Hand Pain

Hand Pain is very common. There are many things that can cause hand pain. By far, the person most qualified to diagnose and treat the source of hand pain is a Hand Surgeon. Hand surgeons have specialized training in the diagnosis and treatment of common and uncommon hand conditions. Hand Surgeons see more hand problems every week than many generalist Orthopaedic Surgeons, Plastic Surgeons and Primary Care Physicians see in years. In addition, specialized list serves and meetings keep interested Hand Surgeons current and up-to-date with all of the latest techniques.

The most common causes of hand pain are Carpal Tunnel Syndrome, Cubital Tunnel Syndrome, Trigger Finger (and Trigger Thumb), Ligament Sprains, Tendon injuries, Tendinitis, fractures, and arthritis. As almost all of these are covered in other sections of this website, for this section I’ll focus on two issues not well-covered elsewhere, ligament sprains and tendinitis.

Each joint is made up of at least two bones. Each joint has ligaments that keep the two bones stable, allowing motion only in the planes that the joint is designed to have motion in. Ligament sprains can be caused by an injury, where the ligament is stretched beyond its normal length, or by repetitive overuse.

Most ligament injuries will heal on their own, provided that repeat injuries are avoided. Otherwise, a chronic injury situation can be created. The best way to protect a healing finger ligament is to ‘buddy tape’ it to the adjacent digit, preferably on the same side as the injured ligament. Finger injuries often lead to stiffness, and so splinting for more than a few days is not a good idea. Buddy taping protects the injured ligament from overuse while still maintaining motion. If the ligament pain is still present after a few weeks, a steroid injection may reduce inflammation, decreasing pain and swelling.

This next point is extremely important: Do NOT assume that a finger injury or pain is ‘just a sprain’. For more on this, please read the ‘Just a Sprain’ section of “Finger Fractures”. Bad situations often occur when someone assumes that the fact that it doesn’t hurt ‘that much’, or ‘still moves’ means that the digit is not fractured or severely injured. Don’t make that mistake. Many bad fractures can become unfixable and very difficult to predictably treat in only a few weeks, leading to a ‘doomed joint’, with a lifetime of pain, stiffness and dysfunction. Get evaluated by a hand surgeon; many Emergency Room X-rays miss significant fractures and subluxations that require early surgery because the correct X-ray views were not taken. A Hand Surgeon will know the correct views to take to minimize missed diagnoses.

Tendinitis often occurs from overuse. This is commonly seen in the small muscles of the hand. The repetitive demands of computer use is responsible for many of these. These respond well to stretching and strengthening. These simple exercises can be taught in only 1-2 sessions with a certified hand therapist, and done at home, where they only take 5 minutes a day. If the pain is severe, or if stretching and strengthening exercises don’t help, a steroid injection can often help decrease pain and swelling. For quickest recovery get an early and accurate diagnosis from a Hand Surgeon and have the correct exercises prescribed.

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