Is Your Hand Pain Arthritis, Carpal Tunnel or Something Else?

Is Your Hand Pain Arthritis, Carpal Tunnel or Something Else?

FRIDAY, March 1, 2019 (HealthDay News) — You use your hands nearly every minute of the day, so any time they hurt it’s important to find out why.

Certain conditions can affect people who do the same hand movements for hours every day. Repetitive strain injury can cause pain in muscles, nerves and tendons. Carpal tunnel syndrome swelling compresses a key nerve. The lesser known de Quervain’s tenosynovitis typically affects tendons on the inner sides of the wrist.

An autoimmune disease like rheumatoid arthritis often causes joint pain. Without treatment, it can lead to deformities in your hands. The wrist and finger joints are common targets of osteoarthritis, which occurs over time from normal wear-and-tear.

Treatment might start with an over-the-counter or prescription NSAID to temporarily relieve pain, but their long-term use has been linked to side effects such as liver or kidney damage and elevated heart attack risk.

Stronger medications may be needed to stop a degenerative disease like rheumatoid arthritis. Corticosteroid injections are an occasional option to reduce inflammation. Heat can ease stiffness while a cold pack can relieve soreness. If you have a chronic condition, an occupational therapist can teach you how to limit stress on joints when using your hands. During a flare, he or she might suggest a splint to stabilize your hand.

Sometimes surgery is needed. Dupuytren’s contracture, a thickening under the skin on the palm of the hand, can develop into firm lumps that cause fingers to bend inward. Unless lumps are removed early, it may be impossible to straighten fingers later on. If other options don’t help carpal tunnel and de Quervain’s, surgery might be the answer.

Many conditions worsen without appropriate treatment, so don’t delay in seeing your doctor or a hand specialist.

More information

The American Academy of Orthopaedic Surgeons has more on painful hand conditions.

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Health Tip: Preventing Carpal Tunnel

Health Tip: Preventing Carpal Tunnel

(HealthDay News) — Carpal tunnel syndrome (CTS) occurs when pressure is placed on a nerve stretching from the arm to the hand.

Often, this is due to stress on the hands and wrists. Adjusting your daily routine can help prevent CTS.

NYU Langone Health offers these suggestions:

Minimize repetitive hand movements.

Keep wrists straight.

Alternate between activities or tasks.

Avoid holding an object the same way for long periods.

Copyright ©2017 HealthDay. All rights reserved.

Health Tip: Preventing Carpal Tunnel

Health Tip: Warning Signs of Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when the nerve that runs from the forearm to the wrist becomes squeezed or compressed.

The condition can be caused by an injury to the wrist, stress to the joint, rheumatoid arthritis, or repetitive motion of the hand and wrist.

Here are some common symptoms of carpal tunnel syndrome, courtesy of the U.S. National Institute of Neurological Disorders and Stroke:

  • Numbness, burning, or tingling sensations in the fingers and/or palms of the hands.
  • Having these sensations at night, with symptoms increasing in severity and frequency.
  • Fingers feeling weak or swollen, even with no visible swelling.
  • Weak grip.
  • Difficulty perceiving hot and cold.
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Too Much or Too Little Weight May Worsen Rheumatoid Arthritis

Too Much or Too Little Weight May Worsen Rheumatoid Arthritis

Obesity may accelerate and amplify the crippling symptoms of rheumatoid arthritis, new research suggests.

Conversely, the researchers also found that unexplained weight loss might also signal problems for these patients, because it could mean that they’re at greater risk for disability.

“While patients and rheumatologists may be focused mostly on disease activity, we should also consider this common condition [obesity], which can contribute to problems that are usually attributed to the arthritis itself,” said study author Dr. Joshua Baker.

“In addition, unintentional weight loss should alert us that the patient may be becoming frail and is at risk for developing new disability,” he added. Baker is an assistant professor of medicine at the University of Pennsylvania’s Perelman School of Medicine.

Rheumatoid arthritis is an autoimmune condition. It develops when immune cells that normally fight germs attack the lining of the joints, or cartilage. This causes the joints to swell and the surrounding bones, ligaments and muscles to gradually erode. Rheumatoid arthritis worsens over time, often leading to disability.

