Carpal tunnel syndrome refers to a condition that manifests as tingling, numbness, pain and weakness in the hand and arm. The condition occurs when the median nerve to the hand is squeezed or compressed at the wrist. Symptoms typically involve decreased or altered sensation in the tips of the thumb, pointer, middle and ring fingers. In most patients, carpal tunnel syndrome gets worse over time. If left untreated, it can lead to further hand weakness, pain, and permanent nerve damage, causing people to drop things out of their hand, and making it difficult to manipulate small objects such as clasps and buttons.
Arthritis is the inflammation of one or more joints, causing pain and stiffness that can worsen with age. There are two types of arthritis, osteoarthritis and rheumatoid arthritis.
Osteoarthritis is a degenerative disease. It affects specific joints that may have been injured or have been subjected to much wear and tear. It is progressive in nature and gradually wears down the joint’s cartilage, which is the body’s natural shock absorber.
Rheumatoid arthritis is an auto-immune disease causing chronic inflammation affecting many joints. Signs and symptoms include tender, warm and swollen joints, joint stiffness that is usually worse in the morning and after inactivity, and fatigue. Early stages tend to affect the smaller joints of the fingers and toes. As the disease progresses, more and more joints are involved. Symptoms may come and go. Periods of increased disease activity, called flare ups can alternate with period of relative calm when the swelling and pain are minimal or non- existent. Over time, rheumatoid arthritis can cause joints to deform and shift of out of place.
Trigger finger, or stenosing tenosynovitis, is a painful condition that causes the fingers or thumb to catch, click or lock when bent. The finger may straighten with a snap, like a trigger being pulled and released. Trigger finger happens when tendons in the finger or thumb become inflamed. This can occur with repetitive use of the finger such as with jobs or hobbies that require repetitive gripping activities or may be related to other medical conditions such as arthritis and carpal tunnel syndrome.
DeQuervains’s tenosynovitis is an inflammation of the tendons on the thumb side of the wrist. The tendons run through a tunnel, known as a sheath. The sheath can narrow or the tendons can take up extra space in the tunnel. This can be due to a thickening of the soft tissues that make up the tunnel or an increase in the amount of soft tissue within the tunnel. With this condition, hand and thumb motion can cause pain, especially with forceful gripping and twisting motions, and when opening the thumb.
All of the above symptoms can be treated with hand therapy. The hand therapist will recommend exercises, teach joint protection techniques and precautions, recommend appropriate splinting when necessary, and help you to decrease pain and regain function.