Hand Pain & Problems

Transcription

1 Anatmy f the hand: Hand Pain & Prblems The hand is cmpsed f many different bnes, muscles, and ligaments that allw fr a large amunt f mvement and dexterity. There are three majr types f bnes in the hand itself, including the fllwing: phalanges - the 14 bnes that are fund in the fingers f each hand and als in the tes f each ft. Each finger has three phalanges (the distal, middle, and prximal); the thumb nly has tw. metacarpal bnes - the five bnes that cmpse the middle part f the hand. carpal bnes - the eight bnes that create the wrist. The carpal bnes are cnnected t tw bnes f the arm, the ulnar bne and the radius bne. Numerus muscles, ligaments, and sheaths can be fund within the hand. The muscles are the structures that can cntract, allwing mvement f the bnes in the Health Prblem -13 Hand Pain & Prblems

2 Hand Pain & Prblems hand. The ligaments are fibrus tissues that help bind tgether the jints in the hand. The sheaths are tubular structures that surrund part f the fingers. What are sme cmmn hand prblems? There are many cmmn hand prblems that can interfere with activities f daily living (ADLs), including the fllwing: arthritis Arthritis is jint inflammatin and can ccur in multiple areas f the hand and wrist. The pain assciated with arthritis may be frm many different surces, including inflammatin f the fllwing: synvial membrane - (jint lining) a clear, sticky fluid that is released by the synvial membrane and acts as a lubricant fr jints and tendns. tendns - the tugh crds f tissue that cnnect muscles t bnes. ligaments - a white, shiny, flexible band f fibrus tissue that binds jints tgether and cnnects varius bnes and cartilage. Ostearthritis, a degenerative jint disease, is the mst cmmn type f arthritis in lder peple. It is a slw-prgressing disease that primarily affects the hands and the large weight-bearing jints f the bdy, such as the knees and hips. Ostearthritis in the hands r hips may run in families, r be caused by injuries, veruse, muscle strain, r fatigue. Heberden ndes, abnrmal enlargements f the bne r cartilage - abut the size f a pea r smaller - may ccur in the finger jints, and may be aggravated by stearthritis. carpal tunnel syndrme Carpal tunnel syndrme is a cnditin in which the median nerve is cmpressed as it passes thrugh the carpal tunnel in the wrist, a narrw cnfined space. Since the median nerve prvides sensry and mtr functins t the thumb and three middle fingers, many symptms may result. The fllwing are the mst cmmn symptms fr carpal tunnel syndrme. Health Prblem -13 Hand Pain & Prblems

3 Hand Pain & Prblems Hwever, each individual may experience symptms differently. Symptms may include: difficulty making a fist difficulty gripping bjects with the hand(s) pain and/r numbness in the hand(s) "pins and needles" feeling in the fingers swllen feeling in the fingers burning r tingling in the fingers, especially the thumb and the index and middle fingers The symptms f carpal tunnel syndrme may resemble ther cnditins such as tendnitis, bursitis, r rheumatid arthritis. Always cnsult yur physician fr a diagnsis. Treatment may include: splinting f the hand (t help prevent wrist mvement and decrease the cmpressin f the nerves inside the tunnel) ral r injected (int the carpal tunnel space) anti-inflammatry medicatins (t reduce the swelling) surgery (t relieve cmpressin n the nerves in the carpal tunnel) changing psitin f a cmputer keybard, r ther ergnmic changes ganglin cysts Sft, fluid-filled cysts can develp n the frnt r back f the hand fr n apparent reasn. These are called ganglin cysts - the mst cmmn, benign (nn-cancerus), sft-tissue tumr f the hand and wrist. The fllwing are the mst cmmn symptms fr ganglin cysts. Hwever, each individual may experience symptms differently. Symptms may include: wrist pain that is aggravated with repeated use r irritatin a slw grwing, lcalized swelling, with mild aching and weakness in the wrist an apparent cyst that is smth, firm, runded, and/r tender Health Prblem -13 Hand Pain & Prblems

