Wrist Ganglion Cyst

Ganglion cysts are the most common mass or lump in the hand. They are not cancerous and, in most cases, are harmless. They occur in various locations, but most frequently develop on the back of the wrist.

These fluid-filled cysts can quickly appear, disappear, and change size. Many ganglion cysts do not require treatment. However, if the cyst is painful, interferes with function, or has an unacceptable appearance, there are several treatment options available.

A ganglion rises out of a joint, like a balloon on a stalk. It grows out of the tissues surrounding a joint, such as ligaments, tendon sheaths, and joint linings. Inside the balloon is a thick, slippery fluid, similar to the fluid that lubricates your joints.

Ganglion cysts can develop in several of the joints in the hand and wrist, including both the top and underside of the wrist, as well as the end joint of a finger, and at the base of a finger. They vary in size, and in many cases, grow larger with increased wrist activity. With rest, the lump typically becomes smaller.

Causes of Ganglion Cyst

It is not known what triggers the formation of a ganglion. They are most common in younger people between the ages of 15 and 40 years, and women are more likely to be affected than men. These cysts are also common among gymnasts, who repeatedly apply stress to the wrist.

Ganglion cysts that develop at the end joint of a finger also known as mucous cysts are typically associated with arthritis in the finger joint, and are more common in women between the ages of 40 and 70 years.

Symptoms of Ganglion Cyst

Most ganglions form a visible lump, however, smaller ganglions can remain hidden under the skin (occult ganglions). Although many ganglions produce no other symptoms, if a cyst puts pressure on the nerves that pass through the joint, it can cause pain, tingling, and muscle weakness.

Large cysts, even if they are not painful, can cause concerns about appearance.

Doctor Examination of Ganglion Cyst

  • Medical History and Physical Examination
  • During the initial appointment, your doctor will discuss your medical history and symptoms. He or she may ask you how long you have had the ganglion, whether it changes in size, and whether it is painful.

Pressure may be applied to identify any tenderness. Because a ganglion is filled with fluid, it is translucent. Your doctor may shine a penlight up to the cyst to see whether light shines through.

  • Imaging Tests

X-rays. These tests create clear pictures of dense structures, like bone. Although x-rays will not show a ganglion cyst, they can be used to rule out other conditions, such as arthritis or a bone tumor.

Magnetic resonance imaging (MRI) scans or ultrasounds. These imaging tests can better show soft tissues like a ganglion. Sometimes, an MRI or ultrasound is needed to find an occult ganglion that is not visible, or to distinguish the cyst from other tumors.

Heberden’s Nodes

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Bony bumps on the finger joint closest to the fingernail are called Heberden’s nodes. Bony bumps on the middle joint of the finger are known as Bouchard’s nodes.

Bony bumps are also common at the base of the thumb. These bumps do not have a nickname, but the joint is called the CMC or carpometacarpal joint. The name comes from the bone of the wrist (carpal) and the bone of the thumb (metacarpal).

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Heberden’s nodes typically develop in middle age, beginning either with a chronic swelling of the affected joints or the sudden painful onset of redness, numbness, and loss of manual dexterity. This initial inflammation and pain eventually subsides, and the patient is left with a permanent bony outgrowth that often skews the fingertip sideways. Bouchard’s nodes may also be present; these are similar bony growths in the proximal interphalangeal (PIP) joints (middle joints of the fingers), and are also associated with osteoarthritis.

Heberden’s nodes are more common in women than in men, and there seems to be a genetic component involved in predisposition to the condition.

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Hand and Finger Arthritis

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Rheumatoid arthritis (RA) is a painful inflammatory disease that causes swelling, stiffness, joint destruction, and deformity. This autoimmune disease has an effect on the cells that coat and lubricate joints (synovial tissue).

Osteoarthritis (the “wear and tear” arthritis”) may often affect just one joint even though it can affect multiple joints. Rheumatoid arthritis, though, typically affects multiple joints and  usually happens symmetrically. For instance, RA may affect  the same joint group on both sides of the body.

What are the symptoms of Hand and Finger Arthritis?

