The hand and wrist is a complex structure made of many tendons, ligaments and nerves. There are several diagnoses that can be made by an orthopaedic surgeon specializing in hand surgery. Someone who is experiencing wrist and thumb pain will need to have a better idea of what this problem could possibly be and when it is best to seek professional medical help.
Symptoms coming from the wrist and thumb can include pain, numbness, weakness and sometimes tingling of the fingers. Wrist pain can cause limited range of motion and sometimes pain going up the arm toward the elbow or even down into the fingertips. Sprains, strains and even fractures can cause severe symptoms, but it is the ongoing symptoms with a non-injury that can constitute a problem such as carpal tunnel or a ganglion cyst.
Knowledge of Hand and Wrist Disorders-Carpal Tunnel Syndrome
There are many disorders that can affect the wrist and the hand, along with having significant thumb pain. Carpal tunnel syndrome is a very painful condition which a person can get from performing repetitive motions over a period of time. The median nerve in your wrist can get irritated by the constant pressure being put on the nerve and can cause carpal tunnel symptoms. A person with this syndrome can have symptoms of tingling in his fingers along with pain sometimes going up the arm.
Knowledge of Hand and Wrist Disorders-Ganglion Cysts
A ganglion cyst can be present as a swelling or a soft-tissue bump around the back of the hand at the wrist joint or at the palm side of the wrist. Its cause is not exactly known, although very active persons are more prone to develop a ganglion cyst. Ganglion cysts form from a joint capsule or tendon underneath the skin and can become quite painful, especially if they become very large. A ganglion cyst is fairly easy to spot and is not very concerning unless there is pain and other symptoms involved.
Knowledge of Hand and Wrist Disorders-Dupuytren's Contracture
A Dupuytren's contracture is best described as a thickening of the skin in the palm and fingers. Nodules may appear in the palm and fingers along with pain. In general, the thickening skin can cause the fingers to drift toward the palm. A Dupuytren's contracture usually involves the small and ring fingers and it is more common in men than women. It does not come from any kind of injury and is more common in older adults.
Knowledge of Hand and Wrist Disorders-Arthritis of the Wrist
Arthritis in the wrist and thumb can cause pain and loss of mobility. It is usually best described as an aching type of pain that can sometimes be relieved by taking over-the-counter medicine. Arthritis of the wrist can affect many people, especially ones who have used their wrists and fingers in repetitive type movements for a long period of time. There are two types of arthritis: osteoarthritis and rheumatoid arthritis. Osteoarthritis typically presents with symptoms of pain, swelling and generalized weakness of the wrist and fingers. Rheumatoid arthritis symptoms present similarly the same except that grip strength is compromised. There can also be painful nodules that appear in the finger joints, especially in the knuckles.
Knowledge of Hand and Wrist Disorders-De Quervain's Tendinitis
De Quervain's tendinitis involves the base of the thumb. The tendons can become swollen and irritated, causing pain and decreased grip. If a tendon becomes inflamed, it causes the tendon to not be able to move like it should. It is sometimes due to overuse of the hand but can also be associated with rheumatoid arthritis and pregnancy.
Diagnosis and Treatment of Wrist and Thumb Pain
Carpal tunnel syndrome can be diagnosed by a series of tests that the physician will perform. He will ask a series of questions about the symptoms, severity and longevity of the problem. He will then perform a series of tests during the exam to determine a carpal tunnel syndrome. Surgical treatment can be considered if there is nerve entrapment determined. Non-surgical treatment can include over-the-counter medications, use of a night splint, and resting the wrist especially from repetitive motion-type activities.
Ganglion cysts are basically not harmful. These cysts are not cancerous and usually go away with time. However, some ganglion cysts can become painful enough that an aspiration of the fluid within the cyst may need to be done in order to relieve pain and, in some cases, shrink the cyst partially or even completely. Surgery may be required if all other forms of treatment have been tried without success.
A Dupuytren's contracture is usually a problem that evolves over time as the skin becomes more thickened in the palm and fingers. If a Dupuytren's contracture is diagnosed, an injection may be helpful to reduce the pain and allow more time before surgery is considered. Surgical treatment for a Dupuytren's contracture is considered when there is decreased motion, pain and when the fingers bend toward the palm and cannot be straightened out.
Arthritis of the wrist and thumb can be easily diagnosed by discussion of symptoms, tests that can be performed by a physician during an office visit and sometimes by the use of X-ray or MRI scanning. Osteoarthritis can be determined by the physician using the description of symptoms provided along with other tests. Osteoarthritis is a progressive condition caused by wear and tear, and the treatment will depend on the severity of the symptoms. Usually non-surgical treatment is utilized first, such as resting, splinting, medications and sometimes an exercise program. Surgical treatment is considered when conservative measures fail. Rheumatoid arthritis is an inflammatory disease that can destroy tissue, joints and bones. The non-surgical treatment is similar to the treatment for osteoarthritis and surgery is considered when conservative measures fail.
De Quervain's tendinitis involves the thumb. Tests to determine De Quervain's can be done at an office visit. Non-surgical treatment can include the use of a splint, anti-inflammatory medications and sometimes the use of a steroid injection to help with the pain and swelling. Surgical treatment is considered when conservative treatment fails and is accomplished by opening the compartment and making more room for the irritated nerve.