Common hand, wrist and elbow disorders

Know the causes, signs and treatments

There are various types of conditions that can cause pain, numbness and tingling in your hands, wrists and elbows. Some of these disorders have similar symptoms, and it can be important to know the difference and what to do if you feel you may have one of these conditions. Such conditions include: 

• Ganglion cysts
• Carpal tunnel syndrome
• Tendonitis
• Arthritis in the hand, wrist and fingers
• Trigger finger
• Cubital tunnel syndrome

 

Ganglion cysts

Often mistaken for a tumor, ganglion cysts are the result of fluid accumulating from a nearby joint. It is unknown what causes this to occur and is the most common of soft tissue hand masses. Usually, it is usually not painful. These cysts are usually located near the wrist, and sometimes near a fingernail. They are usually easy to identify, but on occasion, a physician may recommend an ultrasound or MRI to assist in making a diagnosis. 

When treating a ganglion cyst, your doctor may recommend observing the cyst to see if it disappears on its own. If needed, aspiration, which includes numbing the area and suctioning the gel out, could also be completed. The cyst still may return after this treatment. As a last resort method, surgical excision is possible to remove the cyst, with this method having a 10 to 15% recurrence rate. 

Carpal tunnel syndrome 

Carpal tunnel syndrome is the most common type of nerve compression in the upper body. Symptoms include numbness and tingling that usually occurs at nighttime with the possibility of pain developing over time. These symptoms are usually shown in the thumb along with the index, middle and half of the ring finger. 

To diagnose carpal tunnel, physicians will determine from your history, examine the hand and perform tests by applying pressure to a specific area in the wrist. Another option for diagnosis is a nerve test that involves pins and needles. 

Once diagnosed, treatment can begin. Some doctors may recommend beginning with observation to see if symptoms go away. Anti-inflammatories such as Aleve and ibuprofen may help reduce symptoms. Wrist splints are available to reduce movement in the wrist at nighttime to reduce symptoms. If these steps fail to work, cortisone injections can be used to help determine if surgery would be helpful. Carpal tunnel release surgery may need to be performed to provide pain relief and improve sensation. 

Click here to watch animated videos on what happens during carpal tunnel surgery.

Tendonitis 

Tendonitis is a condition that can occur in various parts of the body. The most common type of tendonitis is De Quervain’s that runs along the side of the thumb and wrist. This is common in middle aged women and involves tenderness and swelling at the back of the wrist. The main causes of this include overusing and repeating movements with the hands. Sprains and strains in the wrist can also lead to tendonitis. 

To treat tendonitis, it is important to modify movements and reduce the activities that cause flareups. Along with adjustments, splints, anti-inflammatories and hand therapy can help aid in pain relief. If these methods are not as effective as hoped, cortisone injections may help, and surgery may be needed to have the most effective results. 

Other types of tendonitis in the hands include intersection syndrome on the back of the hand and flexor carpi radials that are usually accompanied by a ganglion cyst.  

Tendonitis can also occur in the elbow in the form of tennis elbow, impacting the outside of the elbow, and golfer’s elbow impacting the inside of the elbow. These elbow conditions can be treated with cortisone injections, an elbow brace and anti-inflammatories. 
 

Arthritis in the hand, wrist and fingers 

There are various types of arthritis with symptoms including pain, achiness, stiffness and loss of motion. These include: 

• Osteoarthritis being the most common and caused by aging and is not triggered by any other activities.  
• Post-traumatic arthritis is caused by an injury that didn’t heal properly and leads to arthritis in the future.  
• Rheumatoid inflammatory arthritis is caused by an overactive immune system leading to the targeting of healthy cells.  

To diagnose arthritis, strength and motion will be tested. In some cases, a deformity may be present that will make diagnosis easier. History of past trauma in the hand, wrist and fingers or family history of arthritis can increase chances of developing and properly diagnosing arthritis. If it is not easy to tell with these methods, X-rays are helpful to determine a diagnosis. 

Treatment for arthritis is very similar to the treatment of tendonitis. These treatments include modifying common activities along with using a splint and anti-inflammatories to reduce pain. Hand therapy and cortisone shots may also be helpful. In the case that these methods do help reduce pain, surgery may be done to fix the issue. 

Trigger finger 

Trigger finger is most common in middle-aged patients and can affect any finger. Sometimes, trigger finger is secondary to a medical problem such as diabetes, gout or rheumatoid arthritis. A sign of trigger finger is the finger catching or popping while getting flexed or extended. Treatments for trigger finger include taking anti-inflammatories, a steroid injection and surgery if needed. 

Click here to watch animated videos on what happens during trigger finger surgery.
 

Cubital tunnel syndrome

Cubital tunnel syndrome occurs when there is compression of the ulnar, or funny bone, near the elbow. Typically, the pain in the elbow will lead to numbness and tingling of the ring and pinky finger and may end up causing weakness in muscles of the hand. This can be caused by repetitive flexing of the elbow joint or prior fractures. 

When diagnosing cubital tunnel, physicians will look to see if there is any history of numbness in the ring and pinky finger. Along with examining the history, they may perform a hand exam, nerve test or order X-rays to confirm the condition. Treating this syndrome can begin with modifying activities and taking anti-inflammatories. Attending occupational therapy and wearing a splint at nighttime may be needed for an increased chance of healing. If these methods do not help as expected, surgery may be done. 

For more information on hand and wrist pain, click here to watch short videos from Prevea orthopedic experts.

If you have an injury or condition that is causing pain or discomfort, contact an orthopedic and hand specialist today to discuss the right treatment options for you.