Our hands are complex instruments, composed of 27 bones, numerous joints, over 30 muscles, more than 100 ligaments, and a dense arrangement of nerves and blood vessels. This intricate design allows for impressive motion and dexterity, but also makes them susceptible to various conditions and injuries. Understanding common hand ailments is beneficial for maintaining hand health.
Common Inflammatory and Degenerative Conditions
Inflammatory and degenerative conditions frequently affect the hands, often leading to pain and impaired function.
Osteoarthritis, a common form of “wear-and-tear” arthritis, occurs when protective cartilage at bone ends wears down. In the hands, it commonly affects the base of the thumb, the middle joints of the fingers (PIP joints), and the joints closest to the fingertips (DIP joints), causing pain, stiffness, and bony enlargements.
Rheumatoid arthritis, an autoimmune disease, involves the immune system mistakenly attacking joint linings, leading to inflammation. This condition can affect any joint, but frequently targets the small joints of the hands and wrists symmetrically. Symptoms include pain, swelling, stiffness, and warmth, often worse in the mornings. Over time, rheumatoid arthritis can cause joint deformity and erosion.
Tendinitis, or tenosynovitis, involves inflammation of a tendon or its sheath. De Quervain’s tenosynovitis is a specific type that affects tendons on the thumb side of the wrist, causing pain and tenderness when grasping or making a fist. This results from irritation and swelling of tendon sheaths, restricting smooth tendon gliding.
Nerve Compression Syndromes
Nerve compression syndromes occur when a nerve is squeezed or entrapped, leading to symptoms like numbness, tingling, and weakness.
Carpal Tunnel Syndrome is a widely recognized condition caused by compression of the median nerve as it passes through the carpal tunnel in the wrist. This compression can result from swelling, repetitive motions, or underlying medical conditions. Symptoms include numbness, tingling, and pain in the thumb, index, middle, and half of the ring finger, often worsening at night. The median nerve provides sensation to these areas and controls muscles at the base of the thumb. Weakness in hand grip or difficulty with fine motor tasks can also develop.
Cubital Tunnel Syndrome involves compression of the ulnar nerve as it travels through the cubital tunnel on the inside of the elbow. This nerve provides sensation to the little finger and half of the ring finger, and controls most small muscles within the hand. Symptoms include numbness and tingling in these fingers, and can progress to hand weakness or muscle wasting.
Structural and Connective Tissue Disorders
Structural and connective tissue disorders involve physical changes to the hand’s architecture, distinct from inflammation or nerve issues.
Dupuytren’s contracture is a condition where the fascia, a tissue layer just beneath the palm’s skin, thickens and tightens. This thickening can form cords that pull fingers into a bent position, making them difficult to fully straighten. The ring and little fingers are most commonly affected.
Ganglion cysts are non-cancerous, fluid-filled lumps that commonly develop along the tendons or joints of the wrist or hand. Their size can fluctuate; while often painless, they can cause discomfort or interfere with joint movement if they press on a nerve or are located in a high-motion area. These cysts arise when fluid leaks from a joint or tendon sheath, forming a sac.
Trigger finger or thumb occurs when a tendon sheath in the finger or thumb becomes inflamed and thickened, preventing smooth tendon gliding. This can cause the affected digit to catch or “lock” in a bent position, often accompanied by a painful snap when straightened. Nodules can form on the tendon, further impeding its movement through the pulley system.
Vascular and Skin-Related Issues
Conditions affecting blood vessels or skin can manifest in the hands, presenting unique symptoms.
Raynaud’s phenomenon is a condition characterized by episodic spasms of small blood vessels, commonly in the fingers and toes, in response to cold temperatures or stress. During an attack, affected digits may turn white, then blue, then red, often accompanied by numbness, tingling, or pain.
Skin conditions like eczema can cause the skin on the hands to become dry, red, itchy, and inflamed, sometimes leading to cracking or blistering. Infections, such as cellulitis, a bacterial infection, can cause redness, swelling, warmth, and pain in the hand. Fungal infections, like ringworm, can also affect the skin of the hands, leading to dry, scaly patches or blisters.
When to Seek Medical Attention
Prompt medical attention for hand symptoms can help prevent complications and improve outcomes.
Consult a healthcare professional if you experience persistent pain, numbness, or tingling in your hands that does not improve. Swelling, redness, or warmth that suggests inflammation or infection also warrants evaluation. Any noticeable change in the shape of your hand or fingers, such as a new lump or a finger that can no longer straighten, should be assessed. If you experience a sudden loss of strength, difficulty with grip, or an inability to perform daily tasks, seeking medical advice is advisable. Early diagnosis and intervention can be beneficial for managing many hand conditions.