Understanding the Hand

Common Hand Injuries

Fracture

Trauma may break the bones that make up the hand, be it the small (phalanges) or long bones (metacarpals) of the fingers. The injury may need surgical attention should the force of impact cause the bone to break and move from its original position. Fractures can result from a fall, a twisting injury or from direct contact in sports.

Symptoms of bone fracture in the hand include pain, tenderness, swelling, deformity at the area of the fracture and limited movement. For minor cases, treatment usually needs cast support to limit movement until the bone fragments heal, which can take about 6 – 8 weeks. Surgery may be needed to align and stabilise badly deformed fractures. Less severe fractures can also be fixed with strong metal screws and plates instead of having a cast. This allows the immediate use of the hand without the inconvenience of a cast and may hasten a return to sports. Consult with a doctor to understand the treatment options available.

Arthritis

Arthritis is a condition where swelling occurs in the joint area. In the hands, osteoarthritis is common, where the protective cushion between the joints (cartilage) wears out due to ageing or wear and tear. Genetic factors, joint instability and injury may also contribute to osteoarthritis.

Symptoms of osteoarthritis include pain, stiffness, limited motion, swelling at the joint area, and at times a grinding sensation when moving the joint.

Supplements such as glucosamine, fish oil, ginger and turmeric can help with symptoms of arthritis. If the condition worsens, non-steroidal anti-inflammatory medication (NSAIDs) or steroid injections into the joint can relieve pain and swelling swiftly. In very severe cases that are not responding to these, surgery may be needed to fuse the joint or replace it with an artificial one. Consult with a doctor to understand the treatment options available.

Signs & Symptoms

Gradual numbness, an occasional tingling sensation in the fingers (thumb, index and middle fingers) with some feeling of pain, are usually felt at the beginning stages of carpal tunnel syndrome. Other symptoms include:

– Burning, prickling sensations in the hand similar to pins and needles
– Reduced sensitivity to touch
– Discomfort in the hand 
– Weakness of the muscles at the base of the thumb
– Reduced agility and being prone to dropping objects

If left untreated, carpal tunnel syndrome may lead to permanent nerve and muscle damage.

Diagnosis

Your doctor may check your medical history and perform a physical examination. The following diagnostic tests may be used to further assess the condition.

– X-ray
– Nerve conduction study to observe the electrical activity in affected nerves

Treatment

Carpal tunnel syndrome should be treated early when symptoms emerge. Upon early diagnosis, non-surgical methods such as wrist splinting may help improve the condition. The doctor may also prescribe non-steroidal anti-inflammatory medication (NSAIDS) or corticosteroids to help relieve the swelling that may be causing nerve compression and numbness. Carpal tunnel surgery may be advised if the symptoms persist. The goal of the surgery is to relieve pressure on the affected median nerve, this can be done with an endoscope as a form of minimally invasive surgery. Studies show that minimally invasive surgery may result in less scarring and a quicker return to function compared to conventional surgery. Consult a doctor to understand the treatment options available.

Signs & Symptoms

Common signs of trigger finger include:

– Finger stiffness or becoming locked at a bent position
– A painful snapping or popping sensation upon bending and straightening the finger
– A tender bump on the palm of the hand, near the base of the affected finger

If not treated, the affected finger may become permanently stuck in a certain position, leading to difficulty performing everyday tasks.

Diagnosis

Your doctor may check your medical history and perform a physical examination of the hand.

Treatment

Treatment for trigger finger depends on the severity and duration of the symptoms. Upon early diagnosis, non-surgical methods like splinting may help improve the condition. The doctor may also prescribe non-steroidal anti-inflammatory medication (NSAIDS) or corticosteroids to help relieve the pain. Surgery may be advised if symptoms persist. The goal of the surgery is to release the affected sheath so that the tendon may move freely again. Consult a doctor to understand the treatment options available.