The wrist joints and the finger joints are common targets of RA. With hand and finger RA, you may experience the following:

  • Hand pain, finger pain, swelling, and stiffness
  • Hand joints and finger joints that are warm and tender to the touch
  • The same joints affected symmetrically (both wrists and fingers on both hands)
  • Deformities in finger joints
  • Carpal tunnel symptoms such as numbness and tingling of the hands
  • Flu-like feeling
  • Fatigue that is not easily resolved
  • Pain and stiffness that last for more than an hour upon arising

What causes Rheumatoid Arthritis?

Scientists are unsure about the causes of RA. They do know that RA affects about 1.3 million Americans and occurs in all racial and ethnic groups. About two to three times as many women suffer from rheumatoid arthritis as men. Some rheumatoid arthritis research points to the following factors as possibly influencing rheumatoid arthritis:

  • Genetic factors.
  • Environmental factors such as a viral or bacterial infection.
  • Hormones. RA tends to improve with pregnancy. Breastfeeding, and the postpartum period (the time after delivery), however, may aggravate rheumatoid symptoms.

What is a swan-neck deformity?

Rheumatoid arthritis is a common cause of a swan-neck deformity.

With a swan-neck deformity, the base of the finger and the outermost joint bend, while the middle joint straightens. Over time, this imbalance of the finger joints can result in the crooked swan-neck position. (True swan-neck deformity does not occur in the thumb).

A swan-neck deformity can make it almost impossible to bend the affected finger normally; it can make it difficult to button shirts, grip a glass, or pinch with the fingers.

By examining the hand and fingers, a rheumatologist can diagnose a swan-neck deformity and determine appropriate treatment, which may include:

  • Finger splints or ring splints
  • Surgery to realign the joints or fuse the joints for better function

What is a boutonniere deformity?

Boutonniere deformity, also called buttonhole deformity, can occur as a result of rheumatoid arthritis.

With a boutonniere deformity, the middle finger joint will bend toward the palm while the outer finger joint may bend opposite the palm. This deformity may be the result of chronic inflammation of the finger’s middle joint.

Treatment for boutonniere deformity may include splinting to keep the middle joint extended. Surgery may be needed.

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Trigger Finger

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Trigger finger is a painful condition that causes the fingers or thumb to catch or lock when bent. In the thumb its called trigger thumb.
Trigger finger happens when tendons in the finger or thumb become inflamed. Tendons are tough bands of tissue that connect muscles and bones. Together, the tendons and muscles in the hands and arms bend and straighten the fingers and thumbs.

A tendon usually glides easily through the tissue that covers it (called a sheath) because of a lubricating membrane surrounding the joint called the synovium. Sometimes a tendon may become inflamed and swollen. When this happens, bending the finger or thumb can pull the inflamed tendon through a narrowed tendon sheath, making it snap or pop.

trigger-finger

What causes Trigger Finger?

Trigger finger can be caused by a repeated movement or forceful use of the finger or thumb. Rheumatoid arthritis, gout, and diabetes also can cause trigger finger. So can grasping something, such as a power tool, with a firm grip for a long time.

Who gets Trigger Finger?
Farmers, industrial workers, and musicians often get trigger finger since they repeat finger and thumb movements a lot. Even smokers can get trigger thumb from repeated use of a lighter, for example. Trigger finger is more common in women than men and tends to happen most often in people who are 40 to 60 years old.

What are the symptoms of Trigger Finger?
One of the first symptoms of trigger finger is soreness at the base of the finger or thumb. The most common symptom is a painful clicking or snapping when bending or straightening the finger. This catching sensation tends to get worse after resting the finger or thumb and loosens up with movement.

In some cases, the finger or thumb locks in a bent or straight position as the condition gets worse and must be gently straightened with the other hand.

 How is Trigger Finger diagnosed?
Trigger finger is diagnosed with a physical exam of the hand and fingers. In some cases, the finger may be swollen and there may be a bump over the joint in the palm of the hand. The finger also may be locked in bent position, or it may be stiff and painful. No X-rays or lab tests are used to diagnose trigger finger.

How is Trigger Finger treated?
The first step is to rest the finger or thumb. Our doctor may put a splint on the hand to keep the joint from moving. If symptoms continue, our doctor may prescribe drugs that fight inflammation. Our doctor may also recommend an injection of anti-inflammatory medicine into the tendon sheath. If the trigger finger does not get better, our doctor may recommend surgery of Trigger Finger Release.

