Hand problems: causes, symptoms and treatments
We often take our hands for granted, but we rely on them for most of the activities that set humans apart as a species. Stiffness, pain and swelling can all have a huge impact on day-to-day life, but help is at hand.
4 common conditions which affect hands
1. Dupuytren's contracture is rarely painful, but it's certainly debilitating. Caused by a gradual contraction of the tough connective tissue in the palm of the hand, it leads to curling inwards of the little and ring fingers. The joints of your hands aren't affected, but it stops you being able to use them properly. In mild cases you can still lay your hand flat on the table, but if you can't straighten your hand out at all you may be eligible for treatment. This usually involves minor surgery and can be done under local anaesthetic - speak to your GP.
2. Carpal tunnel syndrome is a painful hand condition which arises because your median nerve - which controls the muscles of the palm side of your middle, ring and little fingers and controls sensation in them too - gets squashed. The median nerve passes through an opening in your wrist on its way to your hand. If you hold your palm upwards, the base of the tunnel is formed by your wrist bones (called your carpal bones) and the top is covered by tough connective tissue called a ligament.
As well as the median nerve, blood vessels and strong tendons connecting your fingers to the muscles in your forearm also have to fit in. Fluid retention (such as in pregnancy or if you gain weight) or arthritis of the wrist can reduce the space inside the carpal tunnel. So can overuse of your wrist or conditions like underactive thyroid and type 1 or type 2 diabetes although often no cause is found.
Carpal tunnel syndrome is more common in women than in men, and most often starts in your 40s or 50s. It can run in families. The parts of the hand supplied by the median nerve can become numb or develop pins and needles. You may get pain in this area which is often worse at night and relieved by dropping your arm over the side of the bed. In severe cases, the muscles on the ball of your thumb can waste away and you may get muscle weakness. One in four of all cases goes away on its own within a year, especially if you're pregnant. Using a wrist splint (sometimes just at night) or a steroid injection can help. If symptoms persist or are severe, a minor operation (usually done under local anaesthetic) should solve the problem.
3. Osteoarthritis is the most common joint problem in the UK , and hands (along with knees, elbows and spine) are most commonly affected. The main symptom is pain, made worse with exercise, and stiffness in the mornings. You can also get knobbly swellings on your finger joints, called Heberden's or Bouchard's nodes. These look unsightly but stop getting bigger after a time and don't cause ever-worsening symptoms. A ganglion is a smooth, painless, harmless lump on your wrist or hand which can be removed with minor surgery.
Although exercise makes pain worse, it's essential to keep active to reduce the long-term impact of osteoarthritis. Exercise is key to keeping muscles strong and preventing your joints seizing up. Painkilling tablets or gels can help, and your doctor can refer you to an occupational therapist to help with devices to make life easier around the home. Knitting and sewing may be more challenging if you have hand problems, but they help keep hands flexible4.Rheumatoid arthritis affects about 400,000 people in the UK
It's an autoimmune disease - caused by your body attacking itself - and causes inflammation, swelling and redness of joints, often in the hands. Treatment is very different from osteoarthritis - if you're diagnosed, you should be referred to a specialist to start regular medicine to damp down your immune system. But occupational therapy and physiotherapy can help you, too.
With thanks to 'My Weekly' magazine where this article was originally published.