Hand, Upper Extremeties

It’s easy to take your hands and wrists for granted, but when you think about it, it’s amazing how much your hands can do. Each hand and wrist has 27 bones. It takes all of those to perform tasks, such as brushing your teeth, playing a musical instrument, or making home repairs. The hands also have a complex muscle and tendon system and three major nerves. The ends of these nerves are the most sensitive of all your nerves — they are how we touch and feel. Pick up a beverage and notice how you engage your hand, wrist, elbow and upper extremities.

Hand/upper extremities problems

Carpal tunnel syndrome

This is a common source of hand numbness and/or pain.

Sprains/strains

A sprain is an injury to a ligament in the hand or wrist. A strain is an injury of a muscle or tendon.

Repetitive stress injuries

These can be to any part of the hand, wrist, or elbow when the amount of intensity of the activity increases rapidly. The most common are stress fractures, which occur when muscles become fatigued and the bone takes on more weight. Stress fractures occur most often during exercise and sports participation.

Tennis elbow

This is common, painful injury occurring mostly where your forearm muscles attach to the bony bump on the outside of your elbow. It is not limited to tennis — it is often seen in patients who are plumbers, painters, carpenters, or others who use repetitive motion performing a job or playing a sport.

Ganglion cysts

These are the most common mass or lump in the hand, most frequently seen on the back of the wrist. They are not cancerous and, in most cases, are harmless. However, if the cyst is painful or interferes with function, it may call for treatment.

Osteoarthritis

Almost everyone develops some form of osteoarthritis as we age (though it's diagnosed for some younger people as well). By the time we reach 50 years or older, the cushioning material (cartilage) is eroding away. Without that cushion, bones rub against each other, which can be very painful and cause stiffness.

Rheumatoid arthritis

This disease is the most common form of a group of conditions known as inflammatory arthritis. Unlike osteoarthritis, it is not caused by wear and tear over the years. With rheumatoid arthritis, material, called the synovial membrane, surrounding the joint becomes inflamed and thickened. In time, this causes loss of cartilage along with pain and stiffness.

Post-traumatic arthritis

This is caused by a serious injury, such as a bone fracture or tears in the shoulder ligaments. Again, the cause of the pain and stiffness is the loss of cartilage.

Tendon/nerve injuries

These are generally due to deep cuts on the palm side your fingers, wrist, or forearm.

Dupuytren’s contracture

This is a thickening of the fibrous tissue layer underneath the skin of the palm and fingers. There’s generally no pain, but fibrous tissue can make fingers to flex/curl.

Post-traumatic arthritis

Just as it sounds, this can develop after an injury to the hand, wrist, or elbow. It’s similar to osteoarthritis and may develop years after a fracture, ligament injury, or tendon tear.

When should you see a doctor?

As with any joints, if pain or stiffness in your fingers, hands, wrists, or elbows, are keeping you from normal activities, it’s time to see your doctor. Make an appointment if you:

  • Experience severe pain
  • Feel lasting burning, stinging, tingling
  • Have noticeable swelling in your finger, wrist, or elbow joints
  • Find a bump or lump that concerns you
  • Have pain walking or using stairs
  • See your hands changing color, such as blue or red or getting very pale
  • Have stiffness that limits your mobility and/or range of motion

Surgery

It takes a specialist to determine the nature of the problem and the best medical solution. That’s why The Joint Center at the OICM does an initial evaluation of your symptoms. Minor injuries can often be taken care of by applying ice and wrapping the hand or wrist with an elastic bandage. Other nonsurgical treatments include appropriate pain medication, anti-inflammatory medications, cortisone injections, and physical therapy. When conservative measures fail to alleviate pain and restore mobility, surgery may be necessary.

There is a very long list of hand, wrist, and elbow surgeries our specialists have performed at the OICM. They can range from hand reconstruction to microscopic repair of nerve injuries.