Relief for hand pain

Top 5 ways to reduce crippling hand pain

These nonsurgical solutions will enhance daily activities and independence.

Updated: November 11, 2018Published: July, 2013

Hand pain is more than just annoying. The stiffness and swelling that go along with hand pain can sap strength and diminish the ability to carry out routine functions, like buttoning clothes.

One common cause of hand pain is osteoarthritis—when the shock-absorbing cartilage between bones in the finger joints and at the base of the thumb becomes worn or damaged. Hand pain can also result from nerve conditions, like the pain and tingling you feel when there is pressure on the median nerve in the wrist or the ulnar nerve near the elbow. Sometimes hand pain results from tendinitis, an inflammation of the tissue that attaches muscles to the bones. Here are five methods to help manage hand pain, retain hand function, and avoid surgery.

1. Splinting

A splint stabilizes the position of your fingers, thumb, or wrist. “Wear a splint for a few weeks if arthritis flares, so the inflammation can settle down,” says Dr. Philip Blazar, an orthopedic surgeon and associate professor at Harvard Medical School.

2. Injections

An injection of a corticosteroid into a joint can reduce inflammation. “The relief it provides can last up to a year,” says Dr. Blazar. For some people the amount of relief diminishes with subsequent injections.

3. NSAIDs

A nonsteroidal anti-inflammatory drug (NSAID) helps relieve hand pain by blocking enzymes that produce pain and swelling, but Dr. Blazar says it’s not effective for carpal tunnel syndrome. Long-term use of oral NSAIDs such as ibuprofen (Advil, Motrin) are linked to ulcers, stomach bleeding, liver damage, and increased risk of heart attacks. Topical NSAIDs, such as diclofenac (Voltaren), may pose less risk.

4. Heat and cold

Heat can loosen hand stiffness. Dr. Blazar says a hot shower will do the job. Cold is effective for hand pain that results from activity, such as playing golf. “Apply it in the form of flexible gel pads you keep in the freezer, or even bags of frozen peas or corn, which conform well to the three-dimensional complexities of the hand,” says Dr. Blazar.

5. Exercises and stretches

These focus on your hand’s tendons and muscles. A physical therapist or occupational therapist can guide you through exercises to stretch and strengthen the muscles, which can help absorb the stress on joints in the hand and reduce pain.

Have a question about hand cramps? Learn more about it here.

Disclaimer:
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Hand Pain

Hand conditions we treat include:

  • Hand Nerve Entrapment
    • Carpal Tunnel Syndrome
    • Cubital Tunnel Syndrome
  • Dupuytren’s Contracture
  • DeQuervain’s Disease
  • Finger Conditions
  • Hand Cysts and Tumors
  • Arthritis
  • Thumb Arthritis
  • Fractures and Dislocations
  • Reflex Sympathetic Dystrophy
  • Tendon Conditions
  • Ulnar Nerve Compression

Hand Nerve Entrapment

When the protective covering surrounding the nerves in your hand, arm, or elbow tightens, and squeezes the nerve itself, a condition called hand nerve entrapment can result.

Carpal Tunnel Syndrome

The carpal tunnel is a space in the wrist where a nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome is a type of hand nerve entrapment that occurs when swelling in the tunnel compresses the median nerve. As a result of the pressure on the median nerve, patients with carpal tunnel syndrome may experience symptoms including:

  • Pain in the hand and fingers, including burning, tingling, and numbness
  • Pain in the wrist or hand, extending to the elbow
  • Sensation that the hand is swollen, even if it is not
  • Weakened grip and difficulty picking up small items
  • Problems with fine finger movements in one or both hands
  • Numbness in hands

This condition is common in people who perform repetitive wrist and hand motions, such as typing on a computer keyboard. It also affects those who grip tightly or uses their wrists consistently, such as cashiers, cyclists, meat cutters, and musicians.

Treatment

Many nonsurgical courses of treatment for carpal tunnel syndrome are available, such as

  • Splints or braces to immobilize and rest the wrist
  • Adjustments to how you perform daily activities
  • Oral anti-inflammatory medications
  • Steroid injections

If nonsurgical treatment is not successful or treatment is sought too late, surgery may be required. This surgery involves enlarging the carpal tunnel, which will relieve the swelling and pressure on the nerve.

Learn more about MedStar Health’s approach to minimally invasive nerve surgery.

Cubital Tunnel Syndrome

The cubital tunnel is a narrow tube of tissue at your elbow that contains the ulnar nerve. The ulnar nerve runs from your shoulder down to your wrist and controls movement in your ring and pinky fingers. Cubital Tunnel Syndrome is a type of hand nerve entrapment that forms when this tunnel swells, putting pressure on the ulnar nerve, causing pain and numbness in the hand and fingers.

Cubital tunnel syndrome can cause the following symptoms:

  • Tingling in the ring and pinky fingers, making it more difficult to use them
  • Numbness in the ring and pinky fingers
  • Weakness in the hands

The cubital tunnel is more likely to swell if

  • You sleep or lean on your elbow for too long
  • You bend the elbow back and forth repeatedly
  • Fluid builds up in the elbow
  • You hit or fall on the elbow with force

Other conditions that can contribute to the development of cubital tunnel syndrome include elbow arthritis, fractures, cysts, and bone spurs.

Treatment for cubital tunnel syndrome depends on how severely your nerve is compressed and whether you are beginning to develop muscle weakness. Nonsurgical treatment options may include

  • Braces
  • Splints
  • Injections of steroids or anti-inflammatory medications
  • Physical therapy

If nonsurgical treatment does not relieve your symptoms, or your muscles are weakening too much, you may need surgery. Surgical options can relieve symptoms by:

  • Widening the cubital tunnel to release the pressure on your nerve
  • Moving the nerve so it is more protected from injury

Learn more about MedStar Health’s approach to minimally invasive nerve surgery.

