Hand And Wrist Arthritis
Types of arthritis that most often affect your hand and wrist include:
- Osteoarthritis: The natural aging process can wear away at the protective cartilage that allows the many bones in your hand, wrist, and elbow to move smoothly, causing inflammation, swelling, and pain.
- Rheumatoid arthritis: This immune system dysfunction attacks and wears away at the cartilage lining between the small delicate bones in your hand and wrist. Rheumatoid arthritis generally affects the joints on both hands.
Symptoms of arthritis in hands can include:
- Pain or burning in the hand joints, especially in the morning and with heavy use
- Swelling
- Nearby joints become unusually flexible to compensate for the affected joint
- Feeling or hearing grinding of the joint inside the hand
- Appearance of cysts on the fingers
Arthritis of the wrist generally causes symptoms including:
- Pain
- Weight loss
- Fever
The surgeons at MedStar Health have the expertise to help you overcome any challenge your arthritis presents. We treat the entire spectrum of arthritis disordersfrom early-stage management to end-stage joint replacementand offer advanced arthritis treatment options, including the latest arthroscopic and minimally invasive surgical techniques. We will work with you to develop a treatment plan tailored to your individual needs and the demands of your daily life.
What Causes Carpal Tunnel Syndrome
Doing the same hand movements over and over can lead to carpal tunnel syndrome. Its most common in people whose jobs require pinching or gripping with the wrist held bent. People at risk include people who use computers, carpenters, grocery checkers, assembly-line workers, meat packers, musicians, and mechanics. Hobbies such as gardening, needlework, golfing, and canoeing can sometimes bring on the symptoms.
Women are more likely to develop carpal tunnel syndrome than men. It also tends to be hereditary. This means it runs in families.
Carpal tunnel syndrome may also be caused by an injury to the wrist, such as a fracture. Or it may be caused by a disease such as diabetes, rheumatoid arthritis, or thyroid disease. Carpal tunnel syndrome is also common during the last few months of pregnancy.
Where Does Carpal Tunnel Hurt The Most
Ask any patient,”Where does carpal tunnel hurt the most?”and the answer is almost always,”MY THUMB!”Usually the forefinger runs a close second. But that’s not a rule.
Sometimes the middle fingers hurt more than the thumb. And it’s not unusual for the entire palm to hurt as well. On rare occasion, the wrist is most painful.
The pain can be sharp or dull, shooting or stabbing. The intensity ranges from slightly annoying to cruel and punishing. It’s common for pain feel like electric shocks shooting out of the palm and up the arm.
Once again, the little finger is never involved. And neither is the top side of the hand. But sometimes pain is so intense that it feels like your entire hand and all fingers are being crushed to death.
It’s usually at this severe stage that patients say,”I feel like I want to cut my hand off!”
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Sensitivity After Carpal Tunnel Surgery
I had surgery on my left hand for carpal tunnel syndrome. After the nerve block wore off, the tip of my middle finger became very sensitive to the touch and feels swollen but isnt. My left hand is sweaty and much warmer in comparison to the right. Also, the pad is swollen near the thumb. What do you think might be causing these problems?
Your symptoms suggest a relatively uncommon problem that can follow trauma, surgery, or any painful condition. The inciting event can be minor, and is usually disproportionate to the reaction that follows it. This syndrome is known as reflex sympathetic dystrophy , which implies that the autonomic nervous system plays a role in its development. The syndrome has been renamed complex regional pain syndrome type I by the International Association for the Study of Pain, but most physicians continue to use the term RSD. While an infection seems unlikely, it should be ruled out by your physician.
RSD after surgery for carpal tunnel syndrome is uncommon. This type of day surgery is performed either as an open procedure or arthroscopically . It is usually very successful, especially if performed early in the course of CTS.
A very important additional event is that the bones of the limb eventually lose mineral that is, they become osteoporotic.
Therefore, if RSD remains untreated, it will result in structural changes of the skin, muscles, and bones that severely limit the functioning of the affected extremity.
Why It Happens And Whos At Risk
Ulnar nerve compression can occur in people who hold their elbow bent more than 90 degrees for long periods of time. Bending your elbow repeatedly, sleeping with your elbow bent, or prolonged leaning on your elbow can also cause cubital tunnel syndrome.
People who have fractured or dislocated their elbow or who have bone spurs or swelling in the elbow are at increased risk of ulnar nerve compression. Diabetes is probably the most commonly associated disease, says Dr. Evans.
Cubital tunnel syndrome can also be caused by joint damage from arthritis. However, cubital tunnel syndrome is a very late occurrence in the course of arthritis, which is uncommon at the elbow.
If you think that you may have cubital tunnel syndrome, see your doctor. Your doctor will perform a physical exam and may order nerve conduction studies to identify where the nerve is being compressed. X-rays may be taken to detect visible causes of compression, such as bone spurs or elbow arthritis.
