Anatomy of the hand
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The hand is composed of many different bones, muscles, and ligaments that allow for a large amount of movement and dexterity. There are 3 major types of bones in the hand itself, including:
- Phalanges. The 14 bones that are found in the fingers of each hand and also in the toes of each foot. Each finger has 3 phalanges (the distal, middle, and proximal); the thumb only has 2.
- Metacarpal bones. The 5 bones that compose the middle part of the hand.
- Carpal bones. The 8 bones that create the wrist. The carpal bones are connected to 2 bones of the arm, the ulnar bone and the radius bone.
Numerous muscles, ligaments, and sheaths can be found within the hand. The muscles are the structures that can contract, allowing movement of the bones in the hand. The ligaments are fibrous tissues that help bind together the joints in the hand. Hektor 1 0 – a psychological horror game. The sheaths are tubular structures that surround part of the fingers.
The hand may also become weaker, making everyday activities difficult. Treatment depends on the severity of the pain and disability. Treatment includes: Anti-inflammatory or analgesic painkillers.
What are some common hand problems?
There are many common hand problems that can interfere with activities of daily living (ADLs), including the following:
Arthritis
Arthritis is joint inflammation and can occur in multiple areas of the hand and wrist. Arthritis of the hand can be very painful.
Rheumatoid arthritis, a condition that can attack joints throughout the body, commonly affects the joints and surrounding tendons of the wrist and fingers. It can cause the joints to become swollen, painful and possibly deformed. This can interfere with normal hand function. It can significantly impact a person's quality of life.
Osteoarthritis
Osteoarthritis is one of the most common forms of arthritis in the hands and may be caused by normal use of the hand or it may develop after an injury. Osteoarthritis usually develops in one of 3 places: the base of the thumb, at the end joint closest to the finger tip, or at the middle joint of a finger.
Signs and symptoms of osteoarthritis include:
- Stiffness
- Swelling and pain
- Bony nodules at the middle or end joints of the finger
- Pain and possibly swelling at the base of the thumb
- Loss of strength in the fingers and the grip of the hand
Treatment for osteoarthritis includes:
- Nonsteroidal anti-inflammatory drugs
- Resting the affected hand
- Wearing splints at night
- Using heat to soothe the pain
- Using ice to reduce swelling
- Possible cortisone injections
- Possible surgery when no other treatments work
Osteoarthritis, also called degenerative arthritis, is a degenerative condition that commonly affects the small joints of the fingers and the base of the thumb. Common in both men and women, it can cause the joints to become swollen, stiff and painful. It often leads to joint enlargement, interfering with normal hand function and significantly impacting a person's quality of life. There are two main types of hand arthritis: primary generalized osteoarthritis and erosive osteoarthritis, and they affect the hands differently.
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Carpal tunnel syndrome
Carpal tunnel syndrome Carpal tunnel syndrome is a condition in which the median nerve is compressed as it passes through the carpal tunnel in the wrist, a narrow confined space. Since the median nerve provides sensory and motor functions to the thumb and 3 middle fingers, many symptoms may result. The following are the most common symptoms for carpal tunnel syndrome. However, each individual may experience symptoms differently. Symptoms may include:
- Trouble gripping objects with the hand(s)
- Pain or numbness in the hand(s)
- 'Pins and needles' feeling in the fingers
- Swollen feeling in the fingers
- Burning or tingling in the fingers, especially the thumb and the index and middle fingers
The symptoms of carpal tunnel syndrome may look like other conditions such as tendonitis, bursitis, or rheumatoid arthritis. Always see your healthcare provider for a diagnosis.
Treatment may include:
- Splinting of the hand (to help prevent wrist movement and decrease the compression of the nerves inside the tunnel)
- Oral or injected (into the carpal tunnel space) anti-inflammatory medications (to reduce the swelling)
- Surgery (to relieve compression on the nerves in the carpal tunnel)
- Changing position of a computer keyboard, or other ergonomic changes
This condition is a painful compression of a nerve in the wrist that can interfere with a person's ability to use the wrist and the hand. Carpal tunnel syndrome is a progressive condition that can worsen without proper care.
Ganglion cysts
Soft, fluid-filled cysts can develop on the front or back of the hand for no apparent reason. These are called ganglion cysts — the most common, benign (noncancerous), soft-tissue tumor of the hand and wrist.
