Carpal tunnel syndrome, arthritis, fractures and nerve injuries. When it comes to pain in your hands or wrists, one of these conditions is the most likely culprit.
Think about how often you use your hands every day. Typing on a computer, sending instant messages, tying your shoes, even driving a car can become a difficult task when you have hand pain. “Hand injuries are very common in work, play, and sport, and can often be devastating,” says Nicholas DiNubile, M.D., chief of the Section of Orthopedic Surgery at Delaware County Memorial Hospital and spokesperson for the American Academy of Orthopaedic Surgeons. “Most of these injuries are preventable, and it’s critical to get the right kind of care when a problem with your hand occurs.”
“The orthopedic surgeons of the Crozer-Keystone Health System’s Human Motion Institute are specially trained to evaluate, diagnose, and treat simple to complex hand problems,” says Ronald Rosenfeld, D.O., M.D., chief of the Division of Orthopedic Surgery at Springfield Hospital. “Treatment may include physical and occupational therapy as well as surgery to achieve the best results.”
And, should you be referred for physical and occupational therapy, our hand therapists (located at Crozer-Chester Medical Center, Delaware County Memorial Hospital’s Center for Rehabilitation at Barclay Square, Springfield Hospital at the Healthplex®, and Taylor Made Physical Therapy) will work with you to restore function and independence.
According to the American Academy of Orthopaedic Surgeons, carpal tunnel syndrome affects approximately 10 percent of the population and is more common in women than men. It is caused by pressure on a nerve that runs through the carpal tunnel.
Common symptoms of carpal tunnel syndrome include pain, numbness or tingling of the hand. The only finger that would not be affected is the “pinky.” The pinky is controlled by a different nerve than the one that controls the thumb and other three fingers. “The most common mild symptom of carpal tunnel syndrome is the feeling of ‘pins and needles’ in your hand,” says Frank Giammattei, M.D., chief of the Division of Orthopedic Surgery at Crozer-Chester Medical Center. “It may even radiate up to the shoulder. This sensation is usually felt at night and will wake you up out of sleep, but it can also happen when you are awake.” The numbness or pain may worsen when you pick something up or flex your hand.
“The treatment of carpal tunnel syndrome can include a variety of measures,” says Gregory Tadduni, M.D., a hand surgeon at Taylor Hospital. “Generally, it begins with splints and medication, and can include task or equipment modifications. If symptoms persist, injection or surgical release of the carpal canal may be recommended.”
Arthritis can cause severe pain in the hands, and is characterized by swelling, pain and stiffness in the hand (which limits your ability to pick things up).
“There are several types of arthritis that affect the hand, including osteoarthritis and rheumatoid arthritis,” says Robert Carrigan, M.D., a hand surgeon at Taylor Hospital. “Osteoarthritis is the most commonly encountered form of arthritis. It affects all joints of the hand, including the base of the thumb at the wrist. This causes problems in everyday tasks such as opening jars and turning keys.”
Dr. Carrigan explains that treatment for osteoarthritis includes anti-inflammatory medications, splinting, and the occasional cortisone injection. Splints are often custom-made by an occupational therapist, and are worn when you are doing those activities that cause pain.
Nerve injuries are mainly caused by stretching, pressure, or blunt or sharp injury to the nerve. Surgery is sometimes the only way to correct nerve damage in the hand or wrist. Fractures are commonly caused by an acute injury and are usually characterized by swelling, deformity and pain.
Your physician or surgeon may recommend physical or occupational therapy to treat your hand or wrist injury.
“Many injuries, such as fractures, sprains or strains, and some cases of tendonitis, can be treated without surgery,” says Jeffrey Malumed, M.D., chief of the Section of Orthopedic Surgery at Taylor Hospital. “In these cases, as well as after surgery, hand therapy provided by occupational therapists is one of the most important things a patient can do to regain motion and strength, and to get as close to normal function as possible.”
No matter where you live in Delaware County, physical and occupational therapy services are close to home. Experienced hand therapists will do a comprehensive evaluation, then tailor a treatment plan specifically for you.
Our therapists can treat hand pain using one or more of the following treatments: range-of-motion and strengthening exercises, education, modalities to treat pain and control swelling, and splint fabrication.
For more information about Crozer-Keystone Health System’s Human Motion Institute, or to find a hand specialist who is right for you, call 1-800-CK-HEALTH (1-800-254-3258).
The Hand Commandments
If you have hand pain, or want to prevent it, keep your hands in top form by following these 10 golden rules:
- Avoid excessive pinching activities by wrapping pens and pencils with foam, opening packages with scissors or a knife, and holding a cup with both hands.
- Avoid excessive gripping activities by using your palm to twist off a jar lid and using a flat hand to wash flat surfaces (such as countertops).
- Use electric appliances whenever possible (such as an electric can opener and scissors).
- Avoid positions that place excessive or constant pressure on your joints.
- Avoid prolonged gripping activities (e.g., use shoulder straps for carrying a purse or briefcase).
- Use both hands for lifting and carrying.
- Take frequent breaks and perform stretching activities, especially when working on a computer.
- Re-plan your work area (hand therapists can discuss proper workstation setup with you).
- Recognize your pain (symptoms should not last more than one hour after activity).
- Use safety precautions and use equipment properly (such as lawnmowers). Also, use proper safety equipment, such as wrist guards, when participating in sports (such as rollerblading and skateboarding).