Thumbs Up for Hand Care

Orthopedics Steward Health Care

Each time you tie your shoes, shampoo your hair, cook a meal, tap out an email or a text message, or brush your teeth, you’re using one of the most important parts of your body: your hands.

Usually, hand or arm movements seamlessly involve the ability of joints to move, tendons to slide, and muscles to contract.

But that’s not all. Networks of nerves, from your fingertips to the palm of your hand, to your wrist and forearm, make it possible to experience sensations that help you stay safe (“Ouch, that’s hot!”), perform jobs (carve a turkey, grip a hammer), and provide a tender touch to loved ones.

Given the complexity of the hand, it’s remarkable that injuries are not more frequent. When injuries or new conditions happen, though, a hand injury can be debilitating and require expert care.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is one of the most common hand and wrist conditions. It occurs when tissues surrounding the tendons in the wrist swell and put pressure on the median nerve that runs down the middle of the hand and wrist through the carpal tunnel. Normally, surrounding tissue, called the synovium, lubricates the tendons and makes it easier to move the fingers. However, if the synovium swells, the space within the carpal tunnel becomes tighter. Over time, it compresses the nerve. This results in numbness of the fingers and, sometimes, pain.

While there is no single cause for carpal tunnel syndrome, there are several risk factors. Some of these include:

  • Genetics. Carpal tunnels are smaller in some people, and this trait can run in families.
  • Hand use over time. Use of tools that vibrate, such as saws or jackhammers, are known to intensify symptoms. Motorcycles can aggravate symptoms as well.
  • Hormonal changes related to pregnancy.
  • Age. As with many conditions, carpal tunnel problems occur more frequently with aging.
  • Other medical conditions. Certain medical conditions, such as diabetes, rheumatoid arthritis or thyroid gland imbalance can be associated with carpal tunnel.
  • Smoking. Smoking causes reduced blood flow – in this case, to the median nerve in the carpal tunnel.

Non-surgical and surgical treatment for hand, wrist and upper body conditions

“Southeastern Massachusetts is an area that experiences a significant number of hand and wrist injuries,” says J. Mi Haisman, MD, a board-certified orthopedic surgeon with Steward Health Care. “This incidence is due in part to certain area industries, such as manufacturing, construction and fishing. The nature of these jobs can put people at greater risk for injury.”

Fortunately, there are both non-surgical and surgical solutions for carpal tunnel syndrome as well as other hand and upper extremity conditions.

“Specialized therapy can be very beneficial for injuries affecting the hands, wrists and the upper extremity,” says Dr. Haisman. “For carpal tunnel syndrome, a wrist brace worn during sleep, and taking vitamin B6 supplements or simple anti-inflammatory medications are some of the conservative measures that can help.”

If conservative measures are not effective and surgery is needed, a minimally invasive procedure called endoscopic carpal tunnel release can help. Dr. Haisman notes that this procedure requires just a small incision and three stitches. Best of all, she says, “Patients can move their fingers, dress themselves, and type or text the same day. Most people are able to return to work quickly.”

If you experience numbness, tingling or pain in the hand, arm or shoulder, ask your primary care provider if a referral to a hand surgeon is recommended.

 

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