Hand and wrist

From overuse problems and aging to falling onto an outstretched arm or getting a finger stuck in the wrong place at the wrong time, you can suffer hand and/or wrist pain in a number of ways. Because there are so many structures packed into a small space, wrists and hands are particularly susceptible to problems.

Common diagnoses include carpal tunnel syndrome, sprains, fractures, tendinitis and Dupuytren's disease.

Texas Health Resources has a multidisciplinary team of experts who can quickly and effectively diagnose the source of hand and wrist pain and provide you with a range of treatment options. Texas Health has hand and wrist specialists on the medical staff who can perform advanced surgeries, as well as make recommendations about other treatments. Many Texas Health hospitals offer rehabilitation services with advanced equipment and experienced therapists.

Keep your wrists and hands pain free

    Try the following tips for keeping your wrists and hands pain free:
  • Use the largest, strongest muscle. For example, instead of pulling something, push it with your body weight.
  • Use the appropriate tool for the job. For example, use power tools whenever possible.
  • Avoid awkward posture, such as tight grips, bending, reaching and twisting.
  • Use leverage when possible. For example, install sink faucets that operate with leverage rather than grip.
    To specifically prevent carpal tunnel syndrome:
  • Adjust your computer keyboard so that you do not have to bend your wrist upward while typing.
  • Take frequent breaks from activities that require wrist movement.
  • Work with an occupational therapist.

Diagnosing hand and wrist pain

Your physician will diagnose your hand and/or wrist pain based on the findings of a medical history, physical exam and possibly diagnostic tests.

    For your medical history, your physician may ask questions such as:
  • When did the hand/wrist pain begin?
  • Did it occur suddenly and severely or gradually and mildly?
  • Is the pain constant or does it come and go?
  • Is the pain sharp, throbbing or burning? Is there numbness or tingling in any of your fingers?
  • Where exactly is the pain? In both hands/wrists? Does it extend to the fingers?
  • Is the pain worse with movement?

During the physical exam, the physician will manipulate your hands and wrists to determine their strength and range of motion, and to identify where the pain is located.

Depending on the findings of the medical history and physical exam, your physician may refer you for an X-ray.

    Common diagnoses for wrist and hand pain include:
  • Broken or sprained wrist
  • Carpal tunnel syndrome
  • Trigger finger
  • Dupuytren's disease
  • Ganglion cysts
  • Osteoarthritis
  • Rheumatoid arthritis
  • Lupus
  • Gout

Treatment options

Depending on the source of your hand/wrist pain, treatment can range from rest and anti-inflammatories to therapy to surgery. A number of Texas Health Resources hospitals offer specialized hand clinics designed to treat problems of the wrist and hand. Occupational therapists with experience and certification in hand therapy at the clinics provide direct therapeutic interventions, custom-made splints and preventive services for most hand and wrist pain diagnoses.

    Specific treatment options include:
  • Arthritis: A degenerative disease that can cause stiffness, pain and deformity in the hands; often treated successfully with medication, especially in the early stages; severe cases may need surgery to correct deformations, restore function and ease pain.
  • Dupuytren's Contracture: This hereditary disease causes tissue within the palm to thicken, forming anomalies under the skin that may make fingers contract into the palm; surgery is the recommended treatment, and it is usually successful, although problems may recur.
  • Excisional arthroplasty: Surgical removal of joint surfaces damaged by arthritis; these surfaces are replaced with a cushion of the patient's tissue (often a tendon) that keeps the bones separated while scar tissue has time to form and form a flexible connection between them.
  • Finger joint fusion: A surgical procedure that removes cartilage from a finger joint and pins two bones together so that, over a period of weeks, they fuse together into a single unit; the result is loss of movement that was causing pain.
  • Finger joint replacement: Total replacement of a diseased or damaged metacarpal-phalangeal joint with a prosthetic implant; these joints connect the fingers (phalanges) to the bones of the palm (metacarpals).
  • Ligament surgery: Procedures that repair damaged tendons in the fingers; when the tendons associated with the middle joint (proximal interphalangeal) in a finger are stretched, torn or ruptured, surgery is sometimes required to assure that proper healing occurs.
  • Trigger Finger: Caused by an irritation of the sheath through which a finger's flexor tendon passes; when the sheath swells, it restricts movement of this tendon so that it catches painfully, then releases like a trigger; may be treated successfully with anti-inflammatory medication but can require surgery in more severe cases.

After your treatment

After your initial treatment for a hand or wrist problem, your physician may prescribe physical and/or occupational therapy. Occupational therapists at Texas Health's Hand Clinics provide specialized rehabilitations services for hand and wrist conditions.

Frequently asked questions

Q: If I experience a hand/wrist/finger injury and do not believe it is broken, what initial self-care treatment can I provide?

    A: Try the following:
  • Rest your wrist, and keep it elevated.
  • Apply ice to the tender and swollen area.
  • Take over-the-counter pain medication, such as ibuprofen or acetaminophen.
  • Wear a splint for several days. Wrist splints can be purchased at many drugstores and medical supply stores.

Q: If I am experiencing hand or wrist pain, what are some signs that would indicate that I should see a physician?

    A: Some signs that you should see a physician include:
  • You are unable to move your wrist, hand or a finger.
  • Your wrist, hand or fingers are misshapen.
  • You have hand/wrist/finger pain and a fever over 100 degrees.
  • You have a rash.
  • You have swelling and redness of your wrist, and you have had a recent illness (like a virus or other infection)
  • You have swelling, redness or stiffness in one or both wrists.
  • You have numbness, tingling or weakness in the wrist, hand or fingers with pain.
  • You have lost muscle mass in your wrist, hand or fingers.
  • You have been following self-care treatments for two weeks but still have pain.

Q: What is carpal tunnel syndrome?

A: Carpal tunnel syndrome is a common cause of wrist pain. You may feel aching, burning, numbness, or tingling in your palm, wrist, thumb or fingers. The thumb muscle can become weak, making it difficult to grasp things. Pain may extend up to your elbow.

    Carpal tunnel syndrome occurs when an important nerve (called the median nerve) gets compressed at the wrist because of swelling. Such swelling can occur if you:
  • Do a repetitive motion with your wrist like typing on a computer keyboard, using a computer mouse, playing racquetball or handball, sewing, painting, or writing or using a vibrating tool.
  • Are pregnant, menopausal or overweight.
  • Have diabetes, premenstrual syndrome, an underactive thyroid or rheumatoid arthritis.

Q: What is Dupuytren's disease?

A: Dupuytren's disease is an abnormal thickening of tissue beneath the skin in the palm of the hand or hands and occasionally the soles of the feet. The thickened skin and tendons may eventually limit movement or cause the fingers to bend so they can't be straightened.