Pain on the back of the hand
Cysts on the dorsal side of the wrist
Synovial cysts, or overlegs on the dorsal side of the hand, are soft, fluid-filled chambers under the skin that form at the back of the hand for no apparent reason.
This cyst is also known as a ganglion and is the most common benign tumor of the soft tissues of the hand and wrist.
As a rule, the right hand is affected, but in left-handed people, the cysts form on the left side.
Cysts develop easily in people who play an instrument (e.g. guitar).
- pain on the wrist, which intensifies with repeated exercise, for example, when writing;
- slow and localized increase with swelling, mild pain and numbness in the wrist;
- a clearly visible smooth, firm, roundish protrusion.
The typical symptoms of a ganglion at the back of the wrist can be similar to other ailments and conditions. For a correct diagnosis, a doctor must always be consulted.
At the initial stage, when the cyst is small and does not cause pain, treatment is not necessary.
However, if it grows and the functionality of the hand is impaired, therapy is advisable.
Treatment of a ganglion on the back of the wrist includes:
- immobilization in a bandage;
- anti-inflammatory drugs (nonsteroidal anti-inflammatory drugs, FANS for short);
- Suction (aspiration);
- Cortisone infiltrations;
- surgical removal, although in most cases the ganglion recurs within a few months.
Inflammation of the hand tendons
The two most common tendon diseases are tendinitis and tendovaginitis.
Tendinitis is the acute inflammation of a tendon (tendons are hard connective tissue strands that connect the muscles to the bones); Basically, any tendon can be affected, but most often the inflammation occurs on the wrist and fingers. Inflamed tendons lead to swelling, pain and stiffness.
Tendovaginitis is the inflammation of the tendon sheath, which is the tissue surrounding the tendon. As a rule, only the tendon sheath becomes inflamed, but simultaneous inflammation of the tendon is also possible.
The cause of tenosynovitis is often unknown, but it is most often due to cracks, excessive stress, injury or overuse.
Tendinitis can also occur in connection with a disease (for example, diabetes or rheumatoid arthritis).
Symptoms of tendon disease:
1. The most common form of tenosynovitis is Quervain’s disease; here the tendon sheath of the thumb is inflamed, causing pain and inflammation.
2. The rapid finger is tendovaginitis in which the tendon sheath becomes inflamed and thickened, hindering the extension or flexion of the thumb and other fingers; the finger can block or “rush” in a jerky movement.
3. Tendinitis of the hand extensors or flexors is characterized by the inflammation of the tendons between the wrist and hand, which allow the extensor and flexion movement of the hand.
Tendinitis causes movement pain when the affected tendon is squeezed and stretched; it can also cause movement restriction and swelling.
The pain can radiate to the forearm to the elbow.
The treatment of tendonitis on the hand includes rest, ice, nonsteroidal anti-inflammatory drugs, as well as physical physiotherapy, such as laser and ultrasound treatment.
In more severe cases, surgery may be necessary.
Lesion of extensor tendons
The extensor tendons are located just under the skin, on the back of the hands and fingers. In this situation, they are particularly susceptible to injury, even a small cut can be sufficient. Overstretching of the finger can lead to a tear at the attachment point of the tendons to the bone.
Such an injury can cause problems stretching one or more joints.
To restore tendon functions, the finger must be splinted, in some cases the tendon is sutured as part of a surgical procedure.
Arthrosis of the finger base joints (knuckles)
The joints at the foot of each finger are called finger base joints or metacarpophalangeal joints.
They play an important role in grabbing an object and also act as grippers.
The most common disease of the finger base joints is rheumatoid arthritis, while gout, psoriasis and infections occur less frequently.
Pain in the palm of the hand
Lesion of flexor tendons
Deep cuts on the inside of the palm, wrist and fingers can injure the flexor tendons and possibly nerves and blood vessels. When the tendon of a finger flexor is completely torn, the finger remains partially stretched because the muscle of the tendon cannot transmit enough force to bend the finger.
Typical symptoms are swelling, pain, stiffness and loss of function.
The therapy consists of immobilization of the finger in a rigid splint or – in more severe cases – surgical intervention to suture the tendon.
What is Dupuytren’s disease?
Dupuytren’s disease is a thickening of the connective tissue plate lying directly under the skin of the palm. There is a hereditary predisposition to this disease.
Small nodules or fiber strands are formed, which pull the fingers to the palm of the hand. Dupuytren’s disease can be associated with cigarette consumption, vascular disease, epilepsy and diabetes.
The small nodules in the palm do not necessarily have to be removed, only if they become very large or impair the functionality of the hand.
Surgical treatment may be advisable if the fingers are visibly curved inwards. The fiber strands may reappear or in different fingers.
Pain at the root of the thumb
The fracture of the scaphoid bone occurs mainly when falling on the outstretched hand.
As a rule, a strong pain is noticeable at the beginning, which can decrease over the course of a few days or weeks. Bruises rarely appear on the broken hand, a slight swelling is possible.
Since there is no deformation, many sufferers mistakenly assume that there is a wrist sprain, which delays the diagnosis.
It is not uncommon for a broken scaphoid bone to be detected months or years later.
Arthrosis of the thumb saddle joint
Osteoarthritis often occurs at the thumb saddle joint and is then referred to as rhizarthrosis. The pain localized at this point is the main symptom; it occurs mainly in the morning (when waking up) or during exercise.
Natural remedies include paraffin therapy to relieve pain and swelling.
Spraining of the thumb
This type of injury often occurs during sports or is caused by falls. The thumb comes into conflict with the opponent, the floor or the ball.