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Mallet Finger (Baseball Finger)

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A mallet finger is a deformity of a finger caused when a certain tendon (the extensor tendon) is damaged. When a ball or other object strikes the tip of the finger or thumb, the force damages the thin tendon that straightens the finger. The force of the blow may even pull away a piece of bone along with the tendon. The finger or thumb is not able to be straightened. This condition is also known as baseball finger.

Symptoms of Mallet Finger

The finger is usually painful, swollen, and bruised. The fingertip may droop noticeably. Occasionally, blood collects beneath the nail. The nail can even become detached from beneath the skin fold at the base of the nail.

Diagnosis of Mallet Finger

In most cases, the doctor will order X-rays in order to look for a major fracture or malalignment of the joint.

Non-Surgical Treatment of Mallet Finger
The majority of mallet finger injuries can be treated without surgery. Ice should be applied immediately and the hand should be elevated above the level of the heart. Medical attention should be sought within a week after injury. It is very important to seek immediate attention if there is blood beneath the nail or if the nail is detached. This may be a sign of nail bed laceration or open (compound) fracture.

The doctor may apply a splint to hold the fingertip straight (in extension) until it heals. Most of the time, a splint will be worn full time for eight weeks. Over the next three to four weeks, most patients gradually begin to wear the splint less frequently. Although the finger usually regains an acceptable function and appearance with this treatment plan, many patients may not regain full fingertip extension.

In children, mallet finger injuries may involve the cartilage that controls bone growth. The doctor must carefully evaluate and treat this injury in children, so that the finger does not become stunted or deformed.

Surgical Treatment of Mallet Finger
Surgical repair may be considered when mallet finger injuries also show signs of large fracture fragments or joint malalignment. In these cases, surgery is done to repair the fracture using pins, pins and wire, or even small screws. Surgery may also be considered if nonsurgical treatment fails.
It is not common to treat a mallet finger surgically if bone fragments or fractures are not present. This is usually reserved for patients who have a very severe deformity or who cannot use their finger properly. Surgical treatment of the damaged tendon can include tightening the stretched tendon tissue, using tendon grafts, or even fusing the joint straight.
An orthopaedic surgeon should be consulted in making the decision to treat this condition surgically.

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De Quervain’s Stenosing Tenosynovitis (Wrist Pain)

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De Quervain’s tenosynovitis  is a painful condition affecting the tendons on the thumb side of your wrist. If you have de Quervain’s tenosynovitis, it will probably hurt every time you turn your wrist, grasp anything or make a fist.

Although the exact cause of de Quervain’s tenosynovitis isn’t known, any activity that relies on repetitive hand or wrist movement such as working in the garden, playing golf or racket sports or lifting your baby can make it worse.

Symptoms of de Quervain’s tenosynovitis include:

  • Pain near the base of your thumb
  • Swelling near the base of your thumb
  • Difficulty moving your thumb and wrist when you’re doing activities that involve grasping or pinching
  • A “sticking” or “stop-and-go” sensation in your thumb when trying to move it

If the condition goes too long without treatment, the pain may spread farther into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain.

When to see a doctor
Consult your doctor if you’re still having problems with pain or function and you’ve already tried:

  • Avoiding moving your thumb in the same way over and over again whenever possible
  • Avoiding pinching with your thumb when moving your wrist from side to side
  • Applying cold to the affected area
  • Using nonsteroidal anti-inflammatory drugs.

If the pain continues to interfere with your daily life or activities, seek medical advice.

Causes for De Quervain’s Tenosynovitis

Chronic overuse of your wrist is commonly associated with de Quervain’s tenosynovitis.

When you grip, grasp, clench, pinch or wring anything in your hand, you use two major tendons in your wrist and lower thumb. These tendons normally glide unhampered through the small tunnel that connects them to the base of the thumb. If you repeat a particular motion day after day, it may irritate the sheath around the two tendons, causing thickening that restricts the movement of the tendons.

