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Hand, Finger and Wrist Injuries

At one time or another, everyone has had a minor injury to a finger, hand, or wrist that caused pain or swelling. Most of the time our body movements do not cause problems, but it’s not surprising that symptoms develop from everyday wear and tear, overuse, or an injury.

Finger, hand, or wrist injuries most commonly occur during:

  • Sports or recreational activities.
  • Work-related tasks.
  • Work or projects around the home, especially if using machinery such as lawn mowers, snow blowers, or hand tools.
  • Accidental falls.
  • Fistfights.

The risk of finger, hand, or wrist injury is higher in contact sports, such as wrestling, football, or soccer, and in high-speed sports, such as biking, in-line skating, skiing, snowboarding, and skateboarding. Sports that require weight-bearing on the hands and arms, such as gymnastics, can increase the risk for injury. Sports that use hand equipment such as ski poles, hockey or lacrosse sticks, or racquets also increase the risk of injury.

In children, most finger, hand, or wrist injuries occur during sports or play or from accidental falls. Any injury occurring at the end of a long bone near a joint may injure the growth plate (physis) and needs to be evaluated.

Older adults are at higher risk for injuries and fractures because they lose muscle mass and bone strength (osteopenia) as they age. They also have more problems with vision and balance, which increases their risk of accidental injury.

Most minor injuries will heal on their own, and home treatment is usually all that is needed to relieve symptoms and promote healing.

Sudden (acute) injury

An acute injury may occur from a direct blow, a penetrating injury, or a fall, or from twisting, jerking, jamming, or bending a limb abnormally. Pain may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries include:

  • Bruises. After a wrist or hand injury, bruising may extend to the fingers from the effects of gravity. See a picture of a bruise (contusion) .
  • Injuries to ligaments. See a picture of a torn thumb ligament  as in skier’s thumb.
  • Injuries to tendons, such as mallet finger.
  • Injuries to joints (sprains).
  • Pulled muscles (strains).
  • Broken bones (fractures), such as a wrist fracture .
  • Dislocations.
  • Crushing injury, which can lead to compartment syndrome.

Overuse injuries

Overuse injuries occur when too much stress is placed on a joint or other tissue, often by “overdoing” an activity or repeating the same activity. Overuse injuries include the following:

  • Carpal tunnel syndrome is caused by pressure on a nerve (median nerve ) in the wrist. The symptoms include tingling, numbness, weakness, or pain of the fingers and hand. See a picture of carpal tunnel syndrome .
  • Tendon pain is actually a symptom of tendinosis, a series of very small tears (microtears) in the tissue in or around the tendon. In addition to pain and tenderness, common symptoms of tendon injury include decreased strength and movement in the affected area.
  • De Quervain’s disease can occur in the hand and wrist when tendons and the tendon covering (sheath) on the thumb side of the wrist swell and become inflamed. See a picture of de Quervain’s disease .

Treatment

Treatment for a finger, hand, or wrist injury may include first aid measures; medicine; “buddy-taping” for support; application of a brace, splint, or cast; physical therapy; and in some cases, surgery. Treatment depends on:

  • The location, type, and severity of the injury.
  • How long ago the injury occurred.
  • Your age, health condition, and activities (such as work, sports, or hobbies).

Stop the pain and get your hand checked. Call +65 6471 2744 (24 Hours) or SMS to +65 9235 7641

Finger Arthritis

Joints are places in your body where two bones come together. Arthritis is a problem that causes damage to the normal joint surfaces. These junctions have special surfaces to allow smooth motion. This smooth surface is cartilage, and when the cartilage is damaged, arthritis is the condition that results.

There are two types of arthritis that commonly affect the fingers. These are osteoarthritis and rheumatoid arthritis.

  • Osteoarthritis
    Osteoarthritis, also called wear-and-tear arthritis, is the most common type of finger arthritis. In people with osteoarthritis, the normal cartilage is steadily worn away, exposing bare bone at the joints. The most frequently affected joints in the hand are the knuckles of the mid-finger and fingertip (the PIP and DIP joints), and the joint at the base of the thumb.
  • Rheumatoid Arthritis
    Rheumatoid arthritis causes a different type of joint destruction. Rheumatoid arthritis is a systemic disease that can cause a number of problems. Among these, rheumatoid arthritis can cause inflammation of the soft-tissue surrounding joints. The most commonly affected joints in the hand are the knuckles at the base of the fingers (the MCP joints).

What are the symptoms of finger arthritis?
Symptoms of finger arthritis include:

  • Joint pain
  • Swelling
  • Stiffness
  • Loss of motion

Patients with osteoarthritis often develop lumps or nodules around the knuckles of the fingers. These lumps are called Heberden’s nodes (when around the more distant knuckle) or Bouchard’s nodes (when around the closer knuckle), and actually consist of bone spurs around the joints. These knuckles often become enlarged, swollen, and stiff. People often complain that their rings do not fit, or can’t be removed.