The thumb may be bent in an extreme position due to the sprain. Then the finger swells and bruising may occur.
Usually the movement causes great pain, writing is especially painful. With a sprain or strain, a ligament is stretched excessively. Ligaments consist of connective tissue and represent bone binding within a joint. In the thumb area, the ulten collateral ligament is the most frequently injured ligament.
Pain in the arm nerves with tingling and weakness
Carpal tunnel syndrome
Carpal tunnel syndrome refers to the compression of the median nerve in the carpal tunnel at the level of the wrist; the carpal tunnel is a narrow tube surrounded by bones and tendons.
Especially pregnant women are often affected by this syndrome.
Since the median nerve is responsible for the sensitive and motor innervation of the thumb, index and middle fingers, numerous symptoms can occur.
The following are the most common symptoms of carpal tunnel syndrome. Nevertheless, every person can feel different complaints.
Typical symptoms include:
- difficulty closing a fist;
- difficulty grasping objects, often they fall out of hand;
- pain in the fingers or numbness in the palm of the hand;
- nocturnal tingling in the fingers, especially in the thumb, index and middle fingers;
- Feeling swollen fingers.
The symptoms of carpal tunnel syndrome may be similar to those of other conditions, such as rheumatoid arthritis, bursitis or tendonitis; for a correct diagnosis, therefore, a doctor must always be consulted.
The ideal form of treatment includes:
- immobilization of the hand (to avoid the movement of the wrist and reduce the compression of the nerves running through the tunnel);
- anti-inflammatory infiltrations into the carpal tunnel space to relieve swelling;
- surgical intervention to reduce compression of nerves in the carpal tunnel;
- Change the position of the PC keyboard and mouse; it is recommended to use a mousepad with wrist rest.
Ulnar groove syndrome or compression of the elbow nerve
Ulnar channel syndrome is similar to carpal tunnel syndrome because here too the discomfort is caused by the compression of a nerve, in this case the elbow nerve. He is trapped in the elbow between the humerus and ulna.
Typical symptoms are: numbness or tingling in the little finger and ring finger, constant pain, weakness when gripping. The pain increases when bending the elbow joint.
Therapy consists in immobilization of the elbow and cortisone infiltrations; if these measures prove inadequate, surgery to free the nerve may be considered after a few months.
The term cervicobrachialgia refers to pain that emanates from the cervical spine and radiates along the nerves originating there into the arm to the fingers.
Symptoms include pain, tingling, loss of strength and sensitivity in the region between the neck and fingers.
Treatment includes anti-inflammatories, physiotherapy using the McKenzie method and, in very rare cases, surgery.
Nerves can be injured by pressure, overstretching and cuts.
Under pressure and stretching, the information-carrying fibers can break and block nerve activity without damaging the insulating shell.
The injury to a nerve can interrupt the transmission of signals to and from the brain, preventing muscle work and causing a loss of sensitivity in the area innervated by that nerve.
Diffuse pain on the palm or back of the hand
Arthritis is an inflammation of the joint and can occur in different parts of the hand and wrist.
The pain associated with arthritis can have different origins, including inflammation of the following structures:
- Synovial membrane (inner lining of the joint capsule): it releases a transparent and sticky fluid that acts as a lubrication for joints and tendons.
- Tendons: strong connective tissue strands that connect the muscles to the bones.
- Ligaments: rigid connective tissue fibrous belts that hold the bones together within the joints.
Osteoarthritis is a degenerative joint disease (joint wear) and is one of the most common joint inflammations in older people. The disease develops slowly and mainly affects the hands and large joints that support body weight, such as the knee joints, hip joints and lumbar vertebrae. Joint wear in the hand can occur due to hereditary predisposition or injuries, excessive stress, surgical interventions, etc.
Heberden nodules are cartilaginous-bony growths the size of a pea or smaller that originate in the finger joints of the hand and can be aggravated by osteoarthritis.
Typical symptoms are pain, swollen hands and stiffness, especially in the morning.
Cold and humid climates aggravate the symptoms
Infections of the hand
The hand is particularly susceptible to injury because it first hits the ground in a fall and because it holds and guides numerous objects, including pointed and sharp tools that can injure the skin.
A skin injury can become infected and cause mild discomfort; however, if the infection spreads, surgical intervention may be necessary. If an infection is detected early, it can be cured in many cases with antibiotics and rest.
Sometimes surgery is required even if the antibiotics have no effect or the infection is particularly severe and widespread.
Bite wounds on the hand
Dog bites are particularly common and very dangerous because they can cause severe pain and other problems, such as infections.
Dog saliva is full of bacteria, some of which are harmful to humans but not to animals.
Early detection of alarm signals and appropriate treatment are essential to avoid potential complications that can arise from a bite.
Some fractures have a marked deformation, such as a crooked finger; but this is not always the case.
As a rule, medical evaluations and X-ray examinations are necessary to determine whether there is a bone fracture and what the therapy should look like. Depending on the type of fracture, the doctor may apply a plaster cast or advise surgical intervention.
The plastered hand can hurt and tingle badly if the orthopedist has applied the cast too tightly.
Most often, the spoke breaks. Fracture of the wrist causes severe pain, swelling and difficulty using the hand.
A wrist fracture usually occurs when falling on the hand.
In case of a displaced fracture, the wrist may be crooked and have a deformation.
If it is the fracture of a small bone, such as the scaphoid bone, no deformation is visible; if, on the other hand, the ulna or spoke breaks, the malposition may be recognizable.
In a heart attack, pain can occur throughout the left arm, from the shoulder to the fingertips.