Dupuytren’s Contracture

Dupuytren’s contracture is an abnormal thickening of the tissue between the skin and the tendons in the palm, which may limit the use of one or more fingers or may eventually cause the fingers to be pulled in toward the palm in a bent position.

The first sign of the condition is usually a small lump or nodule in the palm, often occurring in the crease of the hand that is closest to the base of the ring and little fingers. Further indication is that at a certain point, the palm cannot be placed flush with a flat surface such as a table. As the disease progresses, the involved finger is drawn toward the palm by the band of fibrous tissue that forms there.

Dupuytren’s contracture is a hereditary condition and the cause is not known. It is more common in men over the age of 50. The disease appears later in women.

Treatment is most effective when sought at the nodule (small lump) stage. Collagenase injections are available as a nonsurgical option. Surgery will only temporarily restore use to the fingers. With time, the condition will return. You doctor will discuss with you your individual case and whether surgery is a viable option for you.

DeQuervain’s Disease

DeQuervain’s disease is an irritation and swelling of the sheath or tunnel that surrounds the thumb tendons as they pass from the wrist to the thumb. The source of DeQuervain’s disease is often unknown, but it may be caused by overuse and repetitive motions and has been associated with pregnancy and certain inflammatory conditions such as rheumatoid arthritis. Although anyone can get DeQuervain’s, it affects women considerably more often than men.

Symptoms may include

  • Twinges of pain at the base of the thumb or the thumb side of the wrist.
  • Pain that appears gradually or suddenly, and it is felt in the wrist and can travel up the forearm.
  • Pain that is usually worse with use of the hand and thumb, especially when forcefully grasping things or lifting items such as a gallon of milk.

In almost all cases, nonsurgical treatments are explored first. Splints, oral anti-inflammatory medications or injections may help reduce the irritation and swelling. Temporary avoidance of activities that cause pain may also ward off symptoms.

For those cases that do not respond to nonsurgical treatments, surgery may be recommended. The procedure enlarges the tendon compartment to make more room for the irritated tendon. Normal use of the hand can be resumed once comfort and strength return.

Finger Conditions

Mallet finger is a rupture of the tendon at the tip of the finger, which causes the tip of the finger to drop or bend downward, creating a mallet shape. It is usually not painful unless a piece of bone is broken as well. Mallet finger can be caused by a direct blow to the finger and commonly affects athletes.

Nail bed injuries often occur when fingers are crushed, causing the bone beneath the nail to fracture, a cut to the nail bed itself, or, simply, a tremendous bruise. These injuries tend to cause hematomas, blood pooled under the nail that appears black or blue. The pressure of the blood can be very painful and, in some cases, permanent deformity can result. The pain can be reduced by having the blood drained by a physician.

Skier’s and goalkeeper’s thumb, the most common of all ligament tears, is a tear of the ligament at the base of the thumb where it meets the palm. Skier’s/goal keeper’s thumb is usually caused by falling on an outstretched hand and thumb. Nonsurgical treatment involves splinting and casting, but surgery may be required to repair the tear.

Trigger finger is the common name for a condition that leads to swelling in the tendons that control finger bending. Such swelling prevents the tendons from gliding smoothly, which causes pain, popping, or a catching feeling. Whenever possible, nonsurgical treatment are attempted first. Splints, oral anti-inflammatory medications, steroid injections, and adjustments in daily activities may be successful in reducing the swelling around the tendon. If the finger does not respond to nonsurgical treatments, surgery may be recommended.

Hand Cysts and Tumors

A tumor is any kind of unusual group of cells that grows in your body. We often associate tumors with cancer, but most hand tumors are not cancerous.

A ganglion cyst is the most common hand tumor and generally grows either on the top or inner side of your wrist. These fluid-filled pouches can put pressure on your nerves, causing pain.

Symptoms

  • The earliest indicator you will see is the lump (ganglion cyst) itself. The lumps are typically very painful but they can sometimes be painless.
  • Pain and tenderness will increase with extended use of the hand, and range of motion may be restricted.
  • Ganglions often change in size and may disappear spontaneously and completely.

A giant cell tumor of tendon sheath is another common hand tumor, but it is solid, rather than filled with fluid. It grows on the protective covering that surrounds the tendons in the fingers.

Physicians generally seek to heal ganglion cysts without surgery. In some cases, ganglion cysts disappear on their own without any treatment. For cysts that do not resolve themselves, treatment options include:

  • Brace or splint: Wearing a brace or splint keeps the affected wrist from moving. Resting the wrist keeps the cyst from growing, and helps to relieve pain.
  • Aspiration: Your physician may drain the fluid within the cyst, helping it to heal and disappear.
  • Surgery: Surgery is recommended for giant cell tumors of tendon sheath and ganglion cysts that return even after aspiration. Minimally invasive hand surgery is employed to remove the cyst or tumor, as well as any affected surrounding joint tissue.

Arthritis

Arthritis is an inflammation of the tissues that line your joints. This inflammation can cause pain, swelling, and joint damage.

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.

Hand arthritis symptoms can include:

  • Pain or burning in the hand joints, especially in the morning and with heavy use
  • Swelling
  • Warmth due to inflammation
  • 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
  • Swelling
  • Lack of strength
  • Difficulty moving the wrist

Along with the symptoms above, rheumatoid arthritis can also cause:

  • A weak grip
  • Difficulty using the hand
  • Pain in the knuckles
  • Fatigue
  • 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 disorders—from early-stage management to end-stage joint replacement—and 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.

Thumb Arthritis

Thumb arthritis, also called basal joint arthritis, is a type of osteoarthritis caused when cartilage wears away in the joint at the base of the thumb.

