We can help you overcome hand pain and injury
We use our hands to perform almost all daily tasks. It's not a surprise that the hands, fingers and wrist can experience wear, tear, and injury, especially for athletes and individuals with demanding work environments. Without the full use of our hands and wrists, it can be difficult to complete the simplest of tasks.
The hand and wrist are both composed of multiple joints. Injury is common in athletes, recreational sport and exercise, and in the general population. More recently, there has been increased numbers of hand and wrist injuries due to technology use like cell phones, tablets, and keyboarding. These complex movements of fine motor coordination combined with physical activity leave the hand and wrist more vulnerable to injury if preventive measures are not taken or if left undiagnosed and untreated.
Similar to any part of the body, hand and wrist issues can be caused by injuries or the natural process of aging. Symptoms may include burning or stinging sensation, a tired, sore, stiff, or numb feeling, or loss of mobility due to swelling and bruising.
VSMD Approach
At VSMD, we diagnose hand and wrist issues by analyzing medical history, conducting a physical exam, and using imaging such as ultrasound and x-ray. Based on the findings, the doctor may recommend a conservative treatment to reduce pain and swelling and allow the affected area to heal properly. In case of a tear or fracture, the doctor may prescribe a more involved approach to initiate the healing process.
For most hand issues, a non-surgical regiment with frequent evaluation by the doctor is the best course. At VSMD, we treat each patient through a holistic lens. Our doctors not only evaluate the hand and wrist but also the accompanying systems.
Causes of Hand Pain and Injury
There are many injuries that can occur at and near the hand and all athletes are subject to have injury whether from contact, jamming, twisting, or overuse. Below are some common injuries and conditions that affect the hand and wrist.
Common problems include:
Trigger Finger
Trigger finger is when the finger gets caught or stuck in the bent position. Straightening the finger will typically cause a snapping or popping such as when a trigger is released. Trigger finger occurs due to irritation and inflammation of a finger flexor (bending) tendon. When the tendon becomes inflamed, the finger is unable to have a smooth motion and produces the triggering. This typically is painful. Risk factors for trigger finger include repetitive or heavy use of fingers and hands and medical conditions like diabetes, thyroid disease, and rheumatoid arthritis. Trigger finger is most common in the ring finger, followed by the thumb.
Wrist Fracture
The wrist is made up of 8 bones that are all connected by ligaments and the distal radio-ulnar joint (where the arm bones meet the wrist bones). A fracture of the wrist can mean a fracture of the arm bones at the wrist level (radius and ulna) or a fracture of any of the 8 wrist bones.
Symptoms of fracture can include pain, swelling, bruising, and reduced motion of the wrist.
Finger Fracture and Dislocation
The fingers have bones called phalanx (single) or phalanges (plural) and metacarpals (bones between the wrist bones and fingers). The fingers have three main joints: 1) metacarpolphalangeal (the knuckle joint), 2) proximal interphalangeal, and 3) distal interphalangeal. Each of the bones in the hand is susceptible to fracture. Fractures typically occur due to a crush or direct hit or force (like falling on the hand or hitting it against something). Symptoms of a finger fracture and/ or dislocation can include pain, swelling, bruising, and reduced motion of the finger. If there is dislocation, the finger may appear crooked or out of alignment.
Skiers Thumb
Skiers thumb is an injury to the ulnar collateral ligament (UCL) of the thumb. The UCL is a strong band of fibrous tissue that resists separation of the thumb from the index finger. An ulnar collateral ligament sprain is a stretch or tearing of the ulnar collateral ligament. Sprains occur when the thumb is pulled away from the index finger. This is a common injury in skiing, due to gripping the ski pole during a fall, so it may be referred to as a “skier’s thumb”. It may also occur after falling on an outstretched thumb or hooking a thumb into a jersey or facemask. Sprains may just be stretching of the UCL, partial tearing, or completely tearing the ligament.
Symptoms of an UCL injury include swelling, pain with movement of the thumb and on the inside of the thumb, weakness in pinching and holding objects between the index finger and thumb.
