Four common hand conditions and their treatments

Your hands are complex structures, which include an intricate network of ligaments, bones and muscles. A problem with any of these parts can cause hand pain. Most often, hand pain is caused by an injury or overuse, but sometimes persistent pain can be due to an underlying condition.

Here Mr Gavin Brigstocke, a Consultant Orthopaedic Hand and Wrist Surgeon, shares four of the most common conditions that cause hand pain.

1. Carpal Tunnel Syndrome

Carpal tunnel syndrome gives you a tingling, weak or numb feeling in your hand or fingers. It happens when one of the nerves going into your hand gets squashed as it passes through the “carpal tunnel” in your wrist.

You can get it at any age, but it’s most common in older women. It affects about one in 20 people.

Symptoms can get worse over time and can make it difficult to do everyday tasks like typing or doing up shirt buttons.

You’re more likely to get carpal tunnel syndrome if you have a job or hobby that involves repetitive bending of your wrist or gripping of objects.

Other risk factors include:

• Being obese
• Being pregnant
• Having arthritis or diabetes
• Having close family members with the condition
• Having a past wrist injury

What to look out for

Symptoms usually start slowly. They can come and go, and include:

• Numbness in your hands or thumbs
• Pins and needles in your hand
• Pain in your fingers, hand, arm or shoulder
• Weakness in your grip
• Wrist pain

The tingling and numbness are often worse at night. Symptoms can worsen the more you use your wrist, or when you grip something tightly, such as the car steering wheel or bike handlebars.

Treatment

If the condition is at an early stage, you’ll usually be given a wrist splint and exercises to do. You should also rest your hand and use painkillers to help with the pain. If your case is more advanced, you may be given a steroid injection or surgery to relieve pressure on the nerve.

The surgery is called carpal tunnel release. It’s a short procedure that can be done under local anaesthetic, which means you’ll be awake but won’t feel any pain. A small cut is made at the base of your palm and the ligament is cut to relieve pressure on the nerve. You’ll usually make a complete recovery from the condition after surgery.

2. Trigger Finger

Trigger finger can be a painful condition that causes a clicking feeling when you move a finger or thumb. Sometimes your finger or thumb can get locked in place. It happens when one of the flexor tendons in your palm that moves your fingers and thumb gets inflamed. The inflamed tendon catches on the tendon sheath that it passes through as it moves up and down.

It can happen to anybody, but it’s most common in women over the age of 40, and in people with diabetes and rheumatoid arthritis. Tendonitis and Dupuytren's contracture can also lead to trigger finger.

It usually affects the thumb, ring finger or little finger and you’re most likely to get it in the hand you use most.

What to look out for

Trigger finger is not harmful, but it can be painful and irritating. Symptoms include:

• A clicking sensation as you bend your finger or thumb
• A lump at the base of your finger, on your palm
• Pain in your palm, which is often worse in the morning
• Pain when you bend your finger or thumb
• Your finger or thumb getting locked in a bent position and having to be pulled straight

Treatment

In some cases, trigger finger will go away by itself or with rest and painkillers. Sometimes your doctor will recommend wearing a splint to help rest it. You may also be given a steroid injection to reduce swelling in the tendon. 

If the condition persists, minor surgery can fix it.

The surgery takes place under local anaesthetic which numbs your hand. Your surgeon will open up the tendon sheath to allow your tendon to move more freely. Recovery is quick and you should be able to use your hand soon afterwards.

3. Dupuytren’s contracture

Dupuytren’s contracture causes firm tender nodules and long cords to develop in ligaments just under the skin on your hand. Eventually, the condition can make it hard to straighten your fingers.

It’s a common condition that most often affects men from middle-age onwards. Other risk factors include:

• A family history of the condition
• An injury or surgery on the hand or wrist
• Diabetes or epilepsy
• Heavy alcohol use
• Smoking

What to look out for

Dupuytren's contracture symptoms tend to get slowly worse over time. It can affect both hands and it mainly affects your ring and little fingers. Symptoms include:

• A lump or nodule on the palm of your hand(s), which can be painful
• Hard cords in your palms that appear to grow from a nodule and pull your fingers towards your palm
• Skin texture changes with small pits in your palm(s)

Treatment

If the condition is causing problems in your daily life, you can have an injection to weaken the tissue that’s making your fingers bend. Afterwards, your fingers will be straightened by a surgeon.

In some cases, you may have surgery to straighten your fingers. After surgery, you’ll need to wear a splint and have physiotherapy.

Symptoms can come back, so you might need further treatments in the future.

4. Ganglion cysts

A ganglion cyst is a swelling that grows near a joint or tendon. Some grow as large as a golf ball. They’re harmless but can sometimes be painful.

They can happen at any age but are most common if:

• You have an old injury in the affected joint
• You have osteoarthritis in your fingers
• You’re a woman aged 20-40

What to look out for

The cysts are filled with fluid and they look like a smooth lump. They can develop on any joint but are most common on the back of the wrists, the base of the thumb or fingers or the end-joint of a finger.

They can shrink or grow over time and you might feel pain, tingling, numbness or stiffness in the nearby joint.

Treatment

If your ganglion cyst doesn’t cause any pain, you can leave it alone and it might disappear without treatment. However, if it’s causing you pain or discomfort, there are treatments available.

You can have the cyst drained with a needle and syringe — this is called aspiration. If this isn’t successful, the cyst can be cut out by a surgeon.

Ganglion removal surgery usually takes just 30 minutes. Some people have a local anaesthetic and some will have a general anaesthetic. Your surgeon will remove the whole cyst without disturbing the joint or tendon and close the cut with stitches. The surgery is a routine procedure and you won’t need to stay overnight in hospital. 

If you’re experiencing hand pain and are concerned or it is affecting your ability to do everyday tasks, see your GP. In most cases, hand pain can be effectively treated.