People who work with their hands and perform repetitive gripping movements are more likely to develop the condition. Massage therapists, hairdressers, or others who work with tools or instruments have the greatest risk of developing the disease. Basal joint fractures or ligament injuries can also increase the likelihood of developing thumb arthritis.

Left untreated, thumb arthritis can cause severe pain and make it difficult to perform even simple tasks. The best way to minimize the damage of thumb arthritis and treat it successfully is to see your doctor when symptoms begin. The sooner you begin treatment, the more options you’ll have to manage the condition.

Symptoms often include

  • Pain felt at the base of your thumb when you grip or pinch something.
  • Pain when you apply pressure to the heel of your hand.
  • Stiffness in the morning that gets better during the day, but begins to ache in the evening.
  • Swelling and tenderness at the base of the thumb.
  • Aching in the joint after prolonged use.
  • A limited range of motion in the thumb, or loss of strength while gripping or pinching items
  • A bump on the joint or an enlarged, out-of-joint appearance

Treatment

In the early stages of thumb arthritis, a number of treatments can alleviate symptoms, including:

  • Oral or topical medications, such as acetaminophen, ibuprofen, prescription pain relievers, or pain-relieving gels
  • Icing the area for five to 15 minutes as needed throughout the day to relieve pain and swelling
  • Working with a hand therapist to strengthen supporting muscles and tendons and learning adaptive techniques to lessen the strain on the joint
  • Wearing a supportive splint or brace to limit thumb movement and allow the joint to heal

In many cases, your doctor will suggest a combination of treatments to control symptoms. When medications, self-care, and physical therapy aren’t successful, steroid injections can relieve pain and swelling for several months. Because steroid injections can’t be used indefinitely, they only offer a temporary solution.

When nonsurgical treatments are no longer effective, surgery can offer relief. Most often, surgeons use the ligament reconstruction and tendon interposition (LRTI) technique, which can restore thumb movement and eliminate pain. During this outpatient procedure, surgeons remove the arthritic joint and replace it with a graft from one of your tendons to stabilize the thumb. Because tendons are used, rather than a metal or plastic implant that can wear out, the surgery can provide a long-term solution.

Fractures

Generally, fractured hands, fingers, and wrists will heal without surgery and nonsurgical treatment often includes splints or casts and physical therapy.

If your injury caused your bones to shift out of place or break through the skin, you may need surgery to restore the proper alignment. During surgery, your orthopaedic surgeon may use wires, screws, or plates to secure your bones back to the correct position.

MedStar also offers advanced surgical options, including:

  • Advanced wrist arthroscopy
  • Complex fracture repair of the hand and wrist

Reflex Sympathetic Dystrophy

Reflex sympathetic dystrophy (RSD) is a condition of chronic, burning pain; stiffness; swelling; sweating; and discoloration of the hand or arm that may become disabling. It occurs from over-activity in the sympathetic (unconscious) nervous system that controls the blood flow, sweat glands, and other involuntary bodily functions. Additionally, a patient with RSD who sustains an injury usually feels a greater amount of pain than a person without RSD who has sustained the same injury.

RSD has three stages:

  • Acute: May last up to three months. Symptoms include pain and swelling, increased warmth and redness in the affected part/limb, and excessive sweating.
  • Dystrophic: Can last three to 12 months. Swelling is more constant, skin wrinkles disappear, skin temperature becomes cooler, and fingernails become brittle. Pain is more widespread, stiffness increases, and the affected area becomes sensitive to touch.
  • Atrophic: Lasts one year or more. The skin of the affected area is now pale, dry, tightly stretched and shiny. The area is stiff, pain may decrease, and the chance of getting motion back is decreased.

Causes

In some cases, the cause of RSD is unknown. RSD may follow a sprain, fracture, injury to nerves or blood vessels, or the symptoms may appear after a surgery. Other causes include pressure on a nerve, infection, cancer, neck disorders, stroke, or heart attack.

The pain of RSD may be severe, resulting in physical and psychological alterations. A coordinated multidisciplinary approach to treatment is best, which may include medication (oral and injections), physical or occupational therapy, and/or surgery.

Tendon Conditions

The tissues that attach your bones to your muscles are called tendons. When your muscles flex, tendons spring into action, helping to move your bones. It is easy to injure the tendons in the arms and hands, since we use them so often.

Tendinitis

Tendinitis is an inflammation of a tendon that causes pain near a joint. It generally develops when an accident or injury cuts or damages the tendon.

  • Tennis elbow is the common term for one of the most common types of tendinitis. It is an overuse injury that causes an inflammation of the tendon fibers that attach the forearm muscles to the outside of the elbow. As the name suggests, tennis players, as well as golf players and other athletes, often suffer from this type of tendinitis. But it can also affect you if you twist your wrist repeatedly on a regular basis, or if you type on a computer keyboard without proper support.

Although tendinitis can be painful, the good news is that it rarely becomes chronic if caught early and treated properly with the following

  • Rest
  • Ice
  • Cortisone injections
  • Ceasing or changing your activity
  • Wrist splints

If surgery becomes necessary, arthroscopic procedures are minimally invasive, provide a relatively short recovery period, and can produce long-lasting results.

Tendon Flexor Injuries

The muscles located in the hand and forearm that control the bending or flexing of the fingers are called flexor muscles. The tendons of the flexor muscles that lead to the fingers and the thumb begin just beyond the middle of the forearm.

Deep cuts on the palm side of the wrist, hand, or fingers can cause tendon flexor injuries. With partial cuts, fingers may still bend, but the motion will be painful and the tendon may eventually rupture. When both tendons are cut completely through, the finger joints cannot bend on their own at all.

It is more than likely that your doctor will recommend surgery to repair your cut tendon. Following surgery, and depending on the type of cut, the injured area will either be protected from movement or started on a very specific limited motion program for several weeks.

