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What’s Causing Hand Pain?

What’s Causing Hand Pain

Carpal tunnel syndrome is a condition where compression occurs in the carpal tunnel of the median nerve. It can be provoked by compression or injury.

The concept of tunnel syndrome is not universal for the wrist area; this condition can also manifest itself in other anatomical areas, where the nerves run rather superficially and close to the bone structures simultaneously. However, the syndrome in question manifests itself in the form of a decrease or lack of sensitivity in the thumb, index, middle, and half of the ring finger and impaired motor function in them.

Carpal tunnel syndrome is a common pathology and occurs in 1-3% of the population, mainly in people, an occupation associated with fine, monotonous motor skills. Half of all those suffering from this syndrome are people whose type of employment is associated with using a computer. Also, this disease can be considered an occupational pathology in musicians, tailors, office workers, etc. Hand pain occurs in the active working-age population at an already mature age (40-60 years) and in 105 cases at a younger age. Scientists have concluded that active PC users have a 15% higher risk of developing the syndrome, especially women.

Causes of hand pain

Causes of hand pain

The median nerve of the hand passes through the tunnel formed by the transverse ligament and the carpal bones. Compression of the nerve in the carpal tunnel can be provoked by:

  • Traumatic injuries of the hand. Bruises, dislocations, sprains, and fractures can provoke swelling of the ligaments and muscles or even displace the wrist bones. All this can compress the nerve in the carpal tunnel and disrupt its function. With proper treatment, all these processes are reversible. Still, if you do not provide assistance in time and correctly, then the contractures of muscles and ligaments and deformation of the bones can already be irreversible.
  • Arthrosis, arthritis, and other pathological articular processes of various etiology and genesis. Edema and inflammatory reactions caused by these pathologies, up to tissue necrosis, can also cause nerve compression. With the permanent course of inflammation and the progression of degenerative-dystrophic processes, the articular surfaces of the wrist lose their properties and wear out, resulting in deformation and compression of the nerve in the canal by bone structures that cause hand pain.
  • Inflammation of the tendons or tendovaginitis. Inflammation can be septic (caused by microorganisms) and aseptic (caused by exertion, hypothermia, etc.). Such diseases can provoke septic inflammation as purulent wounds of the hand, including panaritium, the improper technique of taking blood from a finger, etc. Non-infectious inflammation can be caused by chronic traumatic stress, for example, frequent monotonous hand motility, static load on it, temperature trauma.
  • Diseases that lead to water retention in the body can cause swelling of the limbs and, as a result, lead to an increase in soft tissue volume and compression of the median nerve and hand pain. Moreover, violation of the water-electrolyte composition can cause: pregnancy, taking hormonal contraceptives, menopause, kidney disease, etc.
  • Rarely, but there are tumors of the nervous tissue and the median nerve in particular. Most of these are benign neoplasms (schwannomas, neurofibromas, perineuromas), but malignant ones arise from the nerve sheaths. With its growth, the tumor compresses the nerve, which leads to its damage and hand pain.
  • Diabetes. Under the influence of the enzyme protein kinase C, sorbitol and fructose accumulated during the disease begin to break down in nerve tissues. Because of this, and due to a violation of the trophism of neurons and their processes, aseptic inflammation of the nerves and surrounding tissues occurs. Edema increases, which in turn leads to compression of the nerves, including the median.
  • Acromegaly. As a result of the prolonged and intensive growth of a person suffering from acromegaly, disproportionate growth of bone and soft tissues occurs. The median nerve can become pinched in a narrower carpal tunnel due to increased bone volume and lumen narrowing.
  • Congenital malformations. The transverse wrist ligament can be thickened from birth, and there is also weak production of tendon lubrication. One of the predisposition factors to carpal tunnel syndrome can serve as an anatomical feature of the structure, the so-called “square wrist.”

Carpal tunnel symptoms

  • Feeling of numbness in the fingers. The syndrome in question, as a rule, develops gradually, and the lesion manifests itself one-sided. The pathological process occurs in that limb, which is the leading one, in the right-handed – the right hand, and in the left-handers – the left. Thus, the development of carpal tunnel syndrome occurs gradually. However, a two-way process can also be observed with diseases of the endocrine system, pregnancy, etc.
  • Paresthesia symptom. Manifested as tingling sensations and loss of sensitivity in the fingers. They appear in the morning after waking up and disappear within a few hours. But over time, these manifestations become more stable and more intense and can already become permanent; this can disrupt the normal function of the limb, strength, dexterity, etc. The patient has to change hands when performing actions to rest the affected limb. Special inconveniences are caused by manipulations requiring static tension of the limb.
  • Pain. With the manifestation of the disease, such symptoms may appear as a burning sensation and tingling sensation in hand; this is quickly eliminated by lowering the limb and shaking it. The blood flow in the arm resumes, and the painful sensations disappear; this occurs during sleep due to the static position of the hand or during monotonous work performed by the limb. Pain is not common in any specific joint but is a common issue. With the progression of the disease, pain can affect the fingers and the entire hand and arm up to the elbow joint, which often complicates the diagnosis. In addition, the patient cannot carry out their duties because pain can occur during the daytime.
  • Loss of agility and strength. Over time, if the disease is not treated, the limb begins to lose strength and dexterity in movements. It is difficult for the patient to hold objects in their hands, especially small ones; they seem to fall out spontaneously. Besides, the ability to perform fine motor skills is lost (grabbing small things, opposing the thumb, etc.).
  • Decreased sensitivity. Over time, the patient may begin to notice that they do not distinguish the temperature of objects well, cease to feel touches or even pricks. There is a painful burning sensation in the hand, numbness.
  • Amyotrophy. With advanced forms of the syndrome, atrophy of the musculo-ligamentous apparatus of the arm may develop, the muscles and ligaments lose strength and decrease in size. Over time, the hand deforms and takes on a shape resembling a monkey’s paw.
  • Skin discoloration. Because when the innervation of the hand is disturbed, the nutrition of the skin cells also occurs; the color of the skin changes, they become lighter and unevenly colored.

Surgical treatment of hand pain

Surgical treatment of hand pain

For six months or more, if conservative therapy does not give the desired effect, then it makes sense to think about the surgical resolution of the disease. The main task of the surgical intervention is to eliminate the pressure on the median nerve by expanding the carpal tunnel.

Most operations are performed under local anesthesia. 

 

The following methods are used:

  • The carpal ligament is cut through open access through an incision in the region of the carpal canal.
  • Endoscopic surgery. There are two types of endoscopic intervention- two incisions and one incision. In the first case, an endoscope is inserted into one incision, and an instrument is inserted into the second for dissection of the ligament. In the second case, both tools are inserted in one hole.

A plaster cast is applied to the arm at the end of the surgery to immobilize the limb. After removing the plaster, a course of physiotherapy and physiotherapy is carried out. As a rule, complete restoration of hand function occurs within six months. After recovery, the patient can return to work, provided that the protective regime is observed not to provoke a relapse of the disease.

 

In the modern world, where computer technologies have already been introduced everywhere, the pathology we are considering is becoming more common. Timely and qualified assistance and prevention in the event of carpal tunnel syndrome allow complete and sufficient remission to be achieved.

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Lone Star Neurology
4.4
Based on 617 reviews
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Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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