Hand and wrist pain are a common complaint and can be debilitating. Hand and wrist conditions can be evaluated based on the location of the pain. There are many bones, ligaments, and tendons in the hand and wrist:
Wrist – there are eight bones arranged in two rows. These lie between the forearm bones (radius and ulna) and the bones of the hands (metacarpals)
Hand – the metacarpals connect the wrist and the fingers
Fingers – these bones are called phalanges
There are many joints in the wrist and hand, as well as many ligaments and tendons, that allow many movement patterns as well as individual movement of fingers. This varied movement requires assistance from a variety of other structures:
Muscles attach via tendons between the bones of the hand and wrist, allowing them to flex, extend and rotate the hand and fingers
Strong connective tissue provides flexibility and stability in the joints
Blood vessels in the region ensure there is always an adequate blood supply for delivery of nutrients and movement
Nerves communicate signals to provide movement and sensation
With so many complex structures working together to ensure proper function for your hand and wrist, there are many ways in which an injury can occur. If any of these structures wear out or sustain damage, you may experience pain.
Common Causes of Hand and Wrist Pain
There are many potential causes of hand and wrist pain. A proper diagnosis is crucial to ensuring you receive the most effective treatment for your condition.
Wrist Injuries
Fractures – A sudden blow to the wrist may cause one of the forearm bones or one of the many wrist bones to break. There can be an obvious physical deformity of the wrist, and the surrounding ligaments and tendons can be torn. This most commonly occurs in falls and sports injuries.
Sprains and strains – Stretched or torn ligaments result in a sprain. Stretched or torn muscles result in a strain. These injuries occur when you place too much pressure on your muscles and ligaments, which is common in the wrist when participating in sports.
Carpal Tunnel Syndrome – This is one of the more common nerve injuries and occurs when the median nerve becomes compressed under a large band of connective tissue surrounding the wrist called the flexor retinaculum (the carpal tunnel). This can cause weakness, numbness and tingling of the hand and fingers (usually the thumb, first and middle fingers). Carpal tunnel syndrome is typically due to repetitive motion of the wrist.
Compartment Syndrome – Severe crush related injuries can cause swelling of the wrist and hand due to buildup of pressure. This can compress the blood vessels and nerves and can progress rapidly. It is an emergent condition because it can lead to severe functional loss if not treated early.
Hand Injuries
Dislocations – Usually occurs with hyperextension of the middle joint of the finger when the phalange gets knocked out of place. Usually due to sports injuries.
Arthritis
Arthritis can develop from inflammation of the hand and wrist joint, causing pain and stiffness which gets worse over time. It can make fine motor tasks difficult. The most common types of arthritis include:
Rheumatoid arthritis – This occurs when your immune system attacks your joint(s), causing swelling and pain.
Osteoarthritis – This develops when the cartilage in your joint breaks down, causing the bones to rub together. Osteoarthritis results in pain and stiffness.
Psoriatic Arthritis – Seen in people with a history of psoriasis. This can cause deformity of the fingers as well as pain and swelling.
Treatment for Hand and Wrist Pain
At the Denver Spine and Pain Institute, in the absence of more concerning findings such as fracture, instability, and infection, we recommend conservative treatments. Our goal is to reduce pain, increase function, and improve quality of life. If necessary, we will order imaging of the hand and wrist which could include X-rays. Depending on the specific cause of your pain, your treatment may include:
Physical therapy – The goals of physical therapy are to improve mobility, decrease pain and address any mechanical or muscular conditions that may be contributing to your pain.
Medication – Anti-inflammatory medications can help provide short-term relief of symptoms, making it easier for you to participate in physical therapy. Nerve pain medications may also be used if nerve compression is present.
Injections – If the combination of physical therapy and medications don’t provide enough relief, injections may be helpful in both identifying where your pain is coming from, as well as provide long-term relief of your symptoms. The most common types of injections in the hand and wrist are joint and tendon injections using local anesthetic and steroid.
Regenerative medicine –Regenerative medicine therapies include platelet rich plasma (PRP) and stem cell treatments and can also be beneficial in treating wrist and hand pain.
If these conservative treatments fail to provide adequate relief, surgery may be necessary. Our team will perform all appropriate diagnostic testing prior to your surgical consultation to determine the precise cause and location of your pain. These diagnostic tests will provide your surgeon with the information necessary to plan your procedure.
Chronic hand and wrist pain can significantly impact the quality of your life, making it hard to perform routine daily tasks and participate in your favorite activities. Fortunately, you don’t have to live with this pain any longer. At the Denver Spine and Pain Institute, we offer the most advanced treatments to alleviate your hand and wrist pain, helping you enjoy life again.
We’re the only sports, back and pain specialists in the country providing a Connected Care Approach™ specifically designed to get you back to enjoying life faster. This approach involves:
A full spectrum of care, including physicians, physical therapy, massage, diet and lifestyle coaching, behavioral health, research, and cutting edge treatment options
Developing caring and therapeutic relationships that address your unique needs
Discussing options and providing the guidance you need from a dedicated healthcare partner
Mobilizing an experienced team who coordinates your care program
Schedule an Appointment
Please contact us today to schedule an appointment. The Denver Spine and Pain Institute serves patients in Denver and the surrounding areas of Colorado.