4 Hand Pain & Prblems The symptms f ganglin cysts may resemble ther medical cnditins r prblems. Always cnsult yur physician fr a diagnsis. Initially, when the cyst is small and painless, treatment is usually nt necessary. Only when the cyst begins t grw and interferes with the functinality f the hand is treatment usually necessary. Treatment may include: rest splinting nnsteridal anti-inflammatry medicatins aspiratin crtisne injectins surgery Tendn prblems Tw majr prblems assciated with tendns include tendnitis and tensynvitis. Tendnitis, inflammatin f a tendn (the tugh crds f tissue that cnnect muscles t bnes) can affect any tendn, but is mst cmmnly seen in the wrist and fingers. When the tendns becme irritated, swelling, pain, and discmfrt will ccur. Tensynvitis is the inflammatin f the lining f the tendn sheaths which enclse the tendns. The tendn sheath is usually the site which becmes inflamed, but bth the sheath and the tendn can becme inflamed simultaneusly. The cause f tensynvitis is ften unknwn, but usually strain, veruse, injury, r excessive exercise may be implicated. Tendnitis may als be related t disease (i.e., diabetes r rheumatid arthritis). Cmmn tendn disrders include the fllwing: lateral epicndylitis (cmmnly knwn as tennis elbw) - a cnditin characterized by pain in the back side f the elbw and frearm, alng the thumb side when the arm is alngside the bdy with the thumb turned away. The pain is caused by damage t the tendns that bend the wrist backward away frm the palm. medial epicndylitis (cmmnly knwn as glfer's r baseball elbw) - a cnditin characterized by pain frm the elbw t the wrist n the Health Prblem -13 Hand Pain & Prblems

5 Hand Pain & Prblems palm side f the frearm. The pain is caused by damage t the tendns that bend the wrist tward the palm. rtatr cuff tendnitis - a shulder disrder characterized by the inflammatin f the shulder capsule and related tendns. DeQuervain's tensynvitis - the mst cmmn type f tensynvitis disrder characterized by the tendn sheath swelling in the tendns f the thumb. trigger finger/trigger thumb - a tensynvitis cnditin in which the tendn sheath becmes inflamed and thickened, thus preventing the smth extensin r flexin f the finger/thumb. The finger/thumb may lck r "trigger" suddenly. Treatment fr mst tendn prblems may include: activity mdificatin ice splinting r immbilizatin sterid injectins nnsteridal anti-inflammatry medicatins surgery What are ganglin cysts? These nn-cancerus, fluid-filled cysts are the cmmn masses r lumps in the hand and usually fund n the back f the wrist. They arise frm irritated r inflamed ligaments, jint linings, r tendn sheaths. They may appear, disappear, r change size quickly, and may nt require treatment unless they are painful, interfere with activity, r have an undesirable appearance. What is carpal tunnel syndrme? Symptms f carpal tunnel syndrme ften include: numbness and tingling in the hand, especially at night pain with prlnged gripping such as hlding a steering wheel clumsiness in handling bjects Health Prblem -13 Hand Pain & Prblems

6 Hand Pain & Prblems The symptms are caused by pressure n the median nerve as it enters the hand thrugh a tunnel in the wrist. Pain frm carpal tunnel syndrme can radiate up the arm t the shulder. Carpal tunnel syndrme may be treated with: brace r splint ral medicatins crtisne injectin surgery What is tendinitis f the wrist? This cnditin is an irritatin and swelling f the sheath r tunnel that surrunds the thumb tendns. It may be caused by veruse and is als seen in assciatin with pregnancy r inflammatry arthritis. Mdificatin f the activity that initially caused the symptms may be required, fllwed by treatment with a splint, injectin with sterids, r taking anti-inflammatry medicatins. Sme cases may require surgery. Arthritis f the Hand: Arthritis is very cmmn at the base f the thumb, and can be treated with anti-inflammatry medicatin, sterid injectins int the jint, r splinting. Heberden ndes are bumps that ccur at the last jint f the finger r thumb due t arthritis. They are small bne spurs that frm ver the back f the jints and make them appear lumpy, but are nt painful and seldm interfere with functin. Treatment may r may nt be necessary. What is Dupuytren's cntracture? This is a hereditary thickening f the tugh tissue, called fascia, that lies just belw the skin f the palm. Small lumps r bands appear, which may eventually pull the fingers int the palm. Dupuytren's disease runs in Health Prblem -13 Hand Pain & Prblems

7 Hand Pain & Prblems families, but may als be assciated with cigarette smking, vascular disease, epilepsy, and diabetes. The small ndules r lumps in the palm d nt need treatment unless they becme very large r interfere with hand functin. Surgical treatment may be recmmended if there is prgressive drawing f the fingers int the hand. Bands may reappear r ccur in ther fingers. What is trigger finger? This is an irritatin f the digital sheath that surrunds the flexr tendns. When the sheath surrunding the tendn becmes swllen, it pinches the tendn and prevents it frm gliding smthly. The tendn catches and then suddenly releases an actin similar t pulling and releasing a trigger. Swelling in the tendn sheath can be treated with rest, activity mdificatin, anti-inflammatry, r sterid injectins. Sme cases may require surgery t release the tendn. Health Prblem -13 Hand Pain & Prblems