What is Hand and Wrist Pain?
Most cases of hand and wrist pain will not be a sign of a serious or long-term issue and will get better in a few days or weeks with some simple self-care you can do at home.
Specific Hand and Wrist Conditions
There are several conditions that can affect the hand and wrist.
Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when there’s pressure on the median nerve as it passes through the carpal tunnel. This can cause tingling, numbness and pain, mainly in your hand and fingers. It can also cause similar symptoms in the wrist and forearm. Often the symptoms are worse at night.
If you think you have carpal tunnel syndrome, you should get an appointment at your GP surgery. Carpal tunnel syndrome can go away in a few weeks or months. Using a splint or having a steroid injection can help.
If symptoms don’t go away, a minor operation to relieve the pressure in the carpal tunnel can solve the problem.
De Quervain’s Tendinopathy
Problems can develop with tendons in the hand and wrist. Tendons have a protective covering, or sheath, with synovial fluid in. This thick fluid protects the tendon and allows it to move easier. Sometimes tendons or tendon sheaths can become inflamed. This can cause pain, swelling and stiffness and is called tendinopathy.
It can happen if tendons are overused, for example after playing a lot of sport. Arthritis can lead to tendinopathy, and in rare cases so can an infection. Sometimes, there might not be an apparent cause.
De Quervain’s (Dey kwer-veins) tendinopathy is a common condition that can affect tendons in the wrist, causing pain around the wrist and at the base of the thumb. Pain normally eases with rest and can get worse with activity.
Applying ice wrapped in a damp towel and taking an NSAID can help. If your condition is not improving and is affecting your quality of life, steroid injections, splints, hand therapy or surgery might also be helpful.
Trigger Finger
Trigger finger is the name of a condition in which you can’t straighten a finger or thumb properly. You might even need to use your other hand to straighten it. Very occasionally, a finger may become too painful to straighten and may stay stuck in the same position.
Trigger finger most commonly affects the thumb, ring and middle finger. More than one finger can be affected at the same time. The affected finger might swell, and it can be painful.
There can be a clicking or popping sensation that comes from the finger, especially in the morning. It’s thought to be caused by swelling of a tendon or tendon sheath. Sometimes the swelling can cause nodules to form. These are small lumps that form under the skin. Trigger finger can happen to otherwise healthy people for no clear reason. It’s more common among women over the age of 40.
It’s more likely if you’ve had a previous injury to the palm of the hand. Other medical conditions such as diabetes, gout, rheumatoid arthritis and an underactive thyroid may also increase someone’s risk of getting it.
Trigger finger can get better without the need for treatment. You may need to avoid certain activities, if it’s thought they’re making your symptoms worse. NSAIDs, like ibuprofen, can help. If it doesn’t get better on its own and it isn’t treated, it’s possible for an affected thumb or finger to become permanently bent. Treatment can involve steroid injections. In most cases this will sort out the problem.
In some cases, a small operation can be carried out to stop the tendon from catching.
Dupuytren’s Contracture
Dupuytren’s (due-per-trens) contracture can cause the fingers to bend in towards the palm of the hand. It’s caused by tissues in the palms of the hands gradually thickening, which then pulls the fingers towards the palm.
This condition is often mild and might not need specific treatment. It’s more common in men in their middle age. Some heavy, repetitive tasks, such as those that are performed in mining, are thought to increase the risk of Dupuytren’s. It normally affects the middle, ring and little finger. It’s not often painful, but it can make it difficult to straighten out fingers and use your hands properly. It may affect just one hand, but often affects both hands.
Treatment is only needed if fingers have started to bend, or if you can’t use your hand properly. Treatment options available in the earlier stages, include injections of a medicine called collagenase (colla-gen-ayse). This can break down the thickened tissues. This is a quick and easy treatment that doesn’t need to be done as an operation. You will need to have your fingers straightened and stretched afterwards by a healthcare professional, which might be a bit uncomfortable.
There are surgical options including cutting the thickened tissue or cutting it out. This can be done as an operation or using a needle in an outpatient clinic.
Talk to your doctor to discuss your options if your symptoms aren’t improving.