Trigger Finger

Trigger finger is the common name for a condition that leads to swelling in the tendons that control finger bending. Such swelling prevents the tendons from gliding smoothly, which causes pain, popping, or a catching feeling.

Whenever possible, nonsurgical treatment are attempted first. Splints, oral anti-inflammatory medications, steroid injections, and adjustments in daily activities may be successful in reducing the swelling around the tendon. If the finger does not respond to nonsurgical treatments, surgery may be recommended.

Ulnar Nerve Compression

The ulnar nerve is what people commonly call the funny bone. It fits in a groove in the bottom of the elbow and is very vulnerable to stress, trauma, or overuse. Ulnar nerve compression can cause a lack of sensation, muscular weakness, and shooting pain from the elbow down to the pinkie and ring finger. Numbness and tingling in ring and pinkie fingers are the most common symptoms.

Nonsurgical treatments such as splints, oral anti-inflammatory medications, and adjustments in daily activities are typically pursued as the initial course of action. If the swelling around the nerve does not respond to nonsurgical treatments, surgery may be recommended.

Hand and wrist pain

There are a number of conditions that can affect the hand and wrist.

Carpal tunnel syndrome

Carpal tunnel syndrome occurs when there’s pressure on the median nerve as it passes through the carpal tunnel.

This can cause tingling, numbness and pain, mainly in your hand and fingers. It can also cause similar symptoms in the wrist and forearm. Often the symptoms are worse at night.

If you think you have carpal tunnel syndrome, you should get an appointment at your GP surgery.

Carpal tunnel syndrome can go away in a few weeks or months. Using a splint or having a steroid injection can help.

If symptoms don’t go away, a minor operation to relieve the pressure in the carpal tunnel can solve the problem.

De Quervain’s tendinopathy

Problems can develop with tendons in the hand and wrist.

Tendons have a protective covering, or sheath, with synovial fluid in. This thick fluid protects the tendon and allows it to move easier.

Sometimes tendons or tendon sheaths can become inflamed. This can cause pain, swelling and stiffness and is called tendinopathy.

It can happen if tendons are overused, for example after playing a lot of sport.

Arthritis can lead to tendinopathy, and in rare cases so can an infection. Sometimes, there might not be an apparent cause.

De Quervain’s (Dey kwer-veins) tendinopathy is a common condition that can affect tendons in the wrist, causing pain around the wrist and at the base of the thumb. Pain normally eases with rest and can get worse with activity.

Applying ice wrapped in a damp towel and taking an NSAID can help. If your condition is not improving and is affecting your quality of life, steroid injections, splints, hand therapy or surgery might also be helpful.

Trigger finger

Trigger finger is the name of a condition in which you can’t straighten a finger or thumb properly. You might even need to use your other hand to straighten it. Very occasionally, a finger may become too painful to straighten and may stay stuck in the same position.

Trigger finger most commonly affects the thumb, ring and middle finger. More than one finger can be affected at the same time.

The affected finger might swell, and it can be painful.

There can be a clicking or popping sensation that comes from the finger, especially in the morning.

It’s thought to be caused by swelling of a tendon or tendon sheath.

Sometimes the swelling can cause nodules to form. These are small lumps that form under the skin.

Trigger finger can happen to otherwise healthy people for no clear reason. It’s more common among women over the age of 40.

It’s more likely if you’ve had a previous injury to the palm of the hand. Other medical conditions such as diabetes, gout, rheumatoid arthritis and an underactive thyroid may also increase someone’s risk of getting it.

Trigger finger can get better without the need for treatment. You may need to avoid certain activities if it’s thought they’re making your symptoms worse.

NSAIDs, like ibuprofen, can help.

If it doesn’t get better on its own and it isn’t treated, it’s possible for an affected thumb or finger to become permanently bent. Treatment can involve steroid injections. In most cases this will sort out the problem.

In some cases, a small operation can be carried out to stop the tendon from catching.

Dupuytren’s contracture

Dupuytren’s (due-per-trens) contracture can cause the fingers to bend in towards the palm of the hand.

It’s caused by tissues in the palms of the hands gradually thickening, which then pulls the fingers towards the palm.

This condition is often mild and might not need specific treatment. It’s more common in men in their middle age. Some heavy, repetitive tasks, such as those that are performed in mining, are thought to increase the risk of Dupuytren’s.

It normally affects the middle, ring and little finger.

It’s not often painful, but it can make it difficult to straighten out fingers and use your hands properly.

It may affect just one hand, but often affects both hands.

Treatment is only needed if fingers have started to bend, or if you can’t use your hand properly.

Treatment options available in the earlier stages, include injections of a medicine called collagenase (colla-gen-ayse). This can break down the thickened tissues. This is a quick and easy treatment that doesn’t need to be done as an operation. You will need to have your fingers straightened and stretched afterwards by a healthcare professional, which might be a bit uncomfortable.

There are surgical options including cutting the thickened tissue or cutting it out. This can be done as an operation or using a needle in an outpatient clinic.

Talk to your doctor to discuss your options if your symptoms aren’t improving.

Osteoarthritis

Osteoarthritis is the most common type of arthritis. It can affect hands and wrists, particularly the joints at the ends of the fingers or at the base of the thumb.

It can cause pain and stiffness, and make it difficult to use your hands and wrists properly.

Osteoarthritis can cause bony lumps to develop on the hands, particularly on the fingers.

If possible, it can help to avoid tasks that make the pain worse and put strain on your hands and wrists.

Keeping your hands and wrists moving as much as possible can help ease symptoms. There are some examples of simple exercises you could do, try to do these every day.

Taking painkillers, such as paracetamol, or NSAIDs such as ibuprofen can help ease pain and help you to keep moving your hands.