The following are the most common symptoms for ganglion cysts. However, each individual may experience symptoms differently. Symptoms may include:
- Wrist pain that is aggravated with repeated use or irritation
- Aslow growing, localized swelling, with mild aching and weakness in the wrist
- An apparent cyst that is smooth, firm, rounded, or tender
The symptoms of ganglion cysts may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
Initially, when the cyst is small and painless, treatment is usually not needed. Only when the cyst begins to grow and interferes with the functionality of the hand is treatment usually necessary. Treatment may include:
- Rest
- Splinting
- Nonsteroidal anti-inflammatory medications Disk diet 5 4 4.
- Aspiration
- Cortisone injections
- Surgery
A ganglion cyst is a fluid-filled sac that forms as a herniation from a joint capsule or tendon sheath. The sac is attached to the joint or tendon sheath by a 'stalk' that allows fluid to move into the pouch from the joint or sheath. The stalk functions as a valve and often limits fluid drainage out of the cyst, allowing the cyst to increase - but not decrease - in size. In some cases the stalk functions as a two-way valve, allowing fluid to travel in both directions. This can enable the cyst to increase and decrease in size based on activities.
Tendon problems
Two major problems associated with tendons include tendonitis and tenosynovitis. Tendonitis, inflammation of a tendon (the tough cords of tissue that connect muscles to bones) can affect any tendon, but is most commonly seen in the wrist and fingers. When the tendons become irritated, swelling, pain, and discomfort will occur.
Wrist Pain and Tendonitis | FAQ with Dr. Sophia Strike
Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. The tendon sheath is usually the site which becomes inflamed, but both the sheath and the tendon can become inflamed simultaneously. The cause of tenosynovitis is often unknown, but usually strain, overuse, injury, or excessive exercise may be implicated. Tendonitis may also be related to disease (such as, diabetes or rheumatoid arthritis).
Common tendon disorders include the following:
- Lateral epicondylitis (commonly known as tennis elbow). A condition characterized by pain in the back side of the elbow and forearm, along the thumb side when the arm is alongside the body with the thumb turned away. The pain is caused by damage to the tendons that bend the wrist backward away from the palm.
- Medial epicondylitis (commonly known as golfer's or baseball elbow). A condition characterized by pain from the elbow to the wrist on the palm side of the forearm. The pain is caused by damage to the tendons that bend the wrist toward the palm.
- Rotator cuff tendonitis. A shoulder disorder characterized by the inflammation of the shoulder capsule and related tendons.
- DeQuervain's tenosynovitis.The most common type of tenosynovitis disorder characterized by the tendon sheath swelling in the tendons of the thumb.
- Trigger finger/trigger thumb. A tenosynovitis condition in which the tendon sheath becomes inflamed and thickened, thus preventing the smooth extension or flexion of the finger/thumb. The finger/thumb may lock or 'trigger' suddenly.
Treatment for most tendon problems may include:
- Activity modification
- Ice
- Splinting or immobilization
- Steroid injections
- Nonsteroidal anti-inflammatory medications
- Surgery
Hand Arthritis | Bill's Story
What is arthritis?
Arthritis is a disease of the various tissues inside the joints. A joint is a point at which two or more bones meet. Arthritis can occur as a result of acute (short-term) or chronic (long-term) inflammation (irritation and swelling) in a joint and its surrounding soft tissues. It can also occur after trauma to the joint (such as a broken finger) or possibly from genetic (inherited) and environmental causes.
With arthritis, joints continue to worsen as the cartilage wears down. (Cartilage is the smooth “cushioning” tissue that lines joints.) This wear-down of cartilage causes changes in the structure that can be seen on X-rays. The surrounding soft tissues may also get weaker. (Soft tissues are the tendons, ligaments, muscles, and synovial membranes that connect, support, or surround the joint.)
Arthritis is frequently, but not always, painful and may result in a reduced range of motion in the joint, joint deformity, and loss of function. Although almost any joint in the body can be affected, the hand and wrist are common locations for many of the common types of arthritis.
Who is affected by arthritis?
Osteoarthritis affects virtually everyone, especially older people. Women are usually affected more than men and often at an earlier age. X-rays reveal joint damage in approximately 60% of adults over age 60, and in 80% to 90% of patients over age 75.
Rheumatoid arthritis affects about 1% of the adult population. Women are three times more likely than men to develop this disease. Though it may strike persons of any age, it typically begins between the ages of 20 and 40.
What are the types and causes of arthritis?
Osteoarthritis (also known as degenerative arthritis) is the most common type of arthritis. It may affect one or more joints anywhere in the body. Osteoarthritis usually occurs later in life