Suffering from hand or wrist? Read the 6 most common complaints here
Whether you’re peeling potatoes, typing messages on your phone or doing odd jobs in the garden: if your hands or wrists hurt, you’ll notice it all day long. Hand and wrist surgeon Berbel Sluijter, together with her partner Nicoline de Haas, has the ‘Kliniek voor de Hand’ in Woerden. She explains six common hand and wrist complaints. Some complaints get worse if you don’t go to the doctor quickly.
1 Wrist complaints
Berbel Sluijter: ‘This is really a neglected child. I often see people at the office who have had wrist complaints for years. They fell on the wrist five to ten years ago. That gave complaints for a few weeks and then it was over. Years later, the complaints arise again when practicing a sport or hobby.
How come? The wrist consists of eight carpal bones that are connected by straps. When a band is torn, it slowly gets further and further out of the socket. The wrist becomes shaky, you get the feeling that you cannot rely on your wrist. This can cause wear and tear, just outside the socket of the joint.
If you have these kinds of complaints, it is best to ask for a referral to a hand surgeon. He can see on an X-ray whether the bones break apart during movement. Sometimes you can do keyhole surgery. If there is not too much osteoarthritis in the wrist, you can still have the strap imitated. But it is a major operation, with three months of rehabilitation. Advantage: it makes your wrist more powerful and stable, but you sacrifice mobility. If you already have a lot of osteoarthritis, it is often necessary to wear a splint. Or the wrist is partially secured to reduce the pain.’
2 Pain in the fingers or the base of the thumb
‘These complaints usually indicate osteoarthritis. The joints are lined with cartilage, which thins with age. This causes pain when moving. Some people are more prone to cartilage loss than others. Women are more likely to have osteoarthritis in the base of the thumb. The doctor usually refers the pain to a hand therapist who will measure a splint. Movement is good for osteoarthritis, but the hand should not be loaded too much. If you have a heavy bag, it is better to opt for a backpack or trolley, for example, to relieve your hand. You usually only have an operation if you are in a lot of pain, because the hand always loses strength and mobility as a result of an operation.’
3 Tingling or numbness with loss of strength
‘You feel tingling, especially in the index and middle fingers, or you have a numbness in the hand. You wake up at night with a tingling or numbness and you have to wave your hands. The funny thing is: the little finger still feels normal. These are typical symptoms of carpal tunnel syndrome. On the palm side of the wrist is a tunnel, through which many tendons and a large nerve run. If that nerve is pinched, these complaints arise. The nerve can become pinched, due to tendon problems or because you retain fluid. Women can suffer from it during pregnancy or during the menopause.
If you are there within six months, treatment with hand therapy, a splint (also called a ‘brace’) and sometimes a syringe with anti-inflammatories (corticosteroids) still makes sense. If you have had these complaints for a long time, surgery is often necessary. The hand surgeon will try to free the nerves by opening the roof of the carpal tunnel. People get rid of the nasty tingling within two weeks, only the numbness can last longer. And you run the risk of scarring after surgery. So if you have this kind of tingling, seek help quickly.’
4 Bump on the hand
‘A bump or bump on the wrist or hand is often a ‘ganglion’. That is a harmless bump filled with fluid from a joint. If you do a lot with your hand, you inflate the ganglion and it enlarges, after which it slowly shrinks again. A ganglion can disappear spontaneously, but if it hurts you or if you have trouble moving, you can have it treated. Depending on the location, you can have it punctured, but unfortunately the bump often comes back. You can also have it removed, but even then it will return in 30 percent of the cases and you run the risk of a scar. A scar on the hand or wrist can limit your ability to move. Hand surgeon therefore weigh up the pros and cons of a procedure carefully. They can also better assess whether wrist complaints are caused by the ganglion or by another cause. A bump on the hand can also be a benign tumor. If that causes problems when moving, you can have it removed. But even then he can come back.’
5 Stuttering finger
‘A stuttering or choking finger, or ‘trigger finger’, can occur in all five fingers. It causes pain at the base of the finger and difficulty moving. A choking finger occurs because a tendon is overloaded. You are more at risk if you have diabetes or hormone fluctuations (such as during the menopause). Also with this hand complaint, the motto is: rather not operate. Often you are already well helped with hand therapy, a syringe with anti-inflammatories and a splint. But if you ask a lot of your hands, for example because you work with your hands, the hock finger can get in the way. In those cases, surgery is often chosen, but again an annoying scar can arise. Sometimes the finger is very crooked, and then it also has to be operated on.’
6 A bulge in the palm and a finger that doesn’t stretch
‘Is it difficult to straighten a finger and is there a bulge in the palm of that finger? That could well be Dupuytren’s disease, also known as ‘coachman’s hand’. This creates a strand of connective tissue in your palm, causing the finger to bend. Complaints are first treated with a syringe containing anti-inflammatories. If it gets worse, it can be treated with minor surgery. The strand is cut loose by the skin and the finger is straight again. Unfortunately, that doesn’t get rid of the problem, because after a few years the strand will return. The hand surgeon can then remove the entire strand with a larger operation. Unfortunately, after this you have a long recovery of about three months. Dupuytren’s disease is usually hereditary and occurs mainly in North-West Europe. It is more common in men, who also have a more aggressive shape.’
Reference
Do you also have hand or wrist complaints? Don’t keep walking with it, because certain complaints can get worse if you don’t do anything. Go to your GP, ask for a referral to a recognized hand therapist or a recognized hand/wrist surgeon if necessary. You can recognize a good hand surgeon by being registered in the European register FESSH.