Capsaicin cream, which is made from extracts from chili plants, has helped some people with osteoarthritis of the hand. It can help block pain messages sent to nerves.

In some cases, if symptoms don’t improve then surgery might be an option. Finger joints can be fused. This can improve symptoms, but it will lead to a loss of movement.

It’s also possible to have joint replacements for hand osteoarthritis. Another option could be arthroscopy, also known as key-hole surgery, to clean out a joint using a small cut, rather than open surgery.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune condition that can cause inflammation in joints.

This condition can sometimes start in the hands and wrists, with symptoms of pain, swelling and stiffness. This is often worse first thing in the morning. The stiffness can last for longer than half an hour and tends not to ease with movement. Joints can feel warm, and they can sometimes be red.

Rheumatoid arthritis can affect both hands and wrists in the same way at the same time. The symptoms can start quite gradually.

This is an uncommon condition in the general population. But if you do get any of these symptoms in your hands, especially if you also have an overall feeling of being unwell and very tired, see a doctor as soon as you can.

There are drugs that can treat the underlying cause of rheumatoid arthritis, and these can help prevent damage to your joints. The earlier treatment is started, the more effective it’s likely to be.

Hand-arm vibration syndrome

A condition called hand-arm vibration syndrome can affect people who have regularly used vibrating tools and machinery over a period of around 10 years or more. Such tools include pneumatic drills, power drills and chainsaws.

The early symptoms are loss of feeling, numbness and pins and needles in the fingers. Symptoms can often be mild, and just affect the ends of the fingers.

It might cause whole fingers to go numb. For some people this can make tasks such as doing up buttons and picking up small objects like coins difficult.

It’s thought that it could be caused by repeated minor injuries to the small nerves and blood vessels in the fingers.

Hand-arm vibration syndrome can lead to another condition called Raynaud’s phenomenon. See below.

If you think you have symptoms of hand-arm vibration syndrome see a doctor and report it to your manager if you think it’s being caused by something you do at work.

You might need to stop using vibrating tools and machinery to stop your condition getting worse.

Raynaud’s phenomenon

Raynaud’s phenomenon is a condition that causes a reduction in blood supply to the outer parts of the body, including the fingers.

It can happen in the cold or in stressful situations. It can also occur as a result of using hand-held vibrating tools.

During an attack of Raynaud’s, the fingers can change colour. They may first go white or look waxy. They can then go blue, and possibly even purple or black in severe cases. They are then likely to go red, and can be painful, tingly and numb when the blood rushes back.

Keeping warm in cold weather can help reduce the chances of an attack of Raynaud’s. Wearing several layers of clothing, as well as a hat, scarf and gloves will help. Reusable or disposable hand warmers and heated gloves can help.

It’s good to keep the skin of your fingers as healthy as possible by using a moisturiser at least once or twice a day. Your pharmacist will be able to tell you which ones are good for people with Raynaud’s.

Exercising regularly is also good for your circulation.

Smoking is very bad for your circulation and can make Raynaud’s much worse. If you smoke, quitting can be the best thing you do. Your GP will be able to offer advice and support, and there’s useful information on the NHS Smokefree website.

There are drugs available, such as nifedipine, which can improve your blood flow. These will need to be prescribed by a doctor.

8 Simple way’s to Prevent your Hand Aching when Writing

Often when faced with mountains of paperwork, homework or even just sketching, your hands will undoubtedly start to ache. Here are some useful everyday tips you can use to stop this from happening.

1)Take Breaks

Taking small frequent breaks in a long session of writing or sketching will most definitely help reduce the amount your hand will ache. This is due to relaxing the muscles which will help prevent a repetitive strain injury in your wrist and fingers. Taking frequent breaks will also help you focus when you return from a break due to refreshing your mind and having a clear vision of what must be done. The time you take your breaks will depend on how long you plan to work on a task. For example, if you plan on working on a task for an hour, you should take a 5 minute beak every 15 minutes.

2)Improving your posture

Practising good posture when holding your pen will dramatically have an impact on how long you can write for without your hand hurting. By having a comfortable grip on your pen or pencil, you find yourself gaining some rhythm and flow whilst writing. People commonly hold their pen incorrectly (find out how to hold your pen correctly), this will often strain parts of their hand and cause the individual to stop midway through a task.

3)Stretch your hands

Before starting a long period of writing or sketching, it is recommended that you stretch your fingers and warm your hands. This stimulates blood flow improving flexibility and reducing stiffness.

With both hands, grab each finger one by one and bend upwards so the tip is facing up. Do this twice for each finger. You then interlock each finger and push forward until you feel a slight strain.

View the Video

4)Shake it out

After stretching each individual finger, it is vital to shake the tension out. This will help relieve any existing pain or irritation and help increase blood circulation, resulting in a more relaxed hand and therefore better posture.

5)What pen do you use?

If you are using a pen for a long period of time, it is vital that you have a pen with a comfy grip and a sturdy barrel. My preference is the Pilot Capless. This pen gives you an unusual yet extremely comfortable grip due to the clip being in the same place as your figures should be. The creators have cleverly designed the sophisticated pen to look the part and to also perform to its best ability. Choosing the right pen mainly depends on the individual’s hand.

6)Staying Hydrated

Dehydration is usually the common cause of musculature cramps and pain. Muscle cramps can also be caused by lack of potassium and vitamin D. Increasing the intake of these vital vitamins in your diet can have a positive impact on your hands cramping in the future. Drinking water plays a significant part in helping all aspects of your body to function properly.

7)Angle of the paper

Getting the correct positioning of the paper is vital for avoiding arm or hand pains and cramps. Each person is different and has different opinions of how they should position paper on the table. As I am right handed, I’d have the paper angled to the left (angled right for lefthanders).