Other causes of de Quervain’s tenosynovitis include:

  • Direct injury to your wrist or tendon; scar tissue can restrict movement of the tendons
  • Inflammatory arthritis, such as rheumatoid arthritis

If de Quervain’s tenosynovitis is left untreated, it may be hard to use your hand and wrist properly. If the affected tendons are no longer able to slide within their tunnel, you may develop a limited range of motion.

Tests and Diagnostic of the De Quervain Tenosynovitis

To diagnose de Quervain’s tenosynovitis, your doctor will examine your hand to see if you feel pain when pressure is applied on the thumb side of the wrist.

Your doctor will also perform a test called the Finkelstein test. In a Finkelstein test, you bend your thumb across the palm of your hand and bend your fingers down over your thumb. Then you bend your wrist toward your little finger. If this causes pain on the thumb side of your wrist, you likely have de Quervain’s tenosynovitis.

Imaging tests, such as X-rays, generally aren’t needed to diagnose de Quervain’s tenosynovitis.

Treatment for De Quervain’s Tenosynovitis

Treatment for de Quervain’s tenosynovitis may include medications, physical or occupational therapy, or surgery. Treatment is generally successful if begun early on, though the pain may recur if you can’t discontinue the repetitive motions that aggravate your condition. If you start treatment early on, your symptoms of de Quervain’s tenosynovitis should generally improve within four to six weeks. When de Quervain’s tenosynovitis starts during pregnancy, symptoms usually get better around the end of pregnancy or when breast-feeding stops.

Medications
To reduce pain and swelling, your doctor may recommend using non steroid anti-inflammatory injection.

Our doctor may also recommend injections into the tendon sheath to reduce swelling. If treatment begins within the first six months of symptoms, most people recover completely after receiving injections, often after just one injection.

Therapy
Initial treatment of de Quervain’s tenosynovitis may include:

  • Immobilizing your thumb and wrist, keeping them straight with a splint or brace to help rest your tendons
  • Avoiding repetitive thumb movements whenever possible
  • Avoiding pinching with your thumb when moving your wrist from side to side
  • Applying ice to the affected area

You may also see a physical or occupational therapist. These therapists may review your habits and give suggestions on how to make necessary adjustments to relieve stress on your wrists. Your therapist can also teach you exercises focused on your wrist, hand and arm to strengthen your muscles, reduce pain, and limit the irritation of the tendons. The therapist may also make a splint to keep your wrist and thumb from moving if off-the-shelf versions don’t fit you well.

Surgery
If your case is more serious, your doctor may recommend outpatient surgery. Surgery involves a procedure in which your doctor inspects the sheath surrounding the involved tendon or tendons, and then opens the sheath to release the pressure and restore free tendon gliding.

Our Doctor will talk to you about how to rest, strengthen and rehabilitate your body after surgery. A physical or occupational therapist may meet with you after surgery to teach you new strengthening exercises and help you adjust your daily routine to prevent future problems.

Cure your Wrist Pain Today. Effective treatment, Non Surgery. Discuss with our Hand Specialist for the Diagnosis, Treatment and Prognosis of your Wrist Pain. Call us +65 97731458 to schedule for an appointment.

Carpal Tunnel Syndrome

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Definition of Carpal Tunnel Syndrome:

There are several common causes of hand tingling. Carpal tunnel syndrome tends to be one of the most common causes of hand tingling. One of the nerves that supply the hand is called the Median nerve. This nerve travels across the wrist to supply the fingers. With repetitive bending and straightening of the wrist this nerve gets injured. This tends to occur in people that use the computer frequently, use the cash register, or are involved in activities that involve repetitive motion at the wrist.

Another nerve that supplies the hand is called the Ulnar nerve. This nerve passes behind the elbow and could get injured at that point. One of the common causes of injury is from leaning on the elbow which causes pressure on the nerve. Other common causes include pressure from surrounding tissue, arthritis, and injury to the elbow.

Since the nerves that supply the hands originate in the spine, injury to the nerves at this level could cause numbness, tingling, and weakness in the hands. Generally patients often have shooting pain down the arm with this kind of a problem. There could be multiple causes like disk disease, tumors, and arthritis.

Systemic disease like diabetes, kidney failure, infections, and others could cause injury to the nerves so that patients could develop weakness and numbness in their hands. These patients often also have numbness and tingling in their feet first. These patients most often have Neuropathy.

