Hand and Wrist Pain and Injury

Pain and weakness felt in the front of the shoulder could be signs that you’re experiencing biceps tendinitis. Caused by inflammation or irritation to the upper biceps tendon, this condition can lead to a tendon tear or deformity if it’s left untreated.

Biceps tendinitis often occurs alongside other shoulder problems, including:

• Damage to the rotator cuff tendon
• Arthritis of the shoulder joint
• Tears in the glenoid labrum
• Chronic shoulder instability
• Shoulder impingement

Most often, biceps tendinitis is caused from degeneration or overuse. Any repetitive movement in which there is an overhead motion (swimming, tennis and baseball), the risk of acquiring this condition is greater. Symptoms include:

• Pain or tenderness in the front of the shoulder that worsens with activity
• Pain or achiness that moves down the upper arm bone
• Occasional snapping sound or sensation in the shoulder

Typically, biceps tendinitis is treated using nonsurgical methods such as rest, ice, anti-inflammatory medications, injections or physical therapy. If your condition does not improve using nonsurgical methods, surgery may be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your situation.

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A broken hand can be caused by a fall, crush injury, twisting injury or through direct contact like in sports. A fracture can occur in the middle or end of any of the bones that make up your hand or wrist.

You may have a broken hand or wrist if you have any of the following symptoms:

• Swelling
• Bruising
• Tenderness or pain
• Deformity
• Inability to move the finger
• Shortened finger
• Injured finger crosses over its neighbor when making a partial fist

Somtimes, a physician can realign the bone fragments without making an incision. A cast, splint or brace is used to support the broken bone or bones and keep them in place. More complex hand fractures require surgery to realign and stabilize the bone fragments. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan based on the severity of your injury and your personal needs and goals.

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Caused by compression over time in the median nerve in the wrist, carpal tunnel syndrome often gets worse over time and can lead to nerve damage. It and can be treated both surgically and non-surgically by our orthopedic experts on hand conditions.

You may have carpal tunnel syndrome if you are experiencing these signs or symptoms:

• Weakness or clumsiness that make fine movements like buttoning a button difficult
• Numbness, tingling, burning or pain in your fingers
• Pain or tingling that continues up your arm
• A tendency to drop objects or lose awareness of where your hand is

Once diagnosed by an exam and/or imaging studies, carpal tunnel syndrome treatment typically consists of:

• Bracing or splinting
• Medications for pain relief and reduction in swelling
• Modifying activities
• Guided exercise programs or physical therapy
• Injections
• Carpal Tunnel Release Surgery

At OrthoNebraska, treatment plans are developed collaboratively between you and your care team, while discussing the risks and benefits as they pertain to you individually.

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How carpal tunnel release is performed using an open technique

When the tendons around the base of the thumb are irritated or constricted, De Quervain’s tendinosis may be present. Pain and tenderness along the thumb side of the wrist are the most common symptoms and are felt most prominently when forming a fist, grasping or gripping something or when turning the wrist.

De Quervain’s tendinosis or tenosynovitis is generally caused by overuse, but it may also be associated with other medical conditions, notably pregnancy or rheumatic disease.

In addition to the symptoms mentioned above, you may also experience:

• Pain may travel up the forearm
• Swelling over the thumb side of the wrist
• “Catching” or “snapping” sensation when moving the thumb
• May have trouble moving the thumb or wrist due to swelling

Nonsurgical treatment for this hand condition includes:

• Splints
• Anti-inflammatory medications
• Avoiding activities that cause pain and swelling
• Injections

If your hand does not get better using nonsurgical methods, it is possible that surgery will be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your needs and risk.

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Every person has a layer of tissue (called the fascia) that helps anchor and stabilize the skin on the palm side of the hand. For those suffering from Dupuytren’s Disease, the fascia slowly thickens and then tightens pulling the fingers into the palm. The cause of Dupuytren’s Disease is widely unknown, but genetics likely plays an important role.

You may be at risk for developing Dupuytren’s Disease if:

• Men are more likely than women
• You are from northern European or Scandinavian descent
• Other people in your family have had it
• Alcohol use
• Medical conditions such as diabetes and seizure disorders
• Age

Dupuytren’s Disease develops slowly over time with symptoms that include:

• Contractures (fingers are pulled toward your palm and cannot be spread apart)
• Nodules (small lumps in the palm of your hand)
• Tenderness where the nodules are located
• Cords (dense and tough cords of tissue under the skin)

There is no cure for Dupuytren’s Disease; however, it is not dangerous in the sense of threatening your overall health. Nonsurgical treatments include injections or splinting. Surgery may be recommended if your hand function is affected. Your OrthoNebraska care team will work with you to develop the right treatment plan for your individual needs.

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When a finger bone is fractured, your whole hand may be out of alignment. If you feel you may have a finger fracture, it’s important to seek medical attention as soon as possible.

