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Conditions you may be experiencing:
Dupuytren’s Contracture (Thickened, Tight Palm and Finger Tissue)
Dupuytren’s contracture is a hand deformity affecting tissue beneath the palm. Typically developing over the course of many years, the condition arises when the layer of tissue below the skin’s surface thickens and becomes tight in the palm. As it worsens, Dupuytren’s contracture forms fibrous bands, which can pull one or more fingers toward the palm. Although it is painless and slow to develop, the condition can interfere with daily activities.
The cause of Dupuytren’s contracture is not known. Unlike some hand and arm conditions, it does not appear as though occupational risks increase the odds of developing contracture. Nor has sports injury or prolonged overuse been tied to the condition. However, data suggests some contributing factors:
- Northern European Descent – Ancestry predisposes some families to Dupuytren’s contracture.
- Age – The condition occurs more frequently among those over age 50.
- Sex – Men are more likely than women to develop Dupuytren’s contracture.
- Lifestyle – Smoking and drinking alcohol have been tied to higher incidence of this hand condition.
- Illness – Diabetes and other illness may raise the risk of developing conditions like Dupuytren’s contracture.
Both hands may be affected, but contracture is often more pronounced on one side.
Dupuytren’s contracture progresses in stages, sometimes starting with thickened skin in the palm. As it advances, dimples or distinct lumps may appear, with tenderness. Eventually, tough bands of tissue can develop beneath the skins’ surface, extending toward the fingers. The little finger and ring finger are most commonly affected by Dupuytren’s contracture, which prevents them from fully straightening. In severe cases, the presence of Dupuytren’s contracture makes it difficult for sufferers to grasp large objects and flatten the palm.
Dupuytren’s contracture causes these symptoms:
- Gradually occurring symptoms
- Small lumps in palm with tenderness that usually fades
- Tough bands of tissue under skin
- Curled fingers, most commonly ring finger and little finger
- Unable to fully straighten finger or grasp large objects
- May be tender
Trigger finger, or stenosing tenosynovitis is a hand disorder limiting movement in one or more fingers. As a finger is extended, the condition interferes with fluid movement, causing the joints to “hang-up” or lock during the motion. When trigger finger is present, tendons in the fingers and thumb are responsible for fingers “catching” or getting stuck in a bent position. In most cases, the finger continues to move beyond the momentary restriction, but some fingers affected by the condition remain locked in a bent position.
The cause of trigger finger isn’t always known, but several risk factors have been identified for developing the condition:
- Sex – Women are more likely than men to develop trigger finger, and may experience more severe symptoms than men suffering from the irregularity.
- Repetitive Gripping Motions – Whether resulting from hobbies, athletics or occupational responsibilities, frequent, repetitive gripping actions may contribute to the inflammation responsible for trigger finger.
- Existing Conditions – Those with arthritis and other medical complaints are at greater risk for developing trigger finger.
- Age – Trigger finger is thought to strike most often during middle age.
Specialized tendons attach muscles to bones in the fingers. These long, flexor tendons extend from the forearm muscles, passing through the wrist, before connecting to fingers and thumbs. As they contract, the flexor tendons pull on the bones, facilitating movement. When trigger finger strikes, inflammation interferes with the tissue sleeve (tendon sheath) surrounding tendons of the affected finger, causing it to catch or lock.
As the irritation continues, the tendon thickens and the sheath tunnel narrows, further impinging the tendon’s passage. In severe cases, the affected finger becomes fixed in a bent position.
Trigger finger may present the following symptoms:
- Usually there is no known cause, but repetitive use of the hand can cause it
- Pain in the palm at the base of the finger or thumb
- Sensation of finger stiffness that sometimes progresses to a visible “catch” or “trigger”
- In severe cases the finger can become locked and is very painful to straighten
De Quervain’s Tendinitis (Swollen Tendons at Base of Thumb)
De Quervain’s tendinitis is a condition that affects the tendons of the wrist. Tendons are the tough cords of connective tissue which attach muscles to bone. The extensor tendons of the thumb and wrist, known as the Abductor Pollicus Longus and the Extensor Pollicus Brevis, are held in place by a sheath at the wrist. De Quervain’s tendinitis occurs when the extensor tendons become inflamed from stress or overuse, making it difficult for them to slide smoothly through the extensor sheath. This results in pain and tenderness at the thumb side of the wrist and at the base of the forearm. Pain also manifests when the patient moves their thumb or wrist, makes a fist, or grasps and holds objects with the affected hand.