Carpal tunnel syndrome occurs when the median nerve which runs from the forearm into the hand becomes pressed or squeezed at the wrist. This results in pain, weakness, or numbness in the hand and wrist, radiating up the arm.

Hand and Wrist Pain

How is Carpal Tunnel Syndrome Diagnosed?
A physical examination help determine if the syndrome are related to daily activities or to an underlying disorder and can rule out other painful conditions that mimic carpal tunnel syndrome.

Electromyography is often used to confirm the diagnosis. This involves a fine needle being inserted into a muscle where electrical activities are viewed on a screen determining the severity of damage to the median nerve. Ultrasound imaging can also show impaired movement of the median nerve.

What are the causes of Carpal Tunnel Syndrome?
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Most likely the disorder is due to a congenital predisposition. Other contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture. It can also be caused by medical conditions such as diabetes, arthritis, pregnancy and obesity.

What are the treatments of Carpal Tunnel Syndrome?
Treatments for carpal tunnel syndrome should begin as early as possible under a doctor’s direction. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling. In early stage of Carpal Tunnel Syndrome, Injection will be one of the effective way in treating this condition. Surgery is recommended if symptoms last for more than 9-12 months. Surgery involves severing the band of tissue around the wrist to reduce pressure on the median nerve.

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Platelet Rich Plasma (PRP)

Platelet Rich Plasma (PRP) therapy holds Great Promise to heal the Soft Tissue, Chronic Tendon Injury, Knee Osteoarthritis, Sports Injury, Acute Ligament and Muscle Injury. Get your PRP done with us today. Call us at +65 97731458 to schedule for an appointment

During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.

Many famous athletes Tiger Woods, tennis star Rafael Nadal, and several others have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.

Platelet Rich Plasma

What is Platelet Rich Plasma (PRP)?

Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.

PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets and, thereby, the concentration of growth factors can be 5 to 10 times greater (or richer) than usual.

To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.

How does Platelet Rich Plasma (PRP) works?

Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.

To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:

  • PRP can be carefully injected into the injured area. For example, in Achilles tendonitis, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue. Afterwards, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
  • PRP may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with PRP during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.

What conditions are treated with Platelet Rich Plasma (PRP)?

Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary. Factors that can influence the effectiveness of PRP treatment include:

  • The area of the body being treated
  • The overall health of the patient
  • Whether the injury is acute (such as from a fall) or chronic (an injury developing over time)

– Chronic Tendon Injuries

According to the research studies currently reported, PRP is most effective in the treatment of chronic tendon injuries, especially tennis elbow, a very common injury of the tendons on the outside of the elbow.

The use of PRP for other chronic tendon injuries such as chronic Achilles tendonitis or inflammation of the patellar tendon at the knee (jumper’s knee) is promising. However, it is difficult to say at this time that PRP therapy is any more effective than traditional treatment of these problems.

– Acute Ligament and Muscle Injuries
Much of the publicity PRP therapy has received has been about the treatment of acute sports injuries, such as ligament and muscle injuries. PRP has been used to treat professional athletes with common sports injuries like pulled hamstring muscles in the thigh and knee sprains. There is no definitive scientific evidence, however, that PRP therapy actually improves the healing process in these types of injuries.

– Surgery
More recently, PRP has been used during certain types of surgery to help tissues heal. It was first thought to be beneficial in shoulder surgery to repair torn rotator cuff tendons. However, the results so far show little or no benefit when PRP is used in these types of surgical procedures.Surgery to repair torn knee ligaments, especially the anterior cruciate ligament (ACL) is another area where PRP has been applied. At this time, there appears to be little or no benefit from using PRP in this instance.
– Knee Arthritis
Some initial research is being done to evaluate the effectiveness of PRP in the treatment of the arthritic knee. It is still too soon to determine if this form of treatment will be any more effective than current treatment methods.
– Fractures
PRP has been used in a very limited way to speed the healing of broken bones. So far, it has shown no significant benefit.Treatment with platelet-rich plasma holds great promise. Currently, however, the research studies to back up the claims in the media are lacking. Although PRP does appear to be effective in the treatment of chronic tendon injuries about the elbow, the medical community needs more scientific evidence before it can determine whether PRP therapy is truly effective in other conditions.Even though the success of PRP therapy is still questionable, the risks associated with it are minimal: There may be increased pain at the injection site, but the incidence of other problems — infection, tissue damage, nerve injuries — appears to be no different from that associated with cortisone injections.

