By Thomas J. Haverbush, M.D. Orthopaedic Surgeon
Transforming patient information into patient understanding.
Sometimes pain in the hand and wrist becomes so bad you have to stop some of your favorite activities............
I have been there. I have experienced a lot of the things I write about. In other words, I can be empathetic.
The hand and wrist pain you are feeling can be coming from the connective tissue called ligaments and tendons, which hold the hand and wrist together and allow for movement.
Injuries are common especially if you participate in certain activities that involve snapping wrist motions or heavy repetitive wrist or hand use.
In many cases pain can be relieved by self-care measures. When that is not enough, additional measures are available and that is where I come in.
Tendons are the thick round structures patients refer to as cords. They attach muscles to bone. In the wrist they are covered by a slippery tissue called tenosynovium, which allows tendons to glide smoothly. Inflammation can occur in the tendons and synovium and cause problems.
Symptoms of this inflammation are pain, tenderness and sometimes swelling. Pain is increased by moving the affected area.
There is one very common form of tendinitis in the wrist I need to tell you about. It occurs on the thumb side of the wrist right where the wrist bends.
This part of the hand is used in most common activities such as opening doors. It causes pain and swelling and without treatment the pain can spread down the thumb and into the forearm.
It is different from carpal tunnel because it does not cause any numbness or tingling in the hand.
Conservative treatment includes
• Using a heating pad for fifteen minutes followed by an ice pack for fifteen minutes. Therapists do this all the time and it really helps.
• Get yourself some Advil or similar anti-inflammatory medication to help reduce pain and swelling.
• If you are aware of which movements are causing the pain, limit them temporarily.
• Get a splint or brace to restrict hand movement temporarily.
When conservative treatment doesn’t work
• You may need Physical/Occupational Therapy, which has available several modalities like electrical stimulation, ultrasound/cortisone cream.
• Steroid injections are sometimes administered.
• Prescription anti-inflammatory medication is sometimes helpful.
• Surgery is usually curative in stubborn cases to cut a sheath of tissue that encloses the tendons and synovial lining.
Surgery can release pressure and speed healing by giving inflamed and restricted tissues more space. I think the ligament aspect of this discussion will need to wait till next week. Ligament problems are important and somewhat more complicated and merit their own thorough coverage. Please come back next week for part two.
My patients put their trust in me and what I do improves the quality of their lives.
All Orthopaedic Surgery problems including this week’s subject can be evaluated by Dr. Haverbush at his office.
315 Warwick Drive
Alma, Michigan 48801
Office is across the street from Gratiot Medical Center.
Please call to make an appointment usually the same week you call.
Attention!! Besides what you read today there is a huge amount of musculoskeletal information on the office website www.orthopodsurgeon.com. Please check it out.