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Hand Pain and stiffness

Types of Hand Pain & Symptoms
Pain in the hand is a very common symptom reported by patients of all ages. Pain covers a variety of pathological processes, ranging from nerve entrapment to wear and tear osteoarthritis. 

When assessing hand pain in a patient, We need to assess the quality of the pain. Patients in the clinic describe two particularly common types of pain.

A burning sensation, associated with decreased feeling, may well be related to nerve problems. 

Suppose pins and needles are present in a particular area of the hand, such as the thumb, index and middle finger. In that case, it may suggest compression of the median nerve and results in a condition known as Carpal Tunnel Syndrome has been brought on as a result of this compression. 

If the pins and needles and burning type hand pain are in the little finger, it may suggest compression of the ulnar nerve, either at the elbow (Cubital Tunnel Syndrome) or at the wrist (Guyon’s canal compression).

Aching type of hand pain, mainly made worse on use, may suggest osteoarthritis (OA). This background dull ache type of pain is usually made worse on the movement of the affected joint. OA, in the hand, is ubiquitous. It typically occurs at the base of the thumb, particularly in women, but in men. 

OA can also affect the fingertip joints. In this pathological process, the normal articular cartilage, which is the slippery lining of the joint, is worn away. This results in bone rubbing on bone, in turn causing pain. Along with pain, patients with OA in the hand may also notice stiffness and a decreased range of movement. 

As well as the dull ache, patients may also experience sharp exacerbations when performing particular activities, which may represent particular areas of the joint rubbing against each other. Non-traumatic hand pain usually occurs over a gradual onset, over weeks or months. Traumatic pain can usually brought on instantly or within a few hours, i.e. as a result of a direct blow.

What is hand stiffness?

Hand stiffness can involve reducing the overall range of movement in your hands or more difficulty within that range of motion. Stiffness might be constant or it might be worse at certain times of the day. Depending on the cause of the stiffness, symptoms may worsen over time, stay the same, or improve.

What causes hand stiffness?

Some of the leading causes of hand stiffness include injuriesarthritis, and nerve conditions such as carpal tunnel. Rarer causes include Dupuytren’s contracture and scleroderma.

Sprains, bruises, fractures, and wounds are all injuries that can result in pain or stiffness in the hands. Tendonitis (inflammation of the tendons) is a common reaction to injury, and usually, the stiffness should improve as the hand heals. In other cases, such as a rupture to a tendon, or a significant burn injury, there could be permanent damage to mobility.

One class of injury, known as repetitive strain injury, can cause pain and stiffness in the hands due to overuse. In this situation, it’s important to identify the activity that is causing the pain and try to reduce that activity. A GP might offer a number of treatments, such as anti-inflammatory medication, a heat pack, or physiotherapy.
Finally, the soft tissue in your hands can be damaged by infection. Many infections can be treated with antibiotics, so see a doctor if you’ve noticed a discolouration or swelling in your hands that isn’t going away.

Rheumatoid arthritis and osteoarthritis are common causes of hand stiffness in older people. As well as stiffness, you might experience join pain and swelling, and in the case of rheumatoid arthritis symptoms are often worse in the morning.
There are a number of treatments for arthritis. The exact treatment that is right for you will depend on what type of arthritis you have.

Carpal tunnel
Carpal tunnel is a nerve condition which affects the hands and arms. The main symptoms are a tingling sensation and numbness but sometimes weakness and stiffness can occur. Symptoms often go away on their own or with treatment (e.g. wearing a wrist splint), but it is important to see a doctor if they persist.
Rarer causes

Dupuytren’s Contracture is a progressive condition that usually occurs after the age of 50. It gradually pulls the fingers into a bent position, and mainly affects the ring finger and little finger. Treatment can slow the progression of the condition.

Scleroderma is a skin condition that results in the thickening of the skin in various parts of the body. It can result in joint inflammation and swelling, especially in the mornings. Scleroderma is a rare condition with only 3-4 new cases a year.

What are hand pathologies?

The most common hand problems include:
Carpal tunnel syndrome: compression of the nerve that passes through the wrist, causing frequent numbness of the fingers, tingling and pain
Injuries: including fractures, torn ligaments, and dislocations
Osteoarthritis: a degenerative disease that affects joints and cartilage. The cartilage that cushions the joints breaks down, causing bones to rub against each other, pain sets in and this can lead to hand deformity and weakness
Tendonitis: severe irritation of the tendons that connect muscles in the body to the bones. Symptoms include swelling, inflammation and pain when using the hands
Injuries and diseases of the fingers: fractures, breaks and specific deformities of the fingers

Symptoms of hand pathologies

Where there is a condition of the hand, the most common symptoms are:
⦁ Pain in different areas of the hand, from the wrist to the fingers
⦁ Tingling or numbness in the hand and fingers
⦁ Swelling that is painful to touch
⦁ Weakness of the hand
⦁ Stiffness of the hand and fingers
⦁ Change in colour or temperature of the hand or fingers

What are the causes of hand pathologies?

The hands suffer, to a large extent, from wear and tear, which happens earlier in men than in women. Other causes of hand pathologies include:
⦁ Lack of calcium; calcium is essential for strong and healthy bones. A lack of calcium, which can be obtained from dairy sources, broccoli, some leafy green vegetables and beans can lead to weaker bones, increasing the risk of bone-related diseases like osteoporosis
⦁ Hormonal changes; for example, as menopause approaches. A drop in oestrogen levels during menopause can affect the hydration of the joints and tendons, causing cracking fingers, stiffness and inflammation
⦁ Injuries
⦁ Bone-related diseases such as osteoporosis and osteoarthritis
⦁ Pregnancy
Auto-immune diseases 

Can they be prevented?

Hand pathologies can be prevented by regular exercises that relax the joints at times of constant work. These exercises are based on the movement of the wrist and the stretching of the fingers, all of them with the purpose of relaxing the hand, getting rid of the stiffness and making the hands more flexible. By following a diet rich in calcium, vitamin D and omega 3, you can also help to keep the bones and joints healthy.

What does the treatment involve?

The treatment for the hand will depend on the ailment, but all treatments are aimed at restoring functionality. Some injuries can be treated with rest and cessation of activity, but some fractures and diseases that cause limb deformities will require surgery.

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