If you are considering treatment with PRP, be sure to check your eligibility with your health insurance carrier. Few insurance plans, including workers’ compensation plans, provide even partial reimbursement.

Platelet Rich Plasma (PRP) therapy holds Great Promise to heal the Soft Tissue, Chronic Tendon Injury, Knee Osteoarthritis, Sports Injury, Acute Ligament and Muscle Injury. Get your PRP done with us today. Call us at +65 97731458 to schedule for an appointment

Hand and Wrist Pain

Dr Ambrose Yung Knee, Sports and Orthopaedic Centre Knee, Sports and Orthopaedic Clinic

Stop your Hand & Wrist Pain today. Effective Treatment, Non Surgery. Discuss with our Orthopaedic Specialist for the Diagnosis, Treatment and Prognosis of your Hand Pain. Call us +65 97731458 to schedule for an appointment.

Hand and Wrist pain can be caused by one or more of a number of different disorders. Lifestyle diseases will become more common as we live longer and lead more active lives. Hand and wrist pain are among these lifestyle diseases. They are usually amenable to simple treatment strategies, provided they are diagnosed early.

Hand and Wrist Pain

Why are the hand and wrist special?
The hand and wrist are our main point of physical contact with the world. They manipulate objects to aid us in our daily lives. As such, pain that disables our hand and wrist can lead to a marked decrease in our ability to functional at work and play.

Which parts of our hand and wrist are commonly affected by pain?

– Hand pain
A common cause of hand pain that many feel at the base of their fingers, in the palm of the hand, is trigger finger. Trigger finger is a condition where a patient feels pain or discomfort when trying to straighten or bend their finger/thumb. Sometimes the finger may become ‘locked’ or ‘stuck’ when swelling of the tendon sheath occurs. This swelling can be associated with diabetes, rheumatoid arthritis, or even golf.

Carpal Tunnel Syndrome can also cause hand pain. There is a tunnel in the wrist called the carpal tunnel. Nine tendons and the median nerve pass through it. When pressure builds up in the tunnel, the nerve gets compressed and is unable to function properly. This may result in numbness, discomfort and pain in the fingers. This condition usually associated with a tingling sensation over the thumb, index and middle fingers, especially at night. Risk factors for carpal tunnel syndrome include age, diabetes and rheumatoid arthritis.
Another common cause of finger pain is trauma. In this instance, the injured tissue could be the tendon, ligament, bone, or even a combination. It is thus imperative that all injured tissues are adequeately addressed and optimally treated.

– Wrist Pain
Wrist pain is more complex. It is usually divided into conditions that cause pain on the radial side of the wrist, i.e. nearer the thumb, and those that cause pain on the ulnar side of the wrist, i.e nearer the little finger.

Radial-sided wrist pain
Radial-sided wrist pain can be caused by an injury to an important ligament called the scapholunate ligament. This ligament helps two important bones of the wrist joint, namely the scaphoid and the lunate, move in unison. When this ligament is injured, these bones no longer move in tandem, thus leading to pain. This would be aggravated by motion and lead to accelerated arthritis in the wrist, which in turn, manifests as stiffness and poor grip strength.

In addition, woman who are in the perinatal period also belong to a unique population who can suffer from a tendon condition called Dequervain’s Tenosynovitis. It is a condition in which one feels pain over the wrist joint near the base of the thumb. It begins as an aching sensation initially, and progresses to a point when any movement of the wrist or thumb produces sharp pain in the affected area. That area of the wrist may become swollen at times. Often, nursing mothers affected for the period that they are caring for their newborns. This is due to poor ergonomics, or by the hormonal changes that affect their tissues.