Finger fractures are often the result of an injury to your hand. This could be as simple as slamming your fingers in a door or from misusing tools like power saws or drills. Symptoms of finger fractures include:

• Swelling of the fracture site
• Tenderness at the fracture site
• Bruising at the fracture site
• Inability to move the injured finger in completely
• Deformity of the injured finger

Most often, your bone can be put back into place without surgery. Once reset, you may be asked to wear a splint or cast. For more severe finger fractures, surgery may be recommended. Your OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your finger injury.

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Pressure on the ulnar nerve can be felt at your wrist, where numbness and tingling are common. You may also feel weakness when you pinch or grip objects. A soft tissue tumor is more typically the cause. However, repetitive trauma or chronic pressure can also cause finger numbness or tingling.

As symptoms increase it may become difficult to open jars, hold objects or coordinate your fingers while typing or playing an instrument.

Treatment varies by the cause of the pressure on your nerve. If it’s caused by how your wrist is positioned while you type, a simple change in position and padding may correct the feeling of numbness or tingling. However, if your nerve pressure is the result of repeated trauma, you may need to make a more significant lifestyle change, take anti-inflammatory medications or use a wrist splint temporarily. If your symptoms are not helped using nonsurgical methods, it is possible that surgery will be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your situation.

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Flexor tendons help control movement in your hand. When they’re damaged, it can become hard or impossible to bend your fingers or thumb. A torn or cut tendon in your forearm, wrist, palm or along a finger is considered a flexor tendon injury.

Common causes of flexor tendon injuries include:

• Sports activities (football, wrestling, rugby)
• Deep cut
• Health conditions (rheumatoid arthritis)

You may have a flexor tendon injury if the following symptoms are present, usually as a result of trauma like a fall:

• Open injury such as a cut
• Inability to bend one or more joints of your finger
• Pain when your finger is bent
• Tenderness along our finger on the palm side of your hand
• Numbness in your fingertip

A splint may be used to give your arm or finger more protection as it heals, however, if your tendon is cut surgery will likely be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your individual needs.

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The most common lump found on the hand, Ganglion cysts are not cancerous and are typically harmless. These cysts can appear, disappear and change size but do not generally affect the use of your hand. In some instances, though, Ganglion cysts can cause pain.

Ganglion cysts can develop on the top and underside of the wrist, at the end joint of a finger and at the base of a finger. While the cause is unknown, women between the ages of 15 and 40 are the most likely to be affected by this form of cyst.

You might have a Ganglion cyst if any of the following symptoms are present:

• Visible lump
• Pain, tingling and muscle weakness

Most of the time, the Ganglion cyst will disappear on its own; however, there are nonsurgical treatment options as well. This includes immobilizing your hand and wrist with a brace or other supportive device or aspiration (draining of the cyst). If your symptoms are not helped using nonsurgical methods, it is possible that surgery will be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your situation.

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An injury to the thin tendon that straightens the end joint of a finger or thumb, mallet finger is also known as “baseball finger”. This finger condition is caused when an object strikes the tip of a finger or thumb and forces it to bend further than it’s intended to go.

If you have mallet finger, symptoms include pain, swelling and bruising. The fingertip will often droop noticeably.

If your finger is left untreated, permanent stiffness and deformity may occur. Nonsurgical treatment for mallet finger typically includes splinting until the fingertip straight again. If there is more significant damage such as a fracture in your finger, surgery may be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your situation.

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Most often, the ring finger and thumb are affected by trigger finger. This hand condition causes pain, stiffness and a sensation of locking or catching when you bend or straighten your finger. Trigger finger occurs when the flexor tendon in your finger becomes inflamed and develops a small nodule on its surface.

You may be experiencing trigger finger if you have any of the following symptoms:

• Tender lump at the base of the finger on the palm
• Catching, popping or locking sensation with finger movement
• Pain when you bend or straighten your finger

Your initial treatment will include nonsurgical methods such as:

• Resting your hand
• Splinting
• Stretching exercises
• Anti-inflammatory medications
• Injections

If your finger does not get better using nonsurgical methods, it is possible that surgery will be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your situation.

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How trigger finger surgery is performed

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Arthritis can occur when any joint in your body becomes inflamed. The three most common types of wrist arthritis are:

• osteoarthritis (wear and tear)
• rheumatoid arthritis (chronic disease)
• post-traumatic arthritis (post-injury)

While not every person with arthritis experiences symptoms, the following may be signs that you have wrist arthritis:

• Pain
• Swelling
• Reduced range of motion or stiffness
• Weakness in the joint

While there is no cure for arthritis, there are several non-surgical treatments to help alleviate your pain and minimize any other symptoms:

• Change in activity
• Immobilization (splint)
• Anti-inflammatory medications
• Exercise
• Injections
• Additional therapies

If your symptoms are not improved with nonsurgical treatments, surgery may be recommended. The OrthoNebraska team will work collaboratively with you to determine the best treatment plan for your situation.

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