De Quervain’s tendinitis is caused by an irritation of the tendons at the base of the thumb, primarily due to a chronic overuse of the hand. De Quervain’s tendinitis can affect anyone at any age, though it is more common among adults over the age of 40 as well as women and African-Americans. New mothers are especially prone to this type of tendinitis, due to hormonal fluctuations associated with pregnancy and nursing and the often awkward hand positioning that comes with lifting and cradling an infant. Athletes engaging in sports that stress the hand and wrist (such as tennis, golf, and rowing) are also at a greater risk for developing de Quervain’s tendinitis. In younger patients, the excessive use of the thumb caused by texting and gaming has also been linked to instances of De Quervain’s tendinitis.
De Quervain’s tendinitis is most commonly accompanied by one or more of the following symptoms:
• Pain and swelling may be present at thumb side of the wrist, and may make it difficult to move the thumb and wrist
• Pain may appear either gradually or suddenly
• Pain is felt in wrist and can travel up the forearm
• Pain is usually worse when thumb and wrist are in use, especially with forceful grasping or twisting of the wrist
• Fluid-filled cyst over thumb side of wrist may accompany swelling
• A “catching” or “snapping” may be felt when moving the thumb
• Numbness may be experienced on back of thumb and index finger
Arthritis of the Hand (Joint Pain and Inflammation)
Human hands are comprised of many small bones and joints, facilitating flexible movement and fine motor manipulation. The joints rely on cartilage and natural lubricants to move freely, cushioning the space between bones and providing smooth surfaces for them to glide on. Hand arthritis develops as cartilage wears away or breaks down, causing inflammation, pain and joint stiffness. Although aging is a primary risk factor for developing hand arthritis, it may also set-in as the result of a sports injury or fracture.
Cause of Arthritis of the Hand
Several types of arthritis may strike hand joints, including osteoarthritis and rheumatoid arthritis. Osteoarthritis is a degenerative form of the disease, commonly manifesting hand symptoms. This type of arthritis gradually worsens, typically first appearing in middle age or beyond. Because joints are prone to wear, most people experience some degree of osteoarthritis, due to aging. As it progresses, pain, swelling and limited range of motion may occur. Osteoarthritis in the hand sometimes makes it hard for affected individuals to manipulate small objects.
A family history of arthritis increases risk for developing the condition and wear caused by job-related overuse or athletic injury can accelerate its onset.
Rheumatoid arthritis occurs across the entire body, but the small joints of the fingers may be among the first to show signs of disease. Aside from genetic disposition, the cause of the inflammatory autoimmune disease is not always known.
Description of Arthritis of the Hand
Arthritis results from degradation or injury to joints and surrounding soft tissue. As joints wear over time or experience acute trauma, cartilage and joint tissue become less effective cushioning bone contact. Hand and wrist joints are frequently affected by arthritis inflammation, causing pain and stiffness. A history of broken fingers or wrist fracture can contribute to the onset of arthritis in the hand.
