Aug. 14, 2007 When a wrist hurts, it could be carpal tunnel syndrome -- or something else. Over time, many conditions can affect crucial parts of the hands, causing everything from pain to the loss of normal function. Here are a few possibilities.
This occurs when the joint at the wrist and base of the thumb develops osteoarthritis. It’s more common after age 40. A combination of factors, including aging, joint injury or stress, and heredity may lead to thumb arthritis.
Carpal tunnel syndrome
This can start with a vague aching in the wrist that can extend to the hand or up to the arm. Other symptoms can include tingling or numbness in the fingers, especially at night. Over time, the hand can become weak or numb. Too much time at the keyboard often is blamed for this condition. But any activity that requires the repeated flexing and extending of the tendons in the hand or wrist or repeated and prolonged gripping can cause the problem.
These appear as raised fluid-filled lumps near the wrist or finger joints. They are noncancerous and typically develop along the tendons or joints of the wrist and hands. Often, they are painless, but not always. Ganglion cysts also can cause pain, weakness or numbness in the hand if they put pressure on nerves near a joint. The cause of ganglion cysts isn’t clear. The risk may be great in people with osteoarthritis or with injured joints or tendons in the hands.
This condition -- stenosing tenosynovitis -- is typically a painful condition in which one finger or thumb catches in the bent position. In severe cases, the finger may become locked in bent or straight position. The cause is a thickening of the liner, or sheath, which surrounds the tendon in the affected finger. Trigger finger tends to be more common in people whose work or hobby requires repetitive gripping motions, or those who have rheumatoid arthritis, diabetes or hypothyroidism.
Tendonitis of the wrist
The most common symptoms of wrist tendonitis, called de Quervain’s tenosynovitis, are pain and swelling about a half-inch back from the base of the thumb. Pinching, grasping or other thumb and wrist movement may aggravate the pain. Without treatment, the pain may spread in the thumb, forearm or both. Wrist tendonitis is caused by irritation and swelling of the sheath that surrounds the major tendons connecting the wrist and lower thumb. It can result from overuse of the wrist and thumb together. Often called the “new mother’s” disease, it is common in new parents who pick up infants with their thumbs out and wrists bent backwards.
Treatment for these conditions should start with talking to a doctor about pain, swelling or discomfort in the hands and wrists. Depending on the diagnosis, treatment options include self-care (applying heat and cold), physical therapy, medications to reduce pain and swelling, and surgery.
The August issue of Mayo Clinic Women’s HealthSource offers a more detailed description of common hand conditions and treatments.
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