Having another piece of paper underneath the one you are writing on, will help grip and will also heighten the overall sensation and experience. You won’t be able to feel the wood grains through the paper. When writing with a single sheet of paper, there is a chance that you can rip through and ruin any work you have already done.

8)Using the right pen for you

Everyone has a different opinion of what feels comfortable and what doesn’t. When selecting the right pen, you must keep in mind: budget, size of pen, nib size and cartridge capacity. Visit our blog on How to Hold a Pen Correctly. Using a decent pen rather than a free promotional pen really helps. Promotional pens are designed to only last a short period of time whereas pens that cost money are more than likely going to last for a long time.

Conclusion

Some individuals think the best way to prevent their hands and wrists from aching is by taking long breaks, others say stretching their figures and wrist is better. I think by trying all tips provided, will give you a better idea of what works and what doesn’t. When I attempted to try these tips, I found that drinking water had a significant impact on the way I was feeling when I was writing. I had more energy and better concentration. Please comment below, what worked for you?

Office workers in the UK can spend over five hours a day sitting at their desk. This can have a negative effect on our physical health. Whilst steps may have been taken to help, like making desks ergonomically sound, our wrists and hands can often be areas we neglect.

Typing away on a keyboard for hours, or sitting in a meeting jotting down notes without the correct support can lead to both hand and wrist pain. If not properly attended to, further problems like carpal tunnel syndrome or repetitive strain injury (RSI) may develop.

We’ve put together some ways in which you can help reduce any ache and pains that may occur from long stints of typing and writing.

How to ease wrist pain when typing

Pain in the wrist can be problematic when it comes to working, as the constant strain can make it difficult to type or write effectively. However, there are some changes you can make to how you position your arms and hands which may help to ease discomfort.

You should always try to keep your wrists in line with your forearms and not bend them up while typing. Also try to avoid hovering over the keys – this puts unnecessary strain on your wrists. To help avoid sore fingers, try to avoid pressing on your keyboard keys too forcefully.

A gel support can provide some relief when working – simply place it in front of your keyboard. An ergonomic keyboard encourages the natural positioning of your wrists, so you can type comfortably. You could also use a sloped desk when writing, or a laptop or computer stand as it can allow for a better shoulder and elbow position for writing.

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Am I holding my pen correctly?

If you write excessively by hand, writing cramp can become an issue. This can be because of a number of reasons, such as poor writing posture or not holding your pen correctly. Gripping a pen too tightly can also cause wrist pain or sore fingers, so learning (or re-learning) how to hold your pen will be beneficial.

Always choose a pen which feels comfortable to you and writes smoothly. Don’t hold the pen too hard, and allow the whole of your arm to write – not just your fingers. Your hand should be straight and the paper should always be a comfortable distance in front of you, meaning you don’t need to strain or lean in, in any way. Make sure your whole desk is ergonomically optimised – whether you’re working at a standing desk or a sitting desk. A specially designed ergonomic pen or pencil can help provide some relief when handwriting for a substantial amount of time.

What stretches can I do to help ease pain in wrist and fingers?

If you’ve been typing or writing for a while, try doing a few simple exercises which help stretch out your hands and wrists. Shake out your hands and rotate your wrists. This can help keep the blood flowing and avoid cramping.

By making small changes to how you write and type and re-learning techniques like how to hold a pen, you can help yourself to avoid any unnecessary strain or uncomfortable aches. It’s also important to make sure the rest of your body is stretched out – read our guide to office ailments and ergonomic solutions to help prevent any other ailments becoming a more serious issue.

Pain in the hands or wrists is more common than ever, thanks to the prevalence of smartphones and computer-focused work environments. But how do you know if your pain is associated with carpal tunnel syndrome, or a handful of other common diseases?
“Many of the most common conditions impacting the hands and wrists appear to share traits, but they have very different causes,” says Geisinger hand surgeon Dr. Joel Klena. “They can originate in the muscle or the joint, and can be a result of genetics, general overuse or sudden impact.”
Carpal Tunnel Syndrome
Carpal tunnel syndrome affects as many as 3 percent of all working-age Americans, totaling nearly 8 million people. Plus, it can come out of nowhere and pack a serious punch.
“The condition is named after the carpal tunnel in your wrist which acts as a passage for your median nerve,” said Dr. Klena. “This nerve controls feeling and movement in your thumb and fingers, except the pinky.”
In carpal tunnel syndrome, repetitive motions—especially when you’re working with your arms on a downward slant, leaving the hands below your wrists—cause a narrowing of the passage that squeezes the nerve. This can be painful and lead to cramping. In extreme cases, you can also lose muscle mass in the hands leading to chronic cramping and reduced strength.
Carpal tunnel can be diagnosed through several manual tests performed by your doctor, most of which test your wrists’ reflexes or response to stimuli.
“Carpal tunnel can be treated with brief immobilization using a splint to give the wrists a break, but can also call for anti-inflammatory drugs or even surgery in severe cases,” says Dr. Klena.
De Quervain’s Tenosynovitis
De Quervain’s Tenosynovitis, a disease named after the Swiss surgeon who first identified it in 1895, is marked by pain on the “thumb side” of your wrists, making it difficult to make a fist or grasp objects. You may also have trouble moving your thumb or notice swelling near its base.
Though its exact cause hasn’t been proven, experts believe tendon damage from repetitive motions like playing an instrument (or texting!) can trigger or worsen De Quervain’s tenosynovitis.
A positive diagnosis requires the Finkelstein test, where the fingers and hand are positioned in a way that is painful for damaged ligaments.
Similarly to carpal tunnel, De Quervain’s tenosynovitis is treated with over-the-counter anti-inflammatory medication or corticosteroid injections to reduce swelling. Pregnant women are also more prone to the condition, which usually dissipates after birth or the end of breastfeeding.
Ganglion Cysts
Ganglion cysts are a common type of mass that usually appear on the backs of the wrists. They are almost always benign, but can grow and fluctuate in size quickly. In larger sizes, they can also become painful or limit movement in the wrist.
“Ganglion cysts come from the joint’s tissue and are filled with a fluid similar to our joints’ lubricant,” explains Dr. Klena. “Heavy use or repetitive movements often cause the cysts to grow, while rest can shrink the mass.”
Ganglion cysts are most common in women between the ages of 15 and 40, but can also happen in men and people of all ages. If the cyst causes pain or limits movement, your doctor may recommend immobilization or non-surgical draining the fluid using a localized numbing cream. If the growth returns, they may recommend minor surgery for its full removal.
Joel Klena, M.D., is Geisinger’s chief of Hand and Microvascular Surgery. To schedule a consultation for carpal tunnel, hand pain or wrist pain, call 800-275-6401.