Jersey Finger
Jersey finger is an injury to a tendon that flexes, or bends, the fingertip. The injury is named for its common mechanism, when the finger is used to hook a jersey that is being pulled away. This forceful pull on a flexed finger causes disruption and tearing of the tendon. This most commonly occurs in the ring finger. The tendon can retract all the way back to the palm and therefore with no ability to flex the tip of the finger.
Symptoms may include pain and swelling on the palm side of the affected finger and inability to flex the tip of the finger.
Intersection Syndrome
Intersection syndrome is an overuse injury similar to De Quervain’s tenosynovitis and is characterized by irritation and swelling of the thumb side of the wrist and forearm. It is also called “oarsmen’s wrist” because it is most common in sports like rowing, with repetitive wrist movements. It also affects racquet sport athletes and people who participate in weight training.
Symptoms of intersection syndrome may include pain and swelling on the back of their wrist and forearm above their thumb that is made worse by movement. Movement may cause a squeaking or high-pitched noise. They may also have swelling at the site of tendon irritation.
Triangular Fibrocartilae Complex (TFCC) Injury
The TFCC is an area on the ulnar (pinky) side of the wrist and is the most commonly injured area on the pinky side of the wrist. It is composed of various ligaments that help with wrist motion and stability. TFCC injuries may result from a fall onto an outstretched hand and turned out wrist or from a wrist being twisted while supporting weight. Another common way to injure the TFCC is to attempt to catch a falling object with an outstretched, extended and palms out (pronated) wrist. TFCC injuries can also be the result of overuse injuries, particularly in tennis players and heavy topspin forehands or serves, and in volleyball players.
DeQuervain’s Tenosynovitis
De Quervain’s tenosynovitis is an overuse injury characterized by thickening and swelling of the tendons that run from the base of the thumb to the wrist and forearm. The tendons involved move the thumb away from the hand. Most commonly, it occurs in people in their 30s – 50s, and occurs in women more frequently than men. It is most common in athletes who participate in sports with repetitive hand and wrist movements, like racket sports and golf.
Symptoms of de Quervain’s may include pain in the wrist or thumb made worse by movement. They may complain of pain while gripping or hitting, such as while playing golf, tennis, weight lifting, or rowing. They may also have swelling at the base of their thumb, decreased movement of the wrist and thumb, and sense their thumb sticking or locking with movement.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is irritation of the median nerve that passes through the wrist in the carpal tunnel. The carpal tunnel is an area where the nerve and flexor tendons of the fingers course through the wrist. Repetitive motions and/or excessive or prolonged pressure on the wrist can lead to irritation and inflammation of the median nerve. Median nerve injury may also occur with wrist fracture. The median nerve controls muscle strength and skin sensation over specific parts of the hand and wrist. It controls a few small muscles at the base of the thumb and sensation to the palmar side of the thumb, index finger, middle finger, and half of the ring finger. Athletes who are more susceptible to median nerve injury include gymnastics and cyclers.
Symptoms of carpal tunnel syndrome can include numbness, tingling, pain and/or weakness of the hand. Symptoms may be made worse by activity and for a period following activity and tend to be worse at nighttime.
Boxer’s Fracture
A “boxer’s fracture” is a break (fracture) in one of the metacarpal bones of the hand. These bones connect the finger bones to the wrist bones and help form the knuckles. Boxer’s fracture is named for the common injury in boxing that occurs when a person punches a hard object with a closed fist. The fifth metacarpal, or “pinky finger,” is most commonly injured, followed by the ring finger.
Symptoms may include pain around the fracture site, along with swelling, bruising, or discoloration. The injured knuckle may also look different or flat if the break was severe. Sometimes a crack or pop may be heard at the time of injury.
Frostbite and Burn
Frostbite is an injury that can occur after prolonged exposure to below freezing temperatures (< 0° C or 32° F). The most commonly affected body parts are the fingers and toes, although the tips of the nose, ears, and cheeks can be affected as well.
Burns are injuries to skin and soft tissue that may or may not be sport related. There are three degrees of burns depending on the extent of injury.
Symptoms of frostbite and burns depend on the severity of the injury. The most common symptoms of frostbite are “burning” pain or numbness of the affected body part, pale appearing skin, and possibly blistering of the skin.