Symptoms of Arthritis of the Hand
Arthritis in the hand may present some or all of these symptoms:
- Joint pain that may feel “dull,” or a “burning” sensation
- Morning pain and stiffness
- Pain is aggravated by activity or increased joint use, relieved by rest
- Joint pain increases over time
- Pain may intensify with weather changes
- Swelling of the affected joint
- Joints surrounding affected joint may become more mobile than normal
- Joint may feel warm
- May experience a sensation of grating or grinding in affected joint
- Support structures of joint may be unstable or “loose”
- Joint may appear larger than normal
- Small cysts may develop in certain cases
- Cysts may cause ridging or dents in nail plate of affected finger
Carpal Tunnel Syndrome (Constricted Nerve at the Wrist)
Carpal tunnel syndrome is a painful, progressive condition resulting from nerve compression, near the wrist. The median nerve, a key hand nerve responsible for sensation on the palm side of the fingers and thumb, can become constricted or pressed as it passes through the carpal tunnel, at the wrist joint. In addition to the nerve, the rigid tunnel structure houses tendons, which can thicken and narrow the passageway. Carpal tunnel syndrome symptoms appear when the median nerve is impinged and squeezed in the constricted tunnel. Numbness, weakness and pain commonly accompany the syndrome.
Cause of Carpal Tunnel Syndrome
In most cases of carpal tunnel syndrome, the median nerve is healthy, before the condition sets-in. A combination of factors can increase pressure on the nerve, leading to carpal tunnel syndrome. The following may contribute to the syndrome:
- Genetics– Some people suffering from carpal tunnel syndrome may have congenital predisposition for developing the condition. In these cases, the tunnel is naturally narrow, compressing the median nerve as it passes through the wrist.
- Trauma – Athletic injuries may cause or contribute to carpal tunnel syndrome. Sprains and fractures accompanied by swelling, in particular, increase risk for developing carpal tunnel constriction.
- Presence of Arthritis – Arthritis in the hand or wrist may lead to carpal tunnel syndrome.
- Repetitious Activities – Although more research is needed to establish causes, certain job-related activities, such as repetitive keyboarding and operating hand tools, may be linked to the onset of carpal tunnel syndrome.
- Sex – Women are more likely to experience carpal tunnel syndrome than their male counterparts. The increased prevalence may be tied to the smaller anatomy of women’s hands, causing more frequent constriction at the wrist.
Description of Carpal Tunnel Syndrome
Under normal circumstances, the median nerve passes through the carpal tunnel, without incident. The tunnel, located near the base of the wrist, sometimes narrows, as a result of inflammation or injury. Carpal tunnel syndrome symptoms appear when the median nerve becomes constricted as it passes through the opening.
Symptoms of Carpal Tunnel Syndrome
The following symptoms may indicate the presence of carpal tunnel syndrome:
- Numbness, tingling, or shock sensations at the thumb, index, middle, and half of the ring finger
- An electric shock-like feeling mostly in thumb, index, and long fingers
- Strange sensations and pain traveling up arm toward shoulder
- Symptoms usually begin gradually and may become increasingly more constant
- Symptoms at night are common, may disrupt sleep
- Feeling of clumsiness or weakness
- Muscles at base of thumb may become visibly smaller in severe cases
Each human hand relies on more than two dozen bones to execute precise movements. Among them, finger bones make it possible to grasp small objects, throw a ball, grip a racket, and carry-off countless everyday activities. Like other hand bones, the small bones of the fingers are susceptible to dislocation and fracture, particularly among active adults. Because fingers are integral to manual dexterity, a fracture not only causes pain, but a broken digit may also affect the way the entire hand performs.
Cause of Finger Fracture
Broken fingers are typically caused by acute trauma to the affected hand. Sports injuries, for instance may lead to finger fractures. Awkwardly catching a football can result in a “jammed” or broken finger. And extending a hand to break a fall on the playing field may also result in a sports-related finger fracture.
Description of Finger Fracture
Finger fractures are not limited to particular bones, but some fingers are broken more frequently than others. Bones involved with the little finger, for example, account for a substantial share of broken hand bones. Although finger bones are relatively small, failure to treat a broken finger can have lasting consequences, leading to decreased hand functioning and disability.
Several types of fractures break finger bones. Crushing injuries are common, affecting fingertips, and a break called a mallet fracture impacts function in the DIP joints, between the second and third finger bones (phalanges). Substantial impact trauma may cause a break in the middle of a finger bone, between joints.