Finger pain

Injuries are a common cause of finger pain. Your finger may become injured from:

  • Playing contact sports such as football, baseball, or soccer
  • Doing recreational activities such as skiing or tennis
  • Using machinery at home or work
  • Doing tasks at home, such as cooking, gardening, cleaning, or repairs
  • Falling
  • Getting into a fist fight or punching something
  • Doing repetitive movements like typing

Injuries that can cause finger pain include:

  • Smashed fingers, such as from a hammer blow or a car door that crushes the finger.
  • Compartment syndrome, which is severe swelling and pressure in an area of muscles, nerves, and blood vessels. A crushing injury can cause this serious condition, which requires immediate medical attention.
  • Mallet finger, when you can’t straighten your finger. Sports injuries are a common cause.
  • Finger strains, sprains, and bruises.
  • Broken finger bones.
  • Skier’s thumb, an injury to the ligaments in your thumb, such as from a fall during skiing.
  • Cuts and puncture wounds.
  • Dislocation.

Certain conditions can also cause finger pain:

  • Arthritis, the breakdown of cartilage in the joint that causes inflammation with pain, stiffness, and swelling.
  • Carpal tunnel syndrome, pressure on the nerve in the wrist, or other nerve problems causing numbness and pain in the hand and fingers.
  • Raynaud phenomenon, a condition that results in blocked blood flow to the fingers when it is cold.
  • Trigger finger, when a swollen finger tendon makes it hard to straighten or bend your finger.
  • Dupuytrens contracture, which causes tissue in the palm of the hand to become tighter. This makes it hard to straighten the fingers.
  • De Quervain tenosynovitis, which is pain in the tendons along the thumb side of the wrist from overuse.
  • Infections.
  • Tumors.

Sore Wrists And Hands Can Result From Our Work: But Is It Carpal Tunnel Syndrome?

An estimated 260,000 carpal tunnel surgeries are performed annually in the United States, and of those, more than 35,000 were performed in 2006 by neurosurgeons, according to AANS statistics. A neurosurgeon’s primary role in the treatment of carpal tunnel syndrome is diagnosis, interpretation of test results, and when necessary, surgery. There are frequently other medical professionals involved in the treatment process, such as physical therapists.

Carpal tunnel syndrome most often occurs when the median nerve in the wrist becomes inflamed, caused by a combination of thickened ligaments over the nerve and repetitive movements. “Carpal tunnel syndrome is most prevalent in women ages 40 to 60, and also tends to affect people more frequently who use their hands excessively, such as pianists, concert violinists, hairdressers, computer operators, manual laborers, artists, sculptors, dentists, and even neurosurgeons,” says James R. Bean, MD, AANS president-elect.

Any repetitive motions that cause significant swelling, thickening or irritation of membranes around the tendons in the carpal tunnel can result in pressure on the median nerve, disrupting transmission of sensations from the hand up to the arm and to the central nervous system.

Diseases or conditions that may increase your chances of developing carpal tunnel syndrome include pregnancy, diabetes, menopause, broken or dislocated bones in the wrist, and obesity. Additional causes include repetitive and forceful grasping with the hands, bending of the wrist, and arthritis.

It is important to seek medical advice when you first notice persistent symptoms. Do not wait for your pain to become intolerable. Before your doctor can recommend a course of treatment, he or she will perform a thorough evaluation, including a medical history, physical examination and diagnostic tests. Your doctor will ask about the extent to which your symptoms affect daily living. Sometimes a case turns out to be tendonitis and not carpal tunnel, but only a doctor can make a proper diagnosis.

The main purpose of conservative treatment is to reduce or eliminate repetitive injury to the median nerve. In some cases, carpal tunnel syndrome can be treated by immobilizing the wrist in a splint to minimize or stop pressure on the nerves. If that does not work, patients are sometimes prescribed anti-inflammatory medications or cortisone injections in the wrist to reduce swelling. Your doctor may suggest specific types of hand and wrist exercises, which may be helpful. Treatment for carpal tunnel syndrome may include rest, the use of a wrist splint during sleep, or physical therapy. Conservative treatment methods may continue for up to eight weeks.

If conservative treatment methods do not provide sufficient relief, your doctor may perform diagnostic studies to determine if surgery is an effective option. These diagnostic tests include x-rays and electromyogram and nerve conduction studies. X-rays can help determine if any abnormalities in bones of the wrist may be contributing factors. Electromyogram and nerve conduction studies can reveal significant compression on the median nerve in the carpal tunnel.

If patients suffer from severe pain that cannot be relieved through rest, rehabilitation or nonsurgical treatment, there are several surgical procedures that can be performed to relieve pressure on the median nerve. The most common procedure is called a carpal tunnel release, which can be performed using an open incision or with endoscopic techniques. The open incision procedure or carpal tunnel release, involves the neurosurgeon making an incision in the wrist or palm and then releasing the ligament that is compressing and placing pressure on the median nerve. The endoscopic carpal tunnel release procedure involves making a smaller incision and using a miniaturized camera to assist the neurosurgeon in viewing the carpal tunnel.