Patients with rheumatoid arthritis often have the aforementioned symptoms, but can also have more complex deformities of the hands. The fingers may begin to shift from their normal position, and drift away from the thumb.

What are the treatments for finger arthritis?
Early treatments of finger arthritis are focused on managing the symptoms in an effort to avoid surgery. Treatment options include:

  • Anti-Inflammatory Medications
    These medications can help treat the pain of finger arthritis, and also help decrease inflammation and swelling around the joints.
  • Joint Supplements
    Joint supplements consist of glucosamine and chondroitin, two of the major building blocks of normal cartilage. These supplements may be helpful for osteoarthritis.
  • Anti-inflammatory Injections
    Anti-inflammatory is a more powerful anti-inflammatory medication and can be useful in limited applications in the hand.
  • Hand Therapy
    Hand therapy, usually performed by an occupational therapist, is helpful to maintain motion and prevent stiffening of the joints.
  • Ice & Heat Treatment
    Joint stiffness and range of motion can be improved by ice and heat treatments.
  • Splints
    Splinting helps to relax and rest the joints. Splinting should be done for limited periods of time to allow for relief without allowing the joint to stiffen.

If these treatments fail, then surgery may be necessary. In the fingers, several procedures may be done, including removing the bone spurs, fusing the joint, and replacing the joint. The most common surgery is a finger joint fusion. This procedure holds the joint in a fixed position to prevent any further motion at the affected joint. While the joint is then stiff forever, the pain is usually alleviated. Furthermore, during finger joint fusion surgery, your doctor can straighten any deformity and remove bone spurs.

Stop the pain and get your Finger Joint checked today. Call +65 6471 2744 (24 Hours) / Email: info@boneclinic.com.sg

Patient Guide to Finger Pain

Finger pain includes any kind of discomfort in the tissues or joints of the finger. Finger pain may be described as throbbing, aching, increased warmth, tingling, soreness or stiffness. Burning or prickling sensations in a finger, often called pins and needles, are called paresthesias. Paresthesias are often due to temporary or permanent damage or pressure on the nerves that carry sensation messages from the hand and fingers to the spinal cord.

The finger is made up of nerves, bones, blood vessels, muscles and skin. Finger joints are the areas where bones meet and consist of cartilage, ligaments, tendons, bursas (fluid-filled sacs that help cushion the joint), and synovial membranes and fluid, which lubricate joints. Any of these structures in the finger can become irritated or inflamed and painful in response to a variety of mild to serious diseases, disorders or conditions, such as trauma, infection and inflammation.

Common causes of finger pain include injury or trauma, such as bending your finger backward (hyperextension) or from repetitive use, such as long periods of keyboarding. More serious conditions, such as diabetes or a neck or spinal cord injury, can also cause pain or a burning sensation in your fingers. Sore joints in the fingers may be caused byarthritis, inflammation, and age-related wear and tear. Depending on the cause, your pain may be short term and disappear quickly, or it may develop slowly over weeks or months.

Because finger pain can be a sign of a serious infection or inflammation, you should contact your medical professional about your symptoms. Seek prompt medical care if you have finger pain with swelling, redness, warmth or fever.

What other symptoms might occur with finger pain?

Other symptoms may occur with finger pain. Additional symptoms vary depending on the underlying disease, disorder or condition. For example, finger pain due to a serious infection that has spread to the blood may be accompanied by swelling, fever and chills, as well as redness and warmth around the affected area.

Other symptoms that may occur with finger pain include:

  • Arm or wrist pain
  • Bruising or other discoloration
  • Decreased grip strength
  • Drainage or pus
  • Fingernail problems, such as bruising under the nail or detachment of the nail
  • Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains)
  • Lacerations, abrasions, sores or lesions
  • Lumps or bumps along the finger
  • Numbness
  • Reduced range of motion or movement of a joint
  • Stiffness
  • Swelling

Serious symptoms that might indicate a life-threatening condition

In some cases, finger pain may occur with other symptoms that might indicate a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care) if you, or someone you are with, have finger pain along with any of these other symptoms:

  • High fever (higher than 101 degrees Fahrenheit)
  • Inability to move the finger, wrist or arm
  • Partial or total amputation of the finger
  • Red, warm and tender skin or a red streak up the arm
  • Severe pain
  • Uncontrolled bleeding
  • Visible deformity

    What causes finger pain?

    The finger consists of nerves, blood vessels, muscles, skin and joints. The hand and finger joints are made up of cartilage, ligaments, tendons, bursas (fluid-filled sacs that help cushion the joint), and synovial membranes and fluid that lubricate the joints. Any of the structures in the finger can become irritated or inflamed in response to a variety of mild to serious diseases, disorders or conditions, such as trauma, infection and nerve compression.