Because of the interdependent relationship between hand bones and soft tissue, and the potential for complications, complex breaks call for specialized evaluation and treatment. Intervention ranges from conservative measures, like taping fingers for support, to hand and finger surgery.
Symptoms of Finger Fracture
Depending upon the location and severity of the break, a finger fracture may present these and other symptoms:
- Swelling of fracture site
- Tenderness and bruising at fracture site
- May have a hard time moving or stiffer movement
- Deformity of injured finger
- Finger may be stiff and painful
Hands are comprised of many small bones, including 14 finger bones (phalanges) on each hand. A fracture occurs when sufficient force is applied to hand joints and bones, causing a break. Fractures may involve the short bones of the fingers or the longer hand bones (metacarpal bones), connecting the fingers with the wrist. Carpal bones are also subject to fracture, at the wrist joint. Sports-related trauma, falls, and direct blows to the hand are common causes of hand, wrist and finger fractures.
Cause of Hand Fracture
Various activities lead to hand fractures, typically resulting from trauma to the affected structure. Because manual dexterity plays such a prominent role in athletics, hand injuries are associated with a number of sports. Boxing, for example, may contribute to metacarpal breaks, where the bones form the knuckles. And participating in racket sports may cause twisting breaks. Direct blows, from bats and balls, can also carry enough force to break hand bones.
Description of Hand Fracture
27 individual bones make-up the hand’s rigid structure. The network of phalanges, metacarpal bones and carpal bones of the wrist provide a framework for tendons and muscles to connect and control hand movement. The hand’s complex, interconnected structure makes it particularly vulnerable to traumatic injury. Hand fractures are classified according to characteristics of each break:
- Simple Fracture – A fracture is deemed simple when the broken bones remain stable and aligned.
- Displaced – When a bone breaks fully, into two pieces, the fracture is displaced
- Compound – Compound or open fractures occur when an affected bone breaks through the surface of the skin.
Symptoms of Hand Fracture
Depending upon its location and the bones involved, a fractured hand bone may cause these symptoms:
- Inability to move finger
- Shortened finger
- Finger crosses over its neighbor when making a partial fist
- Depressed knuckle
Although any of the bones in the hand can succumb to fracture, thumb breaks may be among the most challenging to overcome. The thumb is constructed much like a finger, but it’s positioning gives it a vital role in hand movement and function. Grasping and pinching motions rely on the thumb and its fulcrum to provide opposing force, enabling humans to manipulate objects in ways other animals can’t. Accidental injury usually causes thumb fracture, but certain factors may increase risk for suffering a broken thumb.
Cause of a Thumb Fracture
Thumb fracture typically results from direct trauma. Car accidents, falls, and sports injuries are all common causes of broken bones, including those of the thumb. Active individuals may experience a thumb fracture resulting from:
- Twisting motion – Rotation creates force, so the bones of the thumb are susceptible to breaks caused by twisting.
- Contact sports – Dexterity and hand-eye coordination are integral to athletics, so sports-related thumb injuries can occur. Wresting, hockey, and football include forceful contact, increasing the risk for thumb fracture. As well as boxing, which subjects thumbs to repetitive trauma.
- Fall– Awkward falls sometimes result in direct impact to the bones of the thumb, causing fractures, sprains or dislocation
- Bat/ball injuries – Direct strikes from baseballs or bats apply force sufficient enough to cause broken bones in the thumb.
Description of a Thumb Fracture
The thumb is comprised of the distal phalange, extending from the knuckle to the tip, and the proximal phalange, joining the knuckle and the base of the thumb. This structure is connected to the hand by the first metacarpal. Any of these bones can fracture, with some of the most serious injuries occurring near joints. A break to the first metacarpal is a serious condition, impacting how the entire hand functions, and calling for specialized treatment.
Symptoms of a Thumb Fracture
Thumb fracture may lead to one or more of these symptoms:
- Severe pain at fracture site
- Limited or no ability to move thumb
- A misshapen or deformed look to thumb
- Numbness or coldness in thumb