The hand is one of the most complex parts of our body, and one which is integral to most of our daily activities ranging from basic to more intricate movements. The hand and wrist comprise 27 bones, and are served by three types of nerves: median, ulnar and radial nerves and their sensory and motor components. The hand also has 120 ligaments, 29 joints and 17 muscles, which are further categorized under intrinsic and extrinsic groups. These different parts work together to give the hand, including the wrist and fingers: movement, strength and sensation.
“Injuries to the hand particularly the wrist and fingers can therefore, prove debilitating, causing extreme pain, swelling, tingling, numbness – all of which result in impairment of function and sometimes more serious problems,” said Dr. Lucia Heras, Consultant Orthopedic Surgeon, who specializes in hand surgery, at Burjeel Hospital for Advanced Surgery, Dubai. “One of the most common conditions affecting people these days is Carpel Tunnel Syndrome – overuse or repetitive strain, genetic factors and age is usually factors that contribute to the development of this condition.”
“This syndrome is a set of symptoms associated with the compression of the median nerve in the carpal tunnel. Symptoms include numbness, tingling, shock-like sensations in the fingers and wrist, and pain in the hand. As the condition worsens, it can cause rigidity in the wrist, decreased grasping strength, and a loss of sensation in the fingers,” she continued. “Early diagnosis and treatment are important to avoid permanent damage to the median nerve. Once electro-diagnostic tests, ultrasound and an MRI (magnetic resonance imaging) confirm the condition, doctors can prescribe non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to relieve pain and swelling. Surgery, though, is the most preferred solution. The surgeon can choose to do an open release surgical procedure, making an incision up to two inches in the wrist and then cutting the carpal ligament to widen the carpal tunnel. The procedure is generally done under local anesthesia.”
“Alternatively, endoscopic surgery is now becoming popular as it allows faster functional recovery, causing lesser discomfort post-surgery compared to the traditionally used method,” said Dr. Lucia added.
Arthritis is another common condition that affects the hands, among other parts of the body. The different types include rheumatoid arthritis, an autoimmune disease that affects the joints, connective and fibrous tissues, muscle and tendons. It tends to affect people between the ages of 20 and 40, and is a chronic disabling condition that causes pain and deformity.
Osteoarthritis, on the other hand, is a degenerative joint disease. It is associated with ageing and impacts the joints that have been continually stressed throughout an individual’s lifetime such as the knees, hips and fingers. Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion.
“Surgery is often the best solution when the arthritic symptoms worsen and impair function. The two main options treating arthritis in the hands are fusion known as arthrodesis, where the bones of the joint are fused together to make them stronger, pain-free and more stable; and total knuckle replacement or arthroplasty, which is an artificial implant,” said Dr. Maria Botella, Specialist hand surgeon.
“Fractures of the hands and fingers especially those caused due to sports or work-related activities may also require surgical intervention depending on their severity, especially if they need plates, screws or nails to hold the bones in place. Injuries or severe infections in the fingers or hand may also need partial or total amputation,” added Dr. Maria. “Sprained ligaments, which connect two bones together to form a joint, are also a common condition due to injuries. Other hand-related conditions that cause pain and restricted function include ‘trigger finger’, where a tendon develops a nodule or thickened area, stopping it from sliding freely through the tendon sheath. This can prevent the finger from straightening and is painful. Like it does in trigger finger, De Quervain’s Tenosynovitis makes it difficult for the tendon at the base of the thumb to slide through its tendon sheath. People suffering from this condition can find it painful and difficult to straighten their thumb.
Pain in the hands, particularly in the joints, is also encountered if a person lacks sufficient vitamins B12 and D, or if they are suffering from fibromyalgia, which affects joints all over the body. These conditions require supplementation and medication for pain relief.