Common Hand conditions including golfer's elbow, tennis elbow, olecranon
bursitis, and cubital tunnel syndrome. These conditions can cause
elbow pain, swelling, and stiffness.
Osteoarthritis of the Wrist
Arthritis is wear and tear of the joint. There are two main types of
arthritis: 'Osteoarthritis' (Degeneration) and 'Inflammatory arthritis'
(Rheumatoid arthritis). Osteoarthritis is a slow process that develops over many
years. In this type of arthritis the joint cartilage gradually roughens
and becomes thin. Small bits of loose cartilage may float around the
joint. The bone underneath thickens and the bone at the edge grows
outwards causing bony spurs (osteophytes). The joint may swell as the
body makes extra fluid to lubricate the joint.
DeQuervains Tenosynovitis
It is a painful condition that affects a couple of tendons of the thumb
as they run through a tunnel on the thumb side of the wrist. It was
described in the late 19th century by De Quervain.
There are two tendons (Abductor Pollicis Longus and Extensor Pollicis
Brevis) that pass through a tunnel known as the first dorsal
compartment on the thumb side of the wrist . They help move
the thumb away from the hand.
In De Quervain’s syndrome there is thickening of this tunnel resulting
in narrowing of the area. The tendons get squeezed and the slippery
covering over the tendons (synovium) become inflamed which causes pain.
Many people have two small separate tendon tunnels and are predisposed
to this problem.
Ganglion and Cysts
Our body has a lubricant in its joints or in the tunnels through which
tendons pass. This lubricant is called the synovial fluid. Usually due
to an unknown cause or sometimes due to an injury or arthritis, this
lubricant leaks. This lubricant has special proteins that make it thick
and the body is unable to absorb it. It so forms a ganglion which is
like a balloon filled with thick fluid.
Complex Regional Pain Syndrome
CRPS is a painful condition of the limb usually after an injury and
with associated swelling, altered sensations, skin colour changes,
altered temperature and sweating. It usually affects the arm and leg,
but has the ability to affect other parts of your body. The pain is out
of proportion to the severity of the injury and will last much longer
than would normally be expected.
CRPS is a well known but unpredictable complication of any upper limb surgery. Reflex Sympathetic Dystrophy (RSD), Causalgia, Sudeck’s dystrophy.
Trigger Finger
It is a painful condition in which the digit clicks or locks as it is bent towards the palm. In a trigger finger there is thickening of this tunnel, leading to
roughness of the tendon surface or a lump in the tendon. The tendon
fails to glide effectively and catches at the mouth of the tunnel
causing clicking or locking.
Arthritis of the Hand
Arthritis is wear and tear of the joint. There are two main types of arthritis that
can affect the finger joints.
Osteoarthritis is a slow process that develops over many years. With
this type of arthritis the joint cartilage gradually roughens and
becomes thin. The bone underneath thickens and the bone at the edge
grows outwards causing bony spurs (osteophytes). The joint may swell as
the body makes extra fluid to lubricate the joint. The joint may get
deformed and there will be gradual loss of movement.
Inflammatory arthritis includes conditions like rheumatoid disease or psoriasis.
If you want to learn more about your hand condition and treatments, please contact a physical therapist at Campus Physical Therapy Center at
650.994.7800
Campus Physical Therapy Center
Wrist Fracture
While any of the many bones in the wrist can break, fracture of the
wrist normally refers to a break(s) of the end of the forearm bones,
which are the 'radius' on the thumb side, and the 'ulna' on the little
finger side. It is very commonly seen in children and in later life
around the age of 60 due to osteopenia. In young adults, it is usually
seen after high-energy injuries (biking accidents). Colles’ fracture or Smiths’ fracture (named after Abraham Colles and
Robert Smith who described patterns of these fractures in 1814 and 1847
respectively). Colles described the fracture, which tips backwards, while Smith described the fracture that tips to the front.
Ligament and TFCC
The wrist is one of the most complex joints in the body. It consists
of 8 carpal bones arranged in two rows. These bones articulate with one
another and the two-forearm bones - the radius on the thumb side and the
ulna on the little finger side. All the bones and the joints they form,
are stabilized by a number of ligaments. The ligaments also control the
movements of the bones with one another.
In addition there is also a joint between the radius and ulna (the
distal radio-ulnar joint). This joint is connected to the wrist by a
complex of ligaments, tendon and a cartilage disc. The complex that
stabilizes the wrist at the distal radioulnar joint is known at the
‘triangular fibrocartilage complex’ (TFCC). It also bears most of the
forces that go through the wrist.
Carpal Tunel Syndrome
The hand is supplied by three nerves. One of them is called the median
nerve and like a telephone cable it passes through a protective conduit
(a tunnel) on the front of the wrist. This tunnel is called the carpal
tunnel. It also contains tendons that bend the finger and thumb. The
nerve can get compressed in this tunnel and cause symptoms. The
condition is known as a Carpal Tunnel Syndrome. The main symptom is tingling or pins & needles in the hand. The
symptoms usually affect the thumb, index, middle and ring fingers. This
is because the median nerve supplies these fingers. Tingling is often
worse at night or first thing in the morning. It may be provoked by
gripping.
In the early stages the symptoms are intermittent but later become
continuous as the condition worsens. The patient will notice numbness in
the fingers and thumb together with weakness and wasting of the muscles
at the base of the thum. They may drop objects and feel
clumsy with their hand(s). They may also complain of pain in the wrist
and forearm.