Ulnar sided wrist pain
Ulnar sided wrist pain is common in a patient who has sustained a twisting injury or a fall on an outstretched hand. This is usually due to a tear of a ligamentous structure called the “triangular fibrocartiligeneous complex”, which stabilises the wrist joint. Patients with this problem can experience pain in their wrists associated with instability and diminished grip strength. Like the radial side of the wrist, tendons on the side of the wrist can also suffer from inflammation which causes pain, and is usually caused by overuse.

How do we diagnose such conditions?
Firstly, we take a history from our patients. This includes finding out the circumtance surrounding their complaint, as well as the nature of the complaint. This can help us ascertain the tissue that is the main “pain generator”.
Secondly, a thorough clinical examination of the hand and wrist helps us confirm or rule out the possible reasons for our patient’s pain.
X-ray, fluoroscopy (real time X-rays), computed tomograpgy (CT) scans and magnetic resonance imaging (MRI) scans are all important diagnostic tools to help Hand Surgeons confirm diagnoses.

Arthroscopy of the wrist is currently the gold standard diagnostic procedure of choice when the internal architecture of the joint, such as the cartilage, needs to be assessed. Therapeutic key-hole surgery can also be performed with the aid of this tool.

Most common causes of Hand and Wrist discomfort includes:

  • CARPAL TUNNEL SYNDROME – Carpal tunnel syndrome occurs when the median nerve which runs from the forearm into the hand becomes pressed or squeezed at the wrist.
  • DE QUERVAIN’S STENOSING TENOSYNOVITIS – is a condition brought by irritation or inflammation of the wrist tendons at the base of the thumb.
  • MALLET FINGER – Mallet finger occurs when the outermost joint of the finger is injured. With mallet finger, the tendon on the back of the finger is separated from the muscles it connects.
  • TRIGGER FINGER – Trigger finger is a common disorder of the hand which causes painful snapping or locking of the fingers or thumb.
  • ARTHRITIS – Osteoarthritis of the fingers and thumb is characterized as chronic and often disabling pain and stiffness of one or more joints.
  • HEBERDEN’S NODES – are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes).
  • WRIST GANGLION CYST – is a swelling that usually occurs over the back of the hand or wrist. These are benign, fluid-filled capsules.

Stop your Hand & Wrist Pain today. Effective Treatment, Non Surgery. Discuss with our Orthopaedic Specialist for the Diagnosis, Treatment and Prognosis of your Hand Pain. Call us +65 97731458 to schedule for an appointment.

Singapore Knee, Sports and Orthopaedic Centre

Dr Ambrose Yung Knee, Sports and Orthopaedic Centre Knee, Sports and Orthopaedic Clinic
Orthopaedics, specialising in degenerative, chronic orthopaedic condition and sports injuries to the musculoskeletal system with an exceptional record in orthopaedic treatment especially to the Knees, Hip, Elbow, Foot and Ankle, Wrist and Hand, and Shoulder joints; with special interest in Sports Medicines, Partial and Total Joint Replacement, and Minimal Invasive Trauma Surgery.

Orthopaedics is the area of medicine focusing specifically on the body’s musculo-skeletal system. This includes bones, ligaments, joints, muscles, tendons, and even nerves – essentially, all the parts of the body needed move, work and enjoy your life.

At Singapore Knee, Sports and Orthopaedic Centre, we aim to partner with you to maintain your health, allowing you to lead an enriched, fulfilling life. In-house Orthopaedic Surgeon, Dr Ambrose Yung Wai Yin is an established professional with a solid medical background and qualifications.

In addition to our specialism in sports injuries of the musculo-skeletal system, we can also help with orthopaedic problems of all different natures.

We have an exceptional record in treating sport injuries, especially to the knees, shoulder and ankle joints. We specialise in:

  • Complex knee ligamentous reconstruction, using soft tissue tendon allographs
  • Meniscus repair
  • Meniscus allograft transplantation
  • Autologous chondrocyte implantation, using stem cells
  • Double bundle anterior cruciate ligament reconstruction
  • Arthroscopy of knee, elbow, shoulder, ankle and hip joints
  • Ankle sprain treatment
  • Treatment of stiff and painful shoulders
  • Complex Partial and Total Joint Replacement
  • Minimal Invasive Trauma Surgery

As professionals, we treat your health with passion and care through 4 key aspects: Diagnosis, Treatment, Rehabilitation and Prevention.

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