HAND, WRIST AND ELBOW ISSUES

The most common repetitive overuse injury in the hand, wrist or elbow is tendinitis. This condition occurs when a tendon—a cord of tissue that connects muscles to bones—becomes inflamed as a result of irritation or stress. Swelling of the surrounding soft tissue is also common, along with tenderness and pain. 

Symptoms tend to worsen during and after physical activity, and they may even expand over time. 

Carpal Tunnel Syndrome

Carpal tunnel syndrome is one of the most common hand and wrist conditions people experience. It is caused by pressure on the median nerve in the carpal tunnel of the wrist. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of the hand. When the median nerve is compressed, symptoms can include numbness, tingling and weakness in the thumb and fingers.

Wrist anatomy, health conditions and possibly repetitive hand motions can contribute to carpal tunnel syndrome. Proper treatment usually relieves the tingling and numbness and restores hand function.

Symptoms of carpal tunnel syndrome usually start gradually and include:

• Tingling and numbness. Tingling and numbness may occur in the fingers or hand. Usually the thumb, index, middle and ring fingers are affected, but not the little finger. You might have a feeling like an electric shock in these fingers. These symptoms often occur while holding a steering wheel, phone or newspaper, or they may wake you from sleep.  The sensation also can travel from the wrist up the arm.

  Many people "shake out" their hands to try to relieve their symptoms. The numb feeling may become constant over time.

• Weakness. People with carpal tunnel syndrome may experience weakness in the hand and drop objects. This may be due to numbness or to weakness of the thumb's pinching muscles, which also are controlled by the median nerve.

De Quervain’s Tenosynovitis 

De Quervain's tenosynovitis is an irritation of the tendons that run from the wrist to the thumb. These tendons are encased in a snug, tunnel-like tissue called a sheath. Repetitive movements of the thumb and wrist, or a direct blow to the area, may irritate these tendons and cause them to swell, hindering their movement through the sheath and causing you pain. 

Activities that may lead to de Quervain’s tenosynovitis include knitting and needlepoint; jobs that involve twisting the wrist, like using a screwdriver; or excessive video game playing involving small movements of the thumb. The condition is often seen in new mothers, because of underlying swelling caused by repetitive lifting of a baby.

Stenosing Tenosynovitis

Stenosing tenosynovitis is commonly known as “trigger finger,” because it can cause a finger to become stuck in a bent position. Flexor tendons, which are located on the palm side of your hand, allow you to bend and flex your fingers. They are enclosed in a protective covering called a synovial sheath, which produces a fluid that keeps the tendons lubricated, allowing them to slide easily through the sheath.

If you put stress on your fingers—for instance, by playing an instrument, using hand tools, or operating a machine frequently—the tendons may swell. Inflammation may also cause the sheath to constrict. The tendons then can’t move easily through the sheath, leading to slower and sometimes painful bending and flexing of the fingers.

People with mild stenosing tenosynovitis may feel a painful popping sensation when they straighten their fingers. If the condition is more severe, one finger can become stuck in a bent position. Stenosing tenosynovitis often leads to finger or thumb stiffness, pain, and swelling. Swollen tendons can also cause a small lump, called a nodule, to develop where the palm meets the affected finger.

Trigger finger is more common in women, and it usually occurs in people 40 to 60 years old. 

Capsulitis

Joints are surrounded by bands of tough, fibrous connective tissue called ligaments that form a capsule around the joints and allow them to function properly. Capsulitis occurs when this capsule becomes inflamed. 

Capsulitis can occur in any joint in the body. When the thumb is overused, inflammation can occur in its joints, causing pain and stiffness. This condition is sometimes referred to as “texting thumb,” because texting has recently become a leading cause of capsulitis in this part of the body. 

Muscle or Tendon Strain

A muscle or tendon can overstretch or tear if you engage in excessive amounts of physical activity or if you put too much stress on a body part or muscle during exercise. This is known as a strain, or a pulled muscle, and it can cause pain and difficulty in moving the injured muscle. It may also cause swelling or bruised skin. Muscle strains are common among musicians, who make repetitive movements with their hands and fingers while playing an instrument, and people who start a new exercise routine without warming up properly. A strain is different from a sprain, in which a ligament—tissue that connects two bones—stretches or tears. 

Diagnostic Tests

To determine if you have a hand or wrist overuse injury, the professionals at Central Virginia Orthopedics and Sports Medicine will ask about your symptoms and medical history and perform a physical examination of your arm, hand, and wrist. They may also check for strength, sensation, and signs of nerve irritation or damage. Imaging tests are often used to get a clearer look at the damage the condition may have caused.

We are committed to providing a high standard of care for patients that have hand, wrist, elbow and other upper extremity conditions. Our goal is to reduce pain and facilitate a rapid recovery to a normal, pain-free lifestyle.

Call 540 372 6737 to rediscover a life free from pain!