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How Do I Get Ready For Carpal Tunnel Surgery
- Tell your doctor about all medicines you are currently taking, including over-the-counter drugs, vitamins, herbs, and supplements. You will probably need to stop taking any medicines that make it harder for the blood to clot, such as ibuprofen, aspirin, or naproxen.
- If youre a smoker, try to quit before to the surgery. Smoking can delay healing.
- You may need to get blood tests or an electrocardiogram before surgery.
- You will usually be asked not to eat or drink anything for 6 to 12 hours before the surgery.
Based on your medical condition, your doctor may request other specific preparations.
Does Carpal Tunnel Syndrome Only Happen To Office Workers Or Factory Workers
No. Many people with carpal tunnel syndrome have never done office work or worked on an assembly line. It affects people who use their wrists and hands repeatedly at work and at play. Anyone can get carpel tunnel syndrome, but it is unusual before age 20. The chance of getting carpal tunnel syndrome increases with age.
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Can Yoga Ease Carpal Tunnel
There’s strong evidence that yoga can reduce pain and improve grip strength. In one small study, participants who did an eight-week yoga regimen of 11 postures designed to strengthen, stretch, and balance the joints of the upper body had better outcomes than participants who wore wrist splints and participants who were given no treatment at all.
How To Treat A Hurting Hand & Fingers
Most people dont realize they can treat a painful hand and fingers very effectivelywithout surgery.The key is to attack the symptomsbeforethey reach the severe level.
Every doctor knows that treating carpal tunnel when itsmild is much easier than when its severe. So treatment should begin as quickly as possible preferably at thefirst sign of carpal tunnel syndrome.
The most effective treatments address tissue inflammation which causes swelling and pressure inside the wrist joint. The treatment combination that works best is B.R.E.M.It means, Bracing, Rest, Exercise, Massage.All four treatments must be used simultaneously to get the best results.
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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
Scientists supported by the NINDS are studying the factors that lead to long-lasting neuropathies, and how the affected nerves are related to symptoms of pain, numbness, and functional loss. Researchers also are examining biomechanical stresses that contribute to the nerve damage responsible for symptoms of carpal tunnel syndrome in order to better understand, treat, and prevent this ailment. By quantifying the distinct biomechanical pressures from fluid and anatomical structures, researchers are finding ways to limit or prevent CTS in the workplace and decrease other costly and disabling occupational illnesses.
Scientists funded through NIHs National Center for Complementary and Integrative Health are investigating the effects of acupuncture on pain, loss of median nerve function, and changes in the brain associated with CTS. In addition, a randomized clinical trial designed to evaluate the effectiveness of osteopathic manipulative treatment in conjunction with standard medical care is underway. Evaluations of these therapies and other therapies will help to tailor individual treatment programs.
When Is Surgery Required For Carpal Tunnel
Going under the knife is always a scary and last resort for most people. With carpal tunnel syndrome, some non-surgery options can be tried before a doctor wants to perform surgery. Over-the-counter medication, wrist splints, physical therapy, steroid shots, or changing equipment at work are things that your doctor may have you try first. Surgery might be recommended within 2 months depending on the severity if these options are not successful and the patient continues to suffer from the pain.The doctor may also perform an electromyography test to determine that carpal tunnel syndrome is present. If the pinching of the median nerve is severe enough that it is causing the muscles to weaken in the hands or wrists, a doctor will want to perform surgery.
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Why Do Certain People Get Carpal Tunnel
There are a number of factors that may be involved in whether someone develops carpal tunnel, Dr. Maschke says, including:
Genetics Some people may simply have a genetic predisposition to carpal tunnel. It is an issue of a size mismatch, Dr. Maschke explains. The carpal tunnel is a tight space, and its a smaller channel in some people than others. This may be why women, who tend to have smaller carpal tunnels, are affected three times more often than men.
Repetitive vibration Research shows that repetitive vibration in particular, but also repetition, wrist flexion and powerful grip, all raise the risk for carpal tunnel. Think of what youd feel when using a jack hammer or other piece of vibrating machinery, Dr. Maschke says.
Underlying health conditions These include pregnancy and menopause, which can cause fluid retention. Diabetes, obesity, thyroid problems and rheumatoid arthritis also may cause the median nerve to become compressed.
Injury Trauma or injury to the wrist, such as a sprain or break, can cause swelling resulting in tingling and pain. Mechanical problems in the wrist also can cause these issues.
Lifestyle factors Spending a lot of time at the keyboard, sleeping with your wrist flexed, or performing tasks that involve repetitive motions with your hands and wrists or pressure on your palms can aggravate carpal tunnel symptoms.
What To Expect After Carpal Tunnel Surgery
Carpal tunnel is a very painful syndrome, and once you experience symptoms, youll want to do everything you can to relieve the pain. After living with the flare-ups and pain for so long, the only option might be surgery. If your carpal tunnel leads to surgery, knowing what to expect after surgery will benefit your recovery.
