There are many causes of hand pain. Arthritis, tendonitis, injury, overuse, trigger digits, and nerve and vascular disease are among the most common causes. While the pain is likely in response to an inflammatory condition associated with the above conditions, the causes and treatments can be very different.
While most new onset pains, especially those that can be related to an event, (i.e. new activity, routine or injury) can be safely treated with rest, some treatment plans require anti-inflammatories, physical therapy, and sometimes a splint or brace. Pain that does not go away or is escalating should be evaluated by a medical professional or Orthopedic Specialist.
Osteoarthritis is the most common cause of hand pain. There are 28 joint surfaces in the wrist and hand, all subject to developing arthritis. Osteoarthritis most commonly affects the joints in the fingers and base of the thumb. Inflammatory Arthritis (Rheumatoid/Psoriatic) preferentially attacks the knuckles and wrist joints. Correct diagnosis is very important as the treatments options can be quite different from one to the other.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is compression of the median nerve in the wrist. This results in numbness and tingling of the fingers including the thumb, index, long, and half of the ring finger. It commonly results from repetitive overuse of the hands. It can be associated with pregnancy and other forms of inflammatory arthritis. Diagnosis can be made by physical exam, or ElectroMyogram Study (EMG). Rest, NSAIDs, Night Splints and stretches can be helpful for episodic or new onset cases, but chronic Carpal Tunnel Syndrome usually responds best to surgery.
Trigger digits involve the flexor tendons of the hand and cause locking and triggering of the fingers when bending and straightening. It can be an annoyance or quite painful. Treatment ranges from rest and anti-inflammatories to surgery when conservative measures are not effective.
Tendonitis can affect any of the tendons in the hand but most commonly at junctions where tendons change directions or through strictures or “pulleys” which control their direction. Common conditions are given specific names, such as DeQuervaines disease, Trigger fingers, etc.
Raynauds disease is a vascular disease involving the hands in which the blood vessels respond to cold and narrow down, limiting blood flow to the fingers. This can be a very painful condition. Early treatment consists of avoiding cold exposure (gloves, hand warmers when outside) to medication. Surgical treatment is rarely necessary.
NonSteroidal Anti Inflammatories Drugs (NSAIDS) may help relieve hand pain. NSAIDS are an over-the-counter option that includes Ibuprofen, Naproxen, and other pain relievers. Topical arthritis remedies such as Voltaren (Diclofenac) Gel is an anti-inflammatory gel available over the counter and is applied to and absorbed through the skin of affected joints and is very effective. BioFreeze, BlueEmu, and Aspercreme are common topicals that are generally safe to use with varied results.
Over-the-counter treatments may help with the symptoms of hand pain, but additional treatment options advised by a physician or orthopedic specialist for some cases and conditions may be necessary if pain persists and does not improve.
Prairie Lakes Orthopedics
The Prairie Lakes Orthopedic Clinic has three Orthopedic Surgeons and two Advance Practice Providers that provide diagnosis, treatment, non-surgical and surgical care for conditions affecting the joints, bones, ligaments, nerves, and tendons. Appointments can be scheduled by calling 605-882-2630. No referral is necessary.
References: Essentials of Musculoskeletal Care 3rd Edition, Operative Surgery of the Hand, WebMD, Netters Atlas of Human Anatomy