Updated: Feb 11
Anatomy of the hand
The hand is made up of many a variety of ligaments, bones, and muscles, that allow for a huge amount of dexterity and movement. There are 3 important types of bones in the hand, these are:
● Phalanges: These are the 14 bones that are seen in the fingers of every hand and also in the toes of every foot. Each finger is made up of 3 phalanges (the proximal, middle, and distal). Only the thumb is made up of 2 phalanges.
● Carpal bones: These are the 8 bones that make the wrist. The carpal bones are joined to 2 bones in the arm, the radius bone and the ulnar bone.
● Metacarpal bones: These are the 5 bones that make up the centre part of the hand.
Many sheaths, muscles, and ligaments can be found within the hand. The sheaths are tubular types of structures that surround part of the fingers. The muscles are the structures that have the ability to contract, making it possible for movement of bones in the hand. The ligaments are fibrous tissues that help in binding the joints together in the hand.
What are common hand problems?
There are a variety of common hand problems that can get in the way of Activities of Daily Living (ADLs). These include:
Arthritis refers to the loss of cartilage joints, often with inflammation, stiffness and pain. It could happen in many areas of the wrist and hand. Arthritis in the hands can be extremely painful.
Osteoarthritis is one of the most usually seen forms of arthritis in the hands. It may have developed after an injury, or it may also be the result of just normal everyday use of the hand. Osteoarthritis generally develops in one of the following 3 places: at the end joint that is closest to the fingertip, at the base of the thumb, or in the middle joint of a finger.
Symptoms of osteoarthritis include:
● Pain and swelling
● Bony nodules in the end joints of the finger or the middle
● Loss of strength in the grip and the fingers of the hand
● Pain and probably swelling at the base of the thumb
Treatment for osteoarthritis involves:
● Use of ice to reduce swelling
● Wearing splints at night
● Over-the-counter fever and pain medicines
● Possible cortisone injections
● Using heat to reduce the pain
● Resting the affected hand
● Possible surgery when no other treatments seem to be working
Fluid-filled, soft cysts can start to develop on the back or front of the hand for no apparent reason at all. These are known as ganglion cysts. They are the most commonly seen noncancer, soft-tissue tumour of the wrist and hand.
Some of the general symptoms for ganglion cysts include:
● Wrist pain that worsens with irritation or repeated use.
● A localised, slow growing swelling, with weakness and mild aching in the wrist
● An apparent cyst that is firm, smooth, tender or rounded.
The symptoms of ganglion cysts may seem like other problems or health conditions. Always consult your doctor for a correct diagnosis.
In the beginning, when the cyst is painless and small, treatment is generally not needed. Only when the cyst starts growing and functioning of the hand gets affected, treatment becomes generally necessary. Treatment may involve:
● Nonsteroidal anti-inflammatory drugs (NSAIDs)
● Cortisone injections
Carpal tunnel syndrome
During this condition, the median nerve is compressed or squeezed as it continues to go into the wrist through the carpal tunnel, a narrow confined space. Since the median nerve allows motor and sensory functions to the thumb along with 3 middle fingers, a variety of symptoms may result. Every person’s symptoms may differ. Symptoms may include:
● Trouble while gripping objects with the hand
● Numbness or pain in the hand
● "Needles and Pins" feeling in the fingers
● Swollen feeling in the fingers
● Tingling or burning in the fingers, especifically the index and the thumb along with the middle fingers
The symptoms of carpal tunnel syndrome may look similar to other conditions like rheumatoid arthritis, tendonitis, or bursitis. Always consult an orthopedist for a diagnosis.
Treatment may include:
● Medicines to help reduce swelling: Anti-inflammatory medicines can be injected or taken by mouth (oral).
● Splinting the hand: This is done in order to reduce the compression of the nerves inside the tunnel and prevent wrist movement.
● Ergonomic changes: Making new and improved changes to your work environment, like changing the position of a computer keyboard, and so forth.
● Surgery: This is done to reduce the compression on the nerves in the carpal tunnel region.
Tendons refer to the tough cords of tissue that join muscles with the bones. Two crucial problems linked to tendons are tenosynovitis and tendonitis. Tendonitis refers to the inflammation of a tendon. It could affect any tendon. But it's generally seen in the fingers and wrist. When the tendons get irritated, pain, discomfort, and swelling will occur.
Tenosynovitis is the inflammation in the lining of the tendon sheaths that encloses the tendons. The tendon sheath is generally the site that gets inflamed. But both the tendon and the sheath can get inflamed at the same time. The cause of tenosynovitis is generally not known. But usually overuse, strain, excessive exercise, or injury may be a factor. Tendonitis might also be attached to diseases like rheumatoid arthritis or diabetes.
Common tendon disorders include:
● Rotator cuff tendonitis. A shoulder disorder that involves inflammation of the shoulder capsule and other related tendons.
● Tennis elbow - There is pain in the outside of the forearm and elbow. The pain is at the side of the thumb when the arm is next to the body. The pain is usually caused by damage done to the tendons that bend the wrist away from the palm backwards.
● Baseball or Golfer’s elbow - Pain travels from the elbow to the wrist on the inner side of the forearm. The pain is generally caused as a result of damage to the tendons that bends the wrist in the direction of the palm.
● Trigger thumb or trigger finger - A tenosynovitis condition in which the tendon sheath starts to get thickened and inflamed. This prevents the flexion or smooth extension of the thumb or finger. The thumb or finger may "trigger" or lock suddenly.
● De Quervain's tenosynovitis - This is the most commonly seen type of tenosynovitis disorder. There is tendon sheath swelling inside the tendons of the thumb.
Treatment for most tendon problems may include:
● Nonsteroidal anti-inflammatory drugs (NSAIDs)
● Immobilisation or splinting
● Steroid injections
● Reducing your activity level
If you’re looking for a professional to look over your pain issue. Get in touch with our expert Orthopaedists and Physicians at 1 Health Medical Centre to get the best Diagnosis and Treatment in Bangalore!