Medicine and Health
The hand is made up of many different bones, muscles, and ligaments that allow for a large amount of movement and dexterity. There are 3 major types of bones in the hand itself, including:
- Phalanges. The 14 bones that are found in the angers of each hand and also in the toes of each foot. Each nger has 3 phalanges (the distal, middle, and proximal). Only the thumb has 2 phalanges.
- Metacarpal bones. The 5 bones that make up the middle part of the hand.
- Carpal bones. The 8 bones that create the wrist. The carpal bones are connected to 2 bones of the arm, the ulnar bone and the radius bone.
Many muscles, ligaments, and sheaths can be found within the hand. The muscles are the structures that can contract, allowing movement of the bones in the hand. The ligament sare
brous tissues that help bind together the joints in the hand. The sheath sare tubular structures that surround part of the ngers.
What are common hand problems?
Thereare many common hand problem that can interfere with activities of daily living. They include:
Arthritis
Arthritis is loss of joint cartilage, often with in ammation, pain and sti ness. It can occurin many areas of the hand and wrist. Arthritis of the hand can be very painful.
Osteoarthritis
Osteoarthritis is one of the most common forms of arthritis in the hands. It may be caused by normal use of the hand. Or it may develop after an injury. Osteoarthritis often develops in one of 3 places: the base of the thumb, at the end joint closest to the ngertip, or at the middle joint of a nger.
Symptoms of osteoarthritis include:
- Sti ness Swelling and pain
- Bony nodules at the middle or end joints of the nger
- Pain and possibly swelling at the base of the thumb
- Loss of strength in the ngers and the grip of the hand Treatment for osteoarthritis includes:
- Over-the-counter pain and fever medicines (NSAID sor nonsteroidal anti-in ammatory drugs)
- Resting the a ectedhand
- Wearing splints at night Using heat to soothe the pain
- Using ice to reduce swelling
- Possible cortisone injections
- Possible surgery when no other treatments work
Carpal tunnel syndrome
With this condition, the median nerve is squeezed or compressed as it passes through the carpal tunnel in the wrist, a narrow, con ned space. Since the median nerve provides sensory and motor functions to the thumb and 3 middle ngers, many symptoms may result. Each person’s symptoms may be di erent. Symptoms may include:
- Trouble gripping objects with the hand
- Painor numbness in the hand
- "Pins and needles" feeling in the ngers
- Swollen feeling in the ngers
- Burning or tingling in the ngers, especially the thumb and the index and middle ngers
The symptoms of carpal tunnel syndrome may look like other conditions, such as tendonitis, bursitis, or rheumatoid arthritis. Always see your healthcare provider for a diagnosis.
Treatment may include:
- Splinting the hand. This is done to help prevent wrist movement and decrease the compression of the nerves inside the tunnel.
- Medicines to reduce swelling. Anti-in ammatory medicines can be taken by mouth (oral) or injected.
- Ergonomic changes. Making changes to your work environment, such as changing the position of a computer keyboard
- Surgery. This is done to relieve compression on the nerves in the carpal tunnel.
Ganglion cysts
Soft,uid- lled cysts can develop on the front or back of the hand for no apparent reason. These are called ganglion cysts. They are the most common noncancer, soft-tissue tumor of the hand and wrist.
- The most common symptoms for ganglion cysts include: Wrist pain that gets worse with repeated use or irritation
- A slow growing, localized swelling, with mild aching and weakness in the wrist
- An apparent cyst that is smooth, rm, rounded, or tender
The symptoms of ganglion cysts may look like other health conditions or problems. Always see your healthcare provider for a diagnosis.
At rst, when the cyst is small and painless, treatment is usually not needed. Only when the cyst begins to grow and hand function is a ected is treatment usually necessary. Treatment may include:
- Rest
- Splinting
- Nonsteroidal anti-in ammatory drugs (NSAIDs), such as ibuprofen
- Aspiratin
- Cortisone injections
- Surgery
Tendon problems
Tendons are the tough cords of tissue that connect muscles to bones. Two major problems linked to tendon sare tendonitis and tenosynovitis. Tendonitis is in ammation of a tendon. It can a ect any tendon. But it's most often seen in the wrist and ngers. When the tendons become irritated, swelling, pain, and discomfort will occur.
Tenosynovitis is the in ammation of the lining of the tendon sheaths which enclose the tendons. The tendon sheath is often the site which becomes in amed. But both the sheath and the tendon can become in amed at thesame time. The cause often osynovitis is often unknown. But usually strain, overuse, injury, or excessive exercise may be a factor. Tendonitis may also be linked to disease, such as diabetes or rheumatoid arthritis.
Common tendon disorders include:
- Tennis elbow (lateral epicondylitis). There is pain in the outside of the elbow and forearm. The pain is along the thumb side when the arm is next to the body with the
- thumb turned away. The pain is caused by damage to the tendons that bend the wrist backward away from the palm.
- Golfer’s or baseball elbow (medial epicondylitis). Pain goes from the elbow to the wrist on the inside of the forearm. The pain is caused by damage to the tendons that bend the wrist toward the palm.
- Rotator cu tendonitis. A shoulder disorder with in ammation of the shoulder capsule and related tendons.
- De Quervain's tenosynovitis. The most common type of tenosynovitis disorder. There is tendon sheath swelling in the tendons of the thumb.
- Trigger nger or trigger thumb. A tenosynovitis condition in which the tendon sheath becomes in amed and thickened. This prevents the smooth extension or exion of the nger or thumb. The nger or thumb may lock or "trigger" suddenly.
Treatment for most tendon problems may include:
- Reducing your activity level
- Ice
- Splinting or immobilization
- Steroid injections
- Nonsteroidal anti-in ammatory drugs (NSAIDs), such as ibuprofen