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Education Links
Elbow and Forearm
Cubital Tunnel Syndrome
Cubital tunnel syndrome is a set of symptoms that may occur if the ulnar nerve in your elbow gets pinched. This may happen if you bend or lean on your elbows often.
Symptoms: Numbness or tingling in the ring and little fingers, loss of finger or hand strength, inability to straighten fingers, and sharp, sudden pain when the elbow is touched.
Nerve Entrapment and Radiculopathy
Tennis and Golfer’s Elbow
Tennis elbow is an inflammation around the bony knob on the outer side of the elbow. It occurs when the tissue that attaches to the bone becomes irritated. Playing racquet sports or anything that involves extending your wrist or rotating your forearm can cause tennis elbow.
Symptoms: Pain on the outer side of the elbow and down the forearm. Pain is usually aggravated by gripping and lifting with the hand in certain positions. There may be swelling on the side of the elbow.
Hand and Fingers
Basal Joint Arthritis
Brought on by wear and tear or degeneration of the cartilage of the joint at the base of the thumb (the basal joint). When the cartilage surface of the joint breaks down, arthritis develops.
Symptoms: Pain in the joint at the base of the thumb, soft tissue swelling around the joint. Thumb joint is stiff, with limited motion.
Links:
Basal Joint Arthritis - Orthohealth
Boutonniere Deformity
Deformity or disruption of the central slip of the finger, usually due to an injury, although it can develop in inflammatory disorders such as rheumatoid arthritis.
Symptoms: Finger(s) is bent down at the middle joint and bent back at the end joint.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition brought on by increased pressure or a pinched nerve at the wrist. Generally patients feel pain, numbness, burning or tingling (like pins and needles) in the hand, wrist, or fingers. Pain may radiate up the arm to the elbow, neck, and shoulder. Symptoms may be constant, or come and go. They often get worse at night, or after strenuous activity involving the hands. Without treatment, CTS symptoms may continue to get worse. You may have increased pain, decreased feeling in the hand, and gradual loss of grip strength. Simple tasks like grasping a handle or utensil may prove difficult.
Symptoms: Pain, tingling, numbness, swelling, weakness or clumsiness of the thumb, index, middle and ring fingers.
deQuervain's Tendinitis
De Quervain's disease is a condition brought on by irritation or swelling of the tendons found along the thumb side of the wrist. The irritation causes the compartment (lining) around the tendon to swell, changing the shape of the compartment or causing the tendon to thicken. This makes it difficult for the tendon to move as it should. Pain over the thumb side of the wrist is the main symptom. The pain is usually worse with repetitive use of the hand and thumb, especially when forcefully grasping things or twisting the wrist.
Symptoms: Pain and tenderness along the thumb side of the wrist, usually noticed when forming a fist, grasping or gripping things, or turning the wrist.
Type:
Dupuytren's Disease
Dupuyten's contracture is a disease that can lead to limited use of your hand. This may happen when certain tissue in the palm thickens. While it doesn't always cause pain, it can make it hard to straighten your fingers. Signs and symptoms include a hard lump forming across your palm, inability to place your palm flat on a surface, scarlike bands forming across your palm, and hand pain (less common.). Symptoms usually appear in 50 to 60 year-old men whose families come from northern European countries.
Symptoms: Thick knuckles. Movement is limited in finger(s).
Fractures
Fractures (or breaks) often take place in the hand or wrist. A fracture can cause chronic pain, stiffness, and loss of movement. Because of the close relationship of bones with soft tissues such as ligaments, tendons, and nerves, movement may be restricted because of injury to soft tissue. Fractures that involve joint surfaces may lead to early arthritis in those involved joints. Certain fractures, especially of the bones in the wrist may not result in severe symptoms. Any injury which results in prolonged symptoms (more than one to two weeks) should be evaluated.
Symptoms: Chronic pain, stiffness, and loss of movement
Ganglion Cysts
Ganglion cysts are very common masses (lumps) that sometimes grow in the hand and wrist. The cysts are generally found on the top of the wrist, sometimes on the palm side of the wrist, the end of the joint finger, and at the base of a finger. Although there is usually no specific cause for ganglions, there has often been an injury before the appearance of a cyst. These cysts can be painful, especially when they first appear, and with constant or strenuous use of the hand or wrist. Ganglions often change in size and may disappear completely.
Symptoms: These lumps are generally found on the top of the wrist, on the palm side of the wrist, the end joint of a finger (mucous cysts), and at the base of a finger.
Links:
Ganglion Cysts - Handsurgery.com
Guyon's Canal Syndrome
Symptoms: The symptoms begin with a feeling of pins and needles in the ring and little finger, starting in the early morning before waking. This progresses to a burning pain of the wrist and hand, followed by decreased sensation and eventually clumsiness in the hand. Inability to spread the fingers, and may include a weak pinch in the thumb.