    Tingling pain in the fingers can be due to compression of the nerves that carry sensation messages from the hand and fingers to the spinal cord. Tingling of both the pinky finger and ring finger together can be a sign of entrapment or compression of the ulnar nerve in the arm due to problems with the shoulder, elbow or wrist joint. Tingling of the thumb, index finger, middle finger and part of the ring finger can be due to problems with the median nerve, such as carpal tunnel syndrome.

    In some cases, finger pain is a symptom of a serious condition that should be immediately evaluated in an emergency setting, such as a broken bone or invasive bacterial infection.

    Injury-related causes of finger pain

    Finger pain can occur from the following types of injuries:

    • Broken finger or stress fracture
    • Contusion or abrasion
    • Crush injury
    • Degloving injury (separation of the skin and top layer of tissue from the finger)
    • Laceration or blunt force trauma, such as a dog bite
    • Repetitive stress injury
    • Splinter or other foreign body
    • Sprain or strain

    Degenerative, infectious and inflammatory causes of finger pain

    Finger pain can be associated with inflammatory or infectious conditions including:

    • Age-related wear and tear on the joints and osteoarthritis
    • Bursitis (inflammation of a bursa sac that protects and cushions joints)
    • Cellulitis (invasive skin infection that can spread to the surrounding tissues)
    • Ganglion cyst (benign growth or swelling on top of a joint or tendon)
    • Infection, such as a Staphylococcus aureus bacterial infection
    • Paronychia (infection around the nail)
    • Rheumatoid arthritis (chronic autoimmune disease characterized by joint inflammation)
    • Septic arthritis (infectious arthritis)

    Nerve-related causes of finger pain

    Finger pain, particularly tingling or numbness in the fingers, may be caused by moderate to serious conditions that compress nerves and can lead to nerve damage including:

    • Carpal tunnel syndrome (compression in the wrist area of the nerve that provides feeling and movement to the palm and thumb side of the hand)
    • Cervical spondylosis (degenerative disc disease in the neck)
    • Herniated disc
    • Neck injury
    • Nerve entrapment or compression, such as the ulnar nerve in the arm

    Other neurological causes of finger pain

    Finger pain can be associated with a variety of other conditions that can affect or damage the nervous system including:

    • Alcoholism
    • Diabetic neuropathy (nerve damage due to high blood sugar levels associated with diabetes)
    • Heavy metal poisoning such as lead poisoning
    • Hypothyroidism (underactive thyroid)
    • Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, lack of coordination, balance difficulties, and other problems)
    • Neuroma in the finger
    • Peripheral neuropathy (damage to the nerves outside the brain and spinal cord)
    • Spinal cord injury or tumor
    • Stroke
    • Systemic lupus erythematosus (disorder in which the body attacks its own healthy cells and tissues)
    • Transverse myelitis (neurological disorder causing inflammation of the spinal cord)
    • Vitamin B12 deficiency

    Other causes of finger pain

    Finger pain can be associated with other conditions including:

    • Buerger’s disease (acute inflammation and clotting of arteries and veins)
    • Circulatory problems (reduced blood flow)
    • Frostbite or extremely cold temperatures
    • Raynaud’s phenomenon (spasms of small blood vessels of the fingers and toes, reducing blood circulation. Raynaud’s phenomenon is secondary to many autoimmune disorders such as lupus)

    Questions for diagnosing the cause of finger pain

    To diagnose the underlying cause of a finger pain, your doctor or licensed health care practitioner will ask you several questions related to your symptoms. Providing complete answers to these questions will help your provider diagnose the cause of your finger pain:

    • What is the exact location of the pain?
    • Describe the pain. Is it sharp or dull, tingling or burning? When did it start? How long does it last? Does the pain occur during or after certain activities?
    • Have you had any recent injuries, including exposure to cold or frostbite?
    • Do you have any other symptoms, such as swelling?
    • What is your full medical history? What medications do you take? Do you smoke?

    What are the potential complications of finger pain?

    Complications associated with finger pain vary depending on the underlying disease, disorder and condition and can be serious. It is important to visit your health care provider when you experience persistent pain or other unusual symptoms related to your fingers or hands. Following the treatment plan you and your health care provider develop specifically for you will minimize the risk of complications including:

    • Chronic disability
    • Finger amputation
    • Finger deformity
    • Inability to perform daily tasks
    • Spread of infection to other tissues

To seek professional opinion about your Finger Pain, call us at +65 6471 2744 / Email: info@boneclinic.com.sg

Swollen Finger Joints

The hand is made of many small bones, and fingers are specially designed to bend at three joints. Swelling at these joints may be the result of an injury or a symptom of a larger problem. Joint swelling is the inflammation of the soft tissue surrounding the bony structures of the joint.

