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Pain in the region of the hand and wrist can come from problems in the joints or surrounding muscle and tendons. Pain in the hand or wrist region, pain with movement, weakness, numbness, stiffness, loss of motion or swelling, can all be related to hand and wrist pathology. Depending on the location and nature of the discomfort, as well as aggravating and relieving factors can help establish the diagnosis. Problems such as tendonitis, ligament tearing, and muscle strains, arthritis, and nerve compression are common in the hand and wrist.
Examination by the doctor and testing such as X-rays or MRI or nerve testing, may used to identify the problems. Treatments can include medications, therapy, injections, and even surgery.
Tendons in the hand and wrist can be injured from trauma, lacerations, overuse, and inflammatory diseases. Depending on how much of the tendon is torn or damaged, will determine treatment recommendations. Examination by the doctor, and possibly MRI will help confirm the diagnosis. Bracing, activity modification, injections, PRP, and surgery may be recommended.
Wrist and hand fractures are common injuries. Slip and fall with arm extended to break the fall is the usual mechanism of injury. Examination by the doctor and X-rays are needed to confirm the diagnosis and guide treatment. The treatment will depend on the bone fractured and severity or displacement of the fracture. Age of the patient, dominate hand, and activity can also influence treatment decisions. Casting or bracing, ice, activity modifications, and surgery are the standard treatment choices. The use of waterproof casts or braces, as well as adjustable or removable braces, are becoming common treatment options.
Compression of the Median nerve at the wrist is called Carpal Tunnel Syndrome. This can be caused by overuse, repetitive activity, and injury. Numbness in the thumb, index, middle and part of the ring finger are common findings. The hand may tingle, feel asleep, and be
aggravated by driving, keyboard use, or repetitive activity. Examination by the doctor and nerve testing (EMG or NCT) are used to confirm the diagnosis and determine the severity of the nerve compression.
The severity of the compression will determine treatment. Mild compression responds well to non-surgical treatment (80%). Moderate compression may respond to non-surgical treatment (50-60%). Severe compression usually requires surgery as only 15-20% responds to non surgical treatment, and some damage may be non-reversible. Treatment includes bracing, NSAIDS, activity modification, and injections. Failure to respond to treatment or severe symptoms may require surgical release of the compression on the nerve.