Type:
Infections of the Hand
Symptoms:
Mallet Finger
A condition in which the end joint of a finger bends but will not straighten by itself.
Symptoms: Joint can be pushed straight but will not hold that position on its own.
Trigger Finger
Trigger finger is an inflammation of tissue inside your finger or thumb. It is also called "tenosynovitis."
Tendons and the synovium (a slick membrane that allows the tendons to move easily) become swollen, making it difficult to straighten the finger or thumb. The first sign of trigger finger may be pain and swelling where the finger or thumb joins the palm. As the tendon becomes more inflamed, the finger may start to catch when you try to straighten it. When the locked tendon releases, the finger jumps as if you were releasing the trigger on a gun.
Symptoms: Pain, swelling, and stiffness in base of hand and fingers. Finger(s) lock in position when bending.
Links:
Trigger Finger - Orthogate
Neck and Shoulder
Impingment and Tendinitis
Involves one or a combination of problems, including inflammation of the lubricating sac (bursa) located just over the rotator cuff, a condition called bursitis; inflammation of the rotator cuff tendons, called tendinitis; and calcium deposits in tendons caused by wear and tear or injury. A torn rotator cuff is a potential outcome of shoulder impingement.
Symptoms: Mild to severe pain and limited movement. Inability to hold the arm in certain positions.
Sympathetically Mediated Pain Syndromes
Symptoms: Persistent and intense limb pain.
Thoracic Outlet Syndrome
Thoracic Outlet Syndrome is a constellation of conditions which can result in arm pain, numbness, tingling and fatigue in the upper extremity. Seen in people who use there arms repetitively and with overhead activity. The nerves which emerge from the spinal cord along with the vessels which leave the chest cavity combine in the upper chest and make their way to the arm. At several points along this path irritation and compression can occur between certain muscles, the collarbone and the upper ribs. This condition and it's diagnosis is complex as symptoms overlap with Carpal Tunnel Syndrome, Cubital Tunnel Syndrome as well as Cervical spine and vascular conditions.
Symptoms: Symptoms vary, depending on which structures (nerves or blood vessels) are being compressed. Pressure on the blood vessels can reduce the flow of blood to your arms and hands, making them feel cool and tire easily. Pressure on the nerves can leave you with a vague, aching pain in your neck, shoulder, arm or hand. Overhead activities are particularly difficult.
Wrist
Fractures
Fractures (or breaks) often take place in the hand or wrist. A fracture can cause chronic pain, stiffness, and loss of movement. Because of the close relationship of bones with soft tissues such as ligaments, tendons, and nerves, movement may be restricted because of injury to soft tissue. Fractures that involve joint surfaces may lead to early arthritis in those involved joints. Certain fractures, especially of the bones in the wrist may not result in severe symptoms. Any injury which results in prolonged symptoms (more than one to two weeks) should be evaluated.
Symptoms: Chronic pain, stiffness, and loss of movement
Ganglion Cysts
Ganglion cysts are very common masses (lumps) that sometimes grow in the hand and wrist. The cysts are generally found on the top of the wrist, sometimes on the palm side of the wrist, the end of the joint finger, and at the base of a finger. Although there is usually no specific cause for ganglions, there has often been an injury before the appearance of a cyst. These cysts can be painful, especially when they first appear, and with constant or strenuous use of the hand or wrist. Ganglions often change in size and may disappear completely.
Symptoms: These lumps are generally found on the top of the wrist, on the palm side of the wrist, the end joint of a finger (mucous cysts), and at the base of a finger.
Links:
Ganglion Cysts - Handsurgery.com
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a condition brought on by increased pressure or a pinched nerve at the wrist. Generally patients feel pain, numbness, burning or tingling (like pins and needles) in the hand, wrist, or fingers. Pain may radiate up the arm to the elbow, neck, and shoulder. Symptoms may be constant, or come and go. They often get worse at night, or after strenuous activity involving the hands. Without treatment, CTS symptoms may continue to get worse. You may have increased pain, decreased feeling in the hand, and gradual loss of grip strength. Simple tasks like grasping a handle or utensil may prove difficult.
Symptoms: Pain, tingling, numbness, swelling, weakness or clumsiness of the thumb, index, middle and ring fingers.
Type:
Distal Radius Fracture
Symptoms: Pain, tingling, numbness, swelling, weakness or clumsiness of the wrist.
Kienbock's Disease
Bone is living tissue that requires a regular supply of blood for nourishment. If the blood supply to a bone stops, the bone can die, a condition known as osteonecrosis. That’s what happens in Kienböck’s disease, which affects the lunate, one of the small bones of the hand near the wrist, causing the bone to die.
Symptoms: A painful and sometimes swollen wrist. Limited range of motion in the affected wrist (stiffness). Decreased grip strength in the hand. Tenderness directly over the bone (on the top of the hand at about the middle of the wrist). Pain or difficulty in turning the hand upward.
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