By Jon Ark, M.D.
Injuries and arthritis in your hands and wrists can make everyday activities – from sending a text to turning a key in the door – painful.
Moreover, as the use of smartphones, tablets and computers continues to rise, so too do hand and wrist problems.
In fact, in addition to overuse injuries such as carpal tunnel syndrome and trigger finger, arthritis of the thumb is becoming an increasingly common problem, especially among women over the age of 40.
However, with the right diagnosis and treatment, people can often find relief.
Arthritis of the Thumb
Your thumb is able to swivel, pivot, pinch and grasp thanks to the joint at its base, near the wrist. But just like other joints in your body, it is susceptible to osteoarthritis.
Osteoarthritis is a common condition characterized by the wearing down of the smooth cartilage that covers the ends of your bones and enables them to glide easily without pain. When the cartilage wears away, the bones rub against each other, damaging the joint and causing symptoms such as:
- Pain and weakness with activities that involve gripping or pinching, such as turning a key or door knob, opening a jar or holding a cell phone.
- Swelling and tenderness at base of the thumb.
- Aching or discomfort after prolonged use.
- Limited motion.
- Bony prominence or bump over the joint.
Arthritis of the thumb is more common in women than in men and usually occurs after age 40. In fact, by age 80, up to 80% of women are affected, according to the Arthritis Foundation.
Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve, which is one of the main nerves in the hand, becomes squeezed or compressed as it travels through the wrist.
This squeezing or compression is typically a result of swelling in the tissues that surround the flexor tendons responsible for bending your fingers and thumb. Like the median nerve, these tendons and tissues also travel through the carpal tunnel in your wrist. When they swell, they take up more space, putting pressure on the nerve and causing symptoms including:
- Tingling or numbness in the fingers or hand.
- Weakness in the hand and wrist and a tendency to drop things.
- Sensation like an electric shock in the fingers.
As the American Academy of Orthopaedic Surgeons notes, studies show that women and older adults are more like to develop carpal tunnel syndrome. Other risk factors include:
- The carpal tunnel may be smaller in some people, a trait that can run in families.
- Repetitive hand use. Performing the same hand and wrist motions or activities over and over again for a prolonged period of time can aggravate the tendons in the wrist, causing swelling that puts pressure on the nerve.
- Hand and wrist position. Activities that involve extreme flexion or extension of the hand and wrist for a prolonged amount of time can increase the pressure on the nerve.
- Changes in hormones during pregnancy can cause swelling.
- Certain health conditions, including diabetes, rheumatoid arthritis and thyroid gland imbalance.
Trigger Finger
Trigger finger is a condition that usually affects the ring finger or thumb, but it can occur in other fingers, too.
In people with trigger finger, the bands of tissue that hold the flexor tendons close to the finger bones become inflamed or thickened, making it harder for the tendon to glide smoothly as the finger bends and straightens.
In addition, the tendon itself may become inflamed, and over time, develop a small nodule that further restricts movement. Symptoms of trigger finger include:
- Finger stiffness, particularly in the morning.
- Popping or clicking sensation during movement.
- Finger catching or locking in a bent position.
- Tenderness or a bump in the palm at the base of the finger.
Though the exact causes of trigger finger are unclear, the condition is often associated with overuse as well as forceful use of the fingers and thumb. Trigger finger is also more common in people with diabetes and rheumatoid arthritis.
Treatment
The sooner you start treating hand and wrist problems the better. Typically, conditions can be diagnosed with a medical exam, imaging tests such as X-rays and MRIs, and tests to determine nerve function in people with carpal tunnel syndrome.
Treatment often begins with conservative measures such as warm soaks or ice in the case of arthritis, anti-inflammatory medication and rest. Splinting may also be recommended. In some instances, education regarding posture and wrist position, manual therapy, custom orthotic fabrication, activity modification and proper workplace ergonomics can help as well.
If problems continue, cortisone shots may help relieve symptoms, and in some cases, surgery may be necessary. A variety of safe and effective surgical options exist for treating hand and wrist problems, and most patients find relief from their symptoms and regain range of motion and function.
If you are experiencing unexplained pain, numbness, swelling or mobility problems in your hand or wrist, the first step is see a doctor to determine the cause and help you get a grip on the condition.
To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.
Jon Ark, M.D., is board certified in orthopaedic surgery and surgery of the hand. He is Chair of Orthopaedics at Penn Medicine Princeton Medical Center.