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Possible Complications Of Distal Radius Fractures
As with all procedures to treat an injury, there are some potential complications that can occur. The chances for the following complications vary based on the condition of the patient and the treatment approach used. Patients should ask their physicians for specific information about their own risk for certain complications.
Possible complications of a distal radius fracture can include, but are not limited to:
- Malunion of the bone and continued deformity
- Residual pain and stiffness
When To See A Doctor
You should see a doctor if your symptoms have been continuing for two weeks or more. At first, the symptoms may come and go. Once they are persistent, waking you up at night, or interfering with everyday tasks, you should seek care. If the symptoms are due to CTS, allowing them to go on for too long increases the risk of muscle atrophy and permanent nerve damage.
Early treatment can also help avoid the need for surgery.
Visit your primary care provider for an assessment and general health check. If you don’t have a primary care provider, you can see an internal medicine physician or an occupational medicine specialist. You may be referred to an orthopedic surgeon, neurologist, hand surgeon, rheumatologist, or physiatrist for further testing or treatment.
Carpal Tunnel Syndrome Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Your doctor will consider other possible causes of the symptoms, including other nerve conditions and arthritis. In addition, carpal tunnel syndrome is seen more frequently in people with underlying conditions such as hypothyroidism, diabetes, and rheumatoid arthritis which you may not be aware that you have. Seeing your doctor will allow you to get a diagnosis and appropriate treatment for both carpal tunnel and any other conditions.
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Protect Your Hands From Cold
- Wear gloves anytime it is cool outside.
- Use an insulated cover when you drink from a cold glass.
- Avoid caffeine and tobacco products. Nicotine and caffeine cause blood vessels to narrow, which decreases blood flow to the hands.
- Eat a hot meal before going out. Eating raises your body temperature and helps keep you warm.
What Causes Carpal Tunnel Pain
Today, we know a great deal about carpal tunnel syndrome. And we know a lot about what causes the various symptoms of carpal tunnel.
Pain, numbness, tingling and other abnormal sensations are the result of nerve damage. At it’s core, a damaged nerve inside the wrist joint causes all of these symptoms.
Carpal tunnel syndrome is a painful and progressive nerve disorder. Doctors technically call it acompressive neuropathy.That means themedian nerve is damaged.
The damaged occurs because nearby tendons inside the wrist joint inflame and push on the median nerve. Nobody is sure why the tendons swell to begin with. But the result is that they swell more and more.Eventually they compress or crush the nerve.
It’s thought the reason tendons swell might be due torepetitive and forceful useof your hands and fingers. That’s why, for instance, typists,hair stylists,carpenters,transcriptionists, auto mechanics,guitar players,and assembly line workers are infamous for getting carpal tunnel syndrome. Actually, anybody with anoccupationthat requires rapid and repetitive hand activity is at high risk.
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Recurrent Carpal Tunnel Syndrome
It is possible to have recurrent symptoms after carpal tunnel surgery. The likelihood of this complication is estimated to be about 10 to 15%.
Unfortunately, even if this problem is addressed with another surgical procedure, the results of a second surgery tend to be not as favorable as the results of initial surgery.
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Apply Pressure To Wrists
Wrist pain, numbness, and tingling can be treated with gentle pressure to the wrists. You can wear a splint or compression gloves to provide that pressure and prevent nighttime swelling. Applying pressure with self massage is another way to relieve pain. Combined with elevating your hands, pressure is an excellent way to get pain relief from carpal tunnel.
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How Is Carpal Tunnel Syndrome Related Arm Pain Treated
As soon as pain begins, you should seek out medical care, as the symptoms will only become worse over time without treatment. Initially, something to reduce inflammation is typically recommended. A course of nonsteroidal anti-inflammatory drugs such as Advil or Motrin or a supplement like curcumin may be prescribed. The affected wrist is typically splinted to restrict movement and aid in resting the nerves and ligaments. In some cases, doctors will discuss injections of corticosteroids to relieve pain. These treatments can provide relief, but they are not a cure.
If the diagnosis is a result of an inflammatory disease such as rheumatoid arthritis, treatment of the disease may supersede treatment of CTS.
Symptoms And Signs Of Carpal Tunnel Syndrome
The earliest symptoms of CTS are usually tingling / pins and needles, in some combination of the thumb, index, middle and ring fingers which most characteristically wake the patient during the night, usually at about 3:00 am but a variety of other things may be noticed by the patient or medical professional examining the hand.
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Carpal Tunnel Syndrome Surgery
If your CTS is getting worse and other treatments have not worked, the GP might refer you to a specialist to discuss surgery.
Surgery usually cures CTS. You and your specialist will decide together if it’s the right treatment for you.
An injection numbs your wrist so you do not feel pain and a small cut is made in your hand. The carpal tunnel inside your wrist is cut so it no longer puts pressure on the nerve.
The operation takes around 20 minutes and you do not have to stay in hospital overnight.
It can take a month after the operation to get back to normal activities.
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