Risks of carpal tunnel surgery are minimal. The majority of individuals recover completely. “The results of surgery are usually excellent, with most patients receiving nearly full relief of their symptoms. The earlier you get diagnosis and treatment, generally the better the outcome,” states Dr. Bean.

PMC

4. Discussion

Pathology in the sensory nerves can cause neuropathic pain. Sensory polyneuropathy is one of the most common causes of neuropathic pain. The diagnosis of distal axonal sensory polyneuropathy is extracted from nerve conduction work-up reports based on the presence of bilateral, symmetric, distal lower, and upper extremity neuropathic pain. The motor nerves are unaffected, and there is no muscle weakness in this condition. Only the hands experienced neuropathic pain in the WHS group, while there was neuropathic pain in both the feet and hands in the polyneuropathy group.

Sensory nerve conduction work-ups of the median, ulnar, and sural nerves are widely used in the electrodiagnosis of sensory polyneuropathy. The long nerves are most commonly affected by polyneuropathy. Thus, the sural sensory nerve action potential (SNAP) amplitude is likely the most useful parameter for differentiating normal subjects from those with distal sensory polyneuropathy. Even the sural SNAP is most sensitive in the diagnosis of early distal sensory polyneuropathy. The sural nerve results were significantly affected in the polyneuropathy group, while the WHS group had normal sural nerve conduction work-ups.

Several diseases affect the nerves of the hand, the most common being CTS, which is caused by median nerves in the carpal tunnels becoming stuck. It is characterized by neuropathic complaints in the first 4 fingers and the palm of the hand. Its symptoms manifest usually during rest hours or nighttime, and the cases identified in this article were similar in that regard. This means the entirety of their hand and the fingers had neuropathic pain. Women are more commonly affected by CTS, and rheumatism, pregnancy, and diabetes are among the known risk factors for CTS. All of my cases were men, and they had no known CTS risk factors. Characteristic electrophysiological findings of CTS include a progressively delayed sensory peak latency, and amplitude becomes smaller in the median nerve. In medium cases, similar findings appear in the motor nerves. In advanced cases, SNAP and compound muscle action potential (CMAP) values decrease, which means that in CTS, a delayed distal latency and decrease in velocity are pronounced in the median nerve. The ulnar nerve conduction work-ups in CTS are normal. In this study, the ulnar sensory nerve conduction work-ups were normal, while the median sensory nerves were affected in the CTS group. In the WHS group, according to the normal group, distal latency and velocity were close to normal, but both the median sensory and ulnar sensory nerve amplitudes were decreased. Motor values were completely normal.

Guyon canal and cubital tunnel entrapment neuropathies can cause neuropathic pain, as well, but neuropathic pain is seen only in the ulnar nerve tract. In nerve conduction studies, distal latency and velocity are affected in the ulnar nerve. In all of the cases here in, neuropathic pain was identified in every region of the hand. Not only the ulnar nerve but also the median nerve was affected.

The mechanical energy created by vibrating tools, which enters the body through the fingers or palms, is called hand-arm vibration. These tools are generally used in the production, stone working, mining, construction, agriculture, and forestry sectors. HAVS is a clinical condition that occurs after exposure to hand-arm vibration. Symptoms of HAVS include numbness, pain, and reduced dexterity, strength, and sensation in the hands. In HAVS, the peripheral and central nervous systems are affected, which can lead to vascular, bone and joint, and tendon and muscle diseases. There is a direct correlation between the disease and the magnitude and duration of hand-arm vibration and cold temperatures. In the cases here in, no vibrating tools were used by the patients, but they did engage in taxing labor using their hands (using such tools as a sledgehammer, hammer, saw, and carry stones). It was argued that the usage of beta-blockers and cigarettes and a decrease in blood circulation due to exposure to the cold lead to an increase in HAVS symptoms. According to the anamnesis of the patients in this study, their symptoms did not change in cold temperatures or after smoking. CTS is often observed in people with HAVS who engage in breaking stones, plating, and forestry. This means that HAVS itself can cause CTS. Electrophysiological studies aimed at defining the nature of a vibration injury have provided conflicting results. Usually, electrophysiological findings related to HAVS are similar to those related to CTS, and the effect on velocity is pronounced. These conditions can be seen together often.

The ulnar nerve is rarely affected in HAVS, but both the ulnar and median nerves were affected in our patients. Especially, the ulnar nerve was affected. In HAVS, slowed sensory nerve conduction velocities are often observed in the hands. In my cases, especially, the amplitude was low without being greatly affected by speed and latency. In vibration-associated neuropathies, conceivable target structures could be peripheral sensory receptors; large or thin myelinated nerve fibers; and small-caliber, non-myelinated C fibers. Pathological studies by cutaneous biopsy have demonstrated demyelinating neuropathy in the digital nerves of individuals with HAVS.

It is believed that WHS is likely a sensory neuropathy with such a mechanism as axonal polyneuropathy, because the ulnar nerve is more affected than the median nerve in the upper extremities in polyneuropathies. I posit that an overload caused by an action repeated chronically by the hand/arm may impair the sensory nerves in said hand/arm. Not only the peripheral nervous system but also the local vessels may also be affected. This process may result in vasoconstriction of the local vessels. This situation leads to hypoxia and a lack of nutrition in the sensory nerves. However, there is not a clear relation between WHS and its pathology. However, in my opinion, genetics, ergonomics, emotional stress, and biodynamic status play an important role in WHS, because this disease does not occur in everyone who is doing the same job.

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