Hand and Wrist
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Problems with the hand and wrist can make even simple tasks difficult. Whether you are experiencing an ongoing condition like arthritis or an injury like a fracture, UM Orthopaedics is here to help.
Our specialists use a comprehensive approach to diagnose and care for conditions of the hand and wrist. Our hand and wrist team of physicians, certified occupational and hand therapists and support staff helps patients resolve a wide range of problems.
Hand and Wrist Injuries
A break in a bone can happen for many reasons including:
- Accidents, falls or sports injuries
- Low bone density and osteoporosis
- Overuse that causes stress fractures, which can then lead to more complicated fractures
Whatever the cause, you need to get medical care right away for any fracture. And if the break is to the hand or wrist, you want to see a specialist trained in providing care to those areas.
When the cartilage that protects your joint wears down, bone rubs on bone, causing the pain, stiffness and swelling of arthritis.
Arthritis often occurs as a result of age and wear and tear on the joints, though it can also be caused by autoimmune conditions or a traumatic incident.
The hand and wrist, which have many bones and joints, are common places for arthritis to occur.
Carpal Tunnel Syndrome
Carpal tunnel syndrome affects the nerve that runs from the forearm through the carpal tunnel in the wrist to the hand. Tendons in the carpal tunnel may thicken or swell and pinch the nerve. This can cause pain, burning, numbness or tingling in your wrist, thumb or fingers.
Women and older people are most likely to have carpal tunnel syndrome. Other risk factors include repetitive motion, such as using a keyboard or mouse or grasping hand tools, and conditions such as arthritis, diabetes and being overweight.
When diagnosed early and if your symptoms are mild, these treatments can relieve pain and swelling without surgery:
- Splint or brace, usually worn at night to prevent movement
- Changes in your computer set-up to reduce wrist strain
- Resting your hands and wrists often during activities that increase pain
- Nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen
- Occupational or physical therapy
- Cortisone injections
However, sometimes surgery is necessary. Carpal tunnel release surgery is usually an outpatient procedure. It may be done as an open surgery or and endoscopic procedure that uses tiny surgical tools and a camera inserted through small incisions.
This thickening of the tough tissue, called fascia, that lies just below the skin of the palm causes small lumps or bands to form. Eventually they pull the fingers into the palm, making it hard to straighten them.
Dupuytren's disease is hereditary but may also be connected to cigarette smoking, vascular disease, epilepsy and diabetes.
Surgery and occupational therapy can usually release the tightening and restore normal movement. A newer treatment involves injections of collagenase, a type of enzyme that breaks down the collagen in the lumps.
Tendinitis and Sprains
A sprain is an injury to the ligaments, the strong, flexible tissue that hold bones together. Sprains happen when a joint is stretched too far or tears, such as with a sprained wrist, resulting in pain and swelling.
A mild sprain may heal in 7-10 days, but a bad sprain can take several weeks for the pain to go away. Occupational or physical therapy can help you regain motion and strength of a severe sprain.
Tendons are the soft tissues that connect muscles to bone and allow joints to move. Overuse can cause an inflammation called tendinitis. Or you may experience a cut tendons that requires physical therapy or even stitches.
This condition occurs when the sheath that surrounds the tendons in finger joints get irritated and swollen. The tendon doesn't move smoothly, catching and then quickly releasing the finger, similar to pulling and releasing a trigger.
Trigger finger can be treated with rest, changes in activity, anti-inflammatories or steroid injections. Some cases may require surgery to release the tendon.