fractured metacarpal bone in the hand using screws, plates, or pins.
  • Hand Tumor Removal: A procedure to remove benign or malignant tumors in the hand.
  • Nerve Decompression: A surgery to decompress or release compressed nerves in the hand or wrist, such as the median nerve or ulnar nerve.
  • Trapeziectomy: A surgery to remove the trapezium bone at the base of the thumb to treat arthritis.
  • Wrist Joint Replacement (Wrist Arthroplasty): A procedure to replace the damaged wrist joint with an artificial joint made of metal and plastic components.

Please note that the appropriateness of these surgical procedures depends on the individual’s specific hand and wrist condition, symptoms, and the expertise of the orthopedic surgeon. Non-surgical treatments are often considered as the first line of management for many hand and wrist conditions, and surgery is typically reserved for cases where conservative measures have not provided adequate relief. Always consult with orthopedic surgeon to determine the most suitable treatment plan for your specific hand and wrist condition.

 

Injections for Arthritis: In cases of severe arthritis, injections of hyaluronic acid or other substances may be considered to provide lubrication and reduce pain.

 

It’s important to remember that proper diagnosis by a orthopedic specialist is essential for effective treatment. Self-diagnosis and self-treatment may not address the underlying cause and can potentially lead to complications. If you experience persistent or severe hand and wrist pain or any accompanying symptoms, it’s crucial to seek medical evaluation from an orthopedic specialist for an accurate diagnosis and personalized treatment plan.

Dr. S. Evan Carstensen

S. EVAN CARSTENSEN, M.D.
ORTHOPEDIC SPECIALIST

Board certified, fellowship trained orthopaedic shoulder, knee, hip, and sports medicine specialist managing injuries both non-operatively and operatively by specifically utilizing evidence-based medicine and minimally invasive techniques.

 

Dr. Daryl Dykes

DARYL DYKES, M.D.​
ORTHOPEDIC SPECIALIST

Board certified orthopedic surgeon with extensive experience in diagnosis, treatment and management of spine, bone or joint condition, and specializes in reconstruction of the shoulder, hip, and knee, including total joint replacement.

 

Dr. Lloyd Johnson

LLOYD JOHNSON, M.D.
ORTHOPEDIC SPECIALIST

Board-certified and fellowship-trained in both reconstructive and spine surgery with extensive experience in the management of complex conditions, diagnosis and treatment of:general orthopedics, spine disorders, sports medicine, orthopedic upper and lower extremities.

 

 

Dr. Loy Vaughan

LOY VAUGHAN, M.D.​
ORTHOPEDIC SPECIALIST

General orthopedic surgeon treating musculoskeletal condition with a particular interest in shoulder, hip, and knee joint replacement, shoulder and knee arthroscopy, and fracture care. Dr. Vaughan is a board-eligible orthopedic surgeon with experience in complex conditions, treatment and management.