Causes of Swollen Finger Joints

Finger joints can become swollen for a variety of reasons. The joint may be wounded if the hand gets injured in some way or if something bends a finger in the wrong direction. Osteoarthritis and rheumatoid arthritis may both cause inflammation of the finger joints. Arthritis can strike any joint in the body, but it is most noticeable in the hands. Other forms of arthritis, like gout, may be at fault.

Symptoms of Swollen Finger Joints

Swollen finger joints are often quite stiff and painful. Swelling may make the joint quite large and misshapen. The joints may even be red and warm to the touch. Arthritis may make fingers appear crooked as each joint turns the bones of the fingers in different directions.

Diagnosis of Swollen Finger Joints

A trip to the doctor may be necessary to diagnose the cause of swollen finger joints. The physician will examine the finger and take X-rays. Further testing like MRIs, CAT scans and blood tests may be ordered.

Risks of Swollen Finger Joints

There is risk of infection if the joint is swollen due to a cut in skin or a broken bone. If the swelling is caused by rheumatoid arthritis, the joint can be damaged by using the joint while it is swollen. If the reason why the joint is swollen is unknown, it may be helpful to immobilize the finger until swelling subsides or a physician is consulted.

Treatment of Swollen Finger Joints

Treatment will largely depend on the cause of the swelling. Often anti-inflammatory drugs are given, either by prescription or purchased over the counter. Injuries may be treated with hot and cold compresses and immobilization of the finger or hand. Still other treatments may involve physical therapy. If excess fluid is the cause, it may be removed from the joint with a needle. Rarely, surgery is needed.

Prevention of Swollen Finger Joints

Protecting the hands and fingers from injury is always important but not always possible. To prevent infection, gloves should be worn whenever performing any task that may cut the skin. Repetitive tasks that may lead to osteoarthritis, like typing or knitting, should be avoided or minimized.

 Get your Finger Joints Check today! Call us at +65 6471 2744 (24 Hours Hotline) / SMS to +65 9235 7641

Boutonniere Deformity

Boutonnière deformity is an injury to the tendons in your fingers that usually prevents the finger from fully straightening. The result is that the middle joint of the injured finger bends down, while the fingertip bends back. This is the characteristic shape of a boutonnière deformity. Unless this injury is treated promptly, the deformity may progress, resulting in permanent deformity and impaired functioning.

Anatomy

There are several tendons in your fingers that work together to bend and straighten the finger. These tendons run along the side and top of the finger. The tendon on the top of the finger attaches to the middle bone of the finger (the central slip of tendon). When this tendon is injured, the finger is not able to be fully straightened.

Causes of Boutonniere Deformity

Boutonnière deformity is generally caused by a forceful blow to the bent finger.

It also can be caused by a cut on the top of the finger, which can sever the central slip from its attachment to the bone. The tear looks like a buttonhole (“boutonnière” in French). In some cases, the bone actually can pop through the opening.

Boutonnière deformities may also be caused by arthritis. About one third of all people with rheumatoid arthritis also have fingers with boutonnière deformities.

Symptoms of Boutonniere Deformity

Signs of boutonnière deformity can develop immediately following an injury to the finger or it may develop seven to 21 days later.

  • The finger at the middle joint cannot be straightened and the fingertip cannot be bent.
  • Swelling and pain on the top of the middle joint of the finger.
Boutonnière deformity must be treated early to help you retain the full range of motion in the finger.

Nonsurgical Options

Nonsurgical treatment is usually preferred.

  • Splints: A splint will be applied to the finger at the middle joint to straighten it. This keeps the ends of the tendon from separating as it heals. It is important to wear the splint for the recommended length of time-usually 6 weeks for a young patient and 3 weeks for an elderly patient. Following this period of immobilization, you may still have to wear the splint at night.
  • Exercises: Your physician may recommend stretching exercises to improve the strength and flexibility in the fingers.
  • Protection: If you participate in sports, you may have to wear protective splinting or taping for several weeks after the splint is removed.

People with boutonnière deformity caused by arthritis may be treated with oral medications or corticosteroid injections as well as splinting.

Surgical Options

While nonsurgical treatment of boutonnière deformity is preferred, surgery is an option in certain cases, such as when:

  • The deformity results from rheumatoid arthritis.
  • The tendon is severed.
  • A large bone fragment is displaced from its normal position.
  • The condition does not improve with splinting.

Surgery can reduce pain and improve functioning, but it may not be able to fully correct the condition and make the finger look normal. If the boutonniere deformity remains untreated for more than 3 weeks, it becomes much more difficult to treat.