The wrist consists of the forearm bones, the radius and ulna, and a group of bones called the carpal bones. Problems of the hand and wrist are common and can affect the bones, cartilage, tendons, and nerves. Problems can arise based on active lifestyle, repetitive motion, injury, overuse, or aging

Orthopedic Associates of Hartford’s hand specialists treat a full range of problems of the hand and wrist including arthritis, broken bones, carpal tunnel syndrome, loss of motion, tendon and nerve injuries, as well as other problems.

Some of the most common hand and wrist problems include: 

Sprains and strains: A sprain is a torn or stretched ligament. A strain is a torn or stretched tendon, which are the tissues that connect muscle to bone. Sprains and strains are two of the most common injuries affecting the hand and wrist. They occur as a result of excessive stress applied during a stretching, twisting, or thrusting action. Sprains and strains can be caused by sports activity or other repeated activity, a sudden twist, or an accidental fall.

Fractures: A bone fracture, or break, occurs when the force applied against a bone is stronger than the bone. The bones of the hands and wrists are very small in comparison to the bones of other joints, such as the hips, knees, and shoulders, and a fracture may be caused by a severe strain of a ligament or muscle. Crushing injuries to the hand or wrist also may cause fractures. Older adults are at higher risk of fractures since they lose muscle mass and bone strength as they age.

Carpal Tunnel Syndrome: Carpal tunnel syndrome is characterized by numbness or pain in the thumb and first two fingers. It is a common problem for people who use their hands for extended periods of time, such as workers in textile manufacturing, upholstering, assembly line, and in clerical keyboard work. Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist.

Arthritis: involves inflammation of one or more joints. The hand and wrist have multiple small joints that work together to produce motion, including the fine motion needed to thread a needle or tie a shoelace. When the joints are affected by arthritis, activities of daily living can be difficult. Arthritis can occur in many areas of the hand and wrist and can have more than one cause. Over time, if the arthritis is not treated, the bones that make up the joint can lose their normal shape. This causes more pain and further limits motion.

Trigger Finger: an inflammation of the tendon of one or more fingers. If you have the condition, it is usually difficult to extend or straighten the affected finger. Occasionally, when trying to open or extend the finger, it will pop or “trigger” into a straight position.

Wrist Ganglion: a small cyst filled with synovial fluid from around the joint. These cysts can usually be seen at the back of the wrist. They are usually painless, but excessive use of the hand or pressure to the ganglion may cause discomfort.

Hand & Wrist Disorders: There is a wide range of hand and wrist disorders that may be the result of injury, genetic predisposition, overuse, or other medical conditions.

These include:

  • Compartment Syndrome
  • Dupuytren's Contracture
  • Reflex sympathetic dystrophy
  • Ulnar Tunnel Syndrome of the Wrist
  • deQuervain's Tendinitis
  • Kienböck's Disease
  • Boutonnière Deformity
  • Dupuytren's Contracture

Symptoms associated with hand and wrist pain are varied based on the condition.

Some possible symptoms may include:

  • Dull or burning pain sensation – especially after increased joint use
  • Numbness or tingling in different parts of the thumb, finger, hand, or wrist
  • Occasional shock-like sensations that radiate from parts of the hand or wrist
  • Pain or tingling that may travel up the forearm toward the shoulder
  • Weakness and clumsiness in the hand – this may make it difficult to perform fine movements such as buttoning your clothes
  • Dropping things – due to weakness, numbness, or a loss of proprioception (awareness of where your hand is in space)

Symptoms vary in intensity from mild to severe.

Medical History and Examination
During your first visit, your orthopedic surgeon will gather information about your general health and ask questions about the extent of your hand and wrist pain and how it affects your ability to perform everyday activities. He will want to understand the duration and intensity of your symptoms and what types of actions lead to increased pain.

During the physical examination, your doctor will examine your hands and wrists and any other joints you may be experiencing problems with. Your doctor will be looking for areas that have tenderness, pain or swelling, as well as indications the joint may be damaged. He will perform physical tests to assess for numbness, weakness, tingling, or atrophy.

Depending on the findings of the history and exam, your doctor may order lab tests and imaging tests to help make or confirm a diagnosis.

X-Ray
These images help to determine the extent of damage or deformity in the hand, wrist, or fingers.

Other Tests
Other tests, such as a magnetic resonance imaging (MRI) scan, CAT scan, or ultrasound may be ordered. These tests can provide more details about internal structures and can show can show soft tissues, such as cartilage, ligaments, and muscles more clearly than x-ray. Electrophysiological tests may be conducted to measure how well nerves in the hand are working and whether nerve compression may be contributing to your symptoms.

 

There are a number of non-surgical and surgical options to restore mobility and reduce pain.

Non-Surgical Options:
When it comes to treating hand and wrist pain, there are many options. Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can help relieve pain and inflammation. When first-line treatment with anti-inflammatory medication is not effective, injections may be used. These typically contain a long-lasting anesthetic and a steroid that can provide pain relief for weeks to months. OAH has state of the art ultrasound machines that allow for these injections to be performed in the office setting. Splinting/bracing of the affected joint can help prevent bending the hand or wrist in certain directions and can reduce pressure on the nerves. The splint helps support the affected joint to ease the stress placed on it from frequent use and activities. Physical therapy may be recommended pre- or post-surgery to increase mobility and reduce pressure on certain joints.

Surgical Options:
If nonsurgical treatment fails to give relief, surgery is usually discussed. There are many surgical options and our team is skilled at the most advanced surgical techniques to inspect, diagnose, and repair hand and wrist problems. The chosen course of surgical treatment should be one that has a reasonable chance of providing long-term pain relief and return to function.

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Specialties

Spine Shoulder Elbow Hip Hand & Wrist Joint Replacement Knee Trauma & Fractures Foot & Ankle Pain Management Sports Medicine

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