For the study, Baker and his colleagues looked at the effects of obesity on the progression of rheumatoid arthritis in just over 25,000 people with the disease.

The investigators found that the disease advanced more quickly among those who were very obese. This was true regardless of the level of inflammation in their joints.

In addition, people who were thin but lost weight without trying also became disabled more quickly.

The study was published April 30 in the journal Arthritis Care & Research.

“So, this study suggests that patients with rheumatoid arthritis and obesity would benefit from intentional weight loss through a comprehensive management strategy,” Baker said in a journal news release.”

“However, when we see that someone is losing weight without trying, it’s probably a poor prognostic sign, especially if they are already thin,” he added.

Although the study could not prove a cause-and-effect link, the researchers suggested that new treatments and strategies to help people maintain a healthy weight might help prevent disability among people with rheumatoid arthritis.

And, Baker’s team noted, the findings could help doctors recognize signs of frailty among their rheumatoid arthritis patients who may benefit from strength training and physical therapy.

More information

The Arthritis Foundation has more about obesity and rheumatoid arthritis.

SOURCE: Arthritis Care & Research, news release, April 30, 2018

4 in 10 People Will Suffer Arthritic Hands Over Lifetime

4 in 10 People Will Suffer Arthritic Hands Over Lifetime

If you have stiff, aching fingers and hands, you’re not alone — a new study reports that 40 percent of people will be affected by the pain of arthritis in at least one hand.

The rate seen in the new research is “just slightly below the percentage of osteoarthritis seen in knees and is significantly greater than that seen in hips,” noted Dr. Daniel Polatsch. He’s co-director of the New York Hand & Wrist Center at Lenox Hill Hospital in New York City.

Arthritis “affects hand strength and function and causes difficulty doing activities of daily living,” Polatsch said.

The study team was led by Jin Qin, of the Arthritis Program at the U.S. Centers for Disease Control and Prevention. The researchers looked at 1999-2010 data on more than 2,200 people from North Carolina. All people in the study were aged 45 or older.

The information collected included symptoms the participants reported as well as hand X-rays.

Women were at higher risk than men, with nearly half of women (47 percent) developing hand arthritis. Only about a quarter of men had hand arthritis, Qin’s team said. Whites were more prone to the ailment than blacks, with rates of 41 percent and 29 percent, respectively.

Excess weight was also a risk factor for hand arthritis. Lifetime risk among obese people was 47 percent, compared to 36 percent for non-obese people, the study found.

Dr. Steven Carsons is chief of rheumatology at NYU Winthrop Hospital in Mineola, N.Y. He said the finding that hand arthritis is more common in women “has been long thought to have a genetic and hormonal basis.”

The obesity link is more intriguing, Carsons said.

“While obesity has always been assumed to be a risk factor for osteoarthritis of weight-bearing joints, such as the knee, these data reveal the somewhat surprising association of obesity and lifetime risk of development of hand osteoarthritis,” he said.

Recent studies have suggested that obesity may set up “systemic inflammation” in the body, Carsons said, which may raise the odds of arthritis in a non-weight-bearing joint, such as the hand.

Because arthritis in the hands can be disabling, Polatsch said, “treatment options and access to hand specialists need to improve in order to minimize the impact of this potentially disabling condition in our aging population.”

The study was published May 4 in Arthritis & Rheumatology.

More information

Find out more about arthritis at the Arthritis Foundation.

Boxer’s Fracture

Boxer’s Fracture

What is a boxer’s fracture?

A boxer’s fracture is a break in the neck of the fifth metacarpal bone in the hand. It gets its name because the injury is common in inexperienced boxers.

The metacarpal bones are the intermediate bones of the hand found inside the flat of the hand. They connect the bones of the fingers (the phalanges) to the bones of the wrist (the carpals). The fifth metacarpal is the metacarpal of the fifth (pinky) finger. The neck of the metacarpal bone is where the main shaft of the bone starts to widen outwards towards the knuckle.

Boxers are not the only people who can get a boxer’s fracture, but usually the injury results from direct injury to a clenched fist. The force fractures the neck of the metacarpal bone below the pinky.

Your doctor will need to distinguish boxer’s fractures from other metacarpal fractures, which break the shaft of the metacarpal, or fractures of the base of the small finger. These injuries may need different treatments.

Metacarpal bones, in general, are some of the most commonly fractured bones in the hands. A large percentage of these qualify as “boxer’s fractures.”

What causes a boxer’s fracture?

Usually, a boxer’s fracture happens when you punch a wall or another solid object at a high speed. You also might get a boxer’s fracture if you fall hard on your closed fist. The neck of the metacarpal bone is its weakest point, so it tends to fracture here.

What are the symptoms of a boxer’s fracture?

Symptoms of a boxer’s fracture can include:

  • Painful bruising and swelling of the back and front of the hand
  • Tenderness of the back of the hand in the region of the fractured fifth metacarpal
  • Bent, “claw-like” pinky finger that appears out of alignment
  • Limited range of motion of the hand and of the fourth and fifth fingers

Your knuckle may also not have its normal bumpy shape. Your symptoms may vary in severity depending on the complexity of your fracture. You might have only mild pain, or the pain might be more severe.

How is a boxer’s fracture diagnosed?

Your doctor will ask you about your symptoms, how you injured the hand, and your past medical problems. Your doctor will also examine your hand carefully, checking for tenderness, strength, misalignment, range of motion, breaks in the skin, and other features.

An X-ray of the hand can clearly confirm a boxer’s fracture.

How is a boxer’s fracture treated?

Your treatment depends on how severe the fracture is. Initial treatment might include:

  • Washing any cuts that are present in the skin
  • Getting a tetanus shot if you have a cut and haven’t had a shot for several years
  • Resting your hand for a few days
  • Keeping your hand above the level of your heart for a few days
  • Icing your injury several times a day
  • Taking pain medicine (prescription or over-the-counter)
  • Wearing a splint for several weeks

Before your doctor puts your hand into a splint, he or she may need to put your bones back into alignment. Usually, you’ll receive a local anesthetic to keep you from feeling any pain, and your doctor will physically manipulate the bones back into place. In some cases, your doctor might have to open up your hand surgically to get the bones back into alignment.

You also may need to work with a physical therapist for a while as your fracture heals. You’ll learn exercises to strengthen the muscles of your hand and keep them from getting stiff.

If you have an unusually severe boxer’s fracture, you may need immediate and more complicated surgery. For example, if your bone has broken through the skin, or if it has broken in several places, you will probably need surgery. You might also need surgery if you have a job or significant hobby that requires a lot of fine-motor movement of the hand, like playing the piano.

Even if you don’t need surgery right away, you might need it at some point. If your hand doesn’t heal as well as expected, surgery might be an option.

What are the complications of a boxer’s fracture?

An untreated boxer’s fracture can lead to a decrease in your ability to grip, limited range of motion of the finger, and an abnormal looking finger. With proper treatment, these complications are usually minor, if present at all.

What can I do to prevent a boxer’s fracture?

Avoid fistfights and punching solid objects to prevent many cases of boxer’s fracture. If you box, make sure you use the correct technique and the proper equipment.

How to manage a boxer’s fracture

Your doctor may give you some instructions about how to manage your boxer’s fracture, such as:

  • Keep your bones strong by eating a healthy diet with enough vitamin D, calcium, and protein
  • Stopping smoking, to help your fracture heal more quickly
  • Keeping your splint from getting wet

Your hand will be very easy to reinjure for 4 to 6 weeks after your splint is gone. You may need to use a hand brace if you return to contact sports during this time. Talk with your doctor about what makes sense for you.

When should I call my healthcare provider?

Call your doctor if:

  • You have numbness or tingling in your fingers
  • You fingers look blue
  • You have severe pain or worsening swelling
  • Your splint gets damaged and you need a new one

Key Points

A boxer’s fracture is a break in the neck of the fifth metacarpal bone in the hand. It usually happens when you punch an object at a high speed.

  • Symptoms of a boxer’s fracture include pain and swelling of the hand, limited range of motion of the pinky finger, and misalignment of the finger.
  • Your doctor can diagnose your boxer’s fracture with a medical history, physical exam, and X-ray.
  • You might need treatment with simple rest, ice, pain medicine, and splinting.
  • You might need surgery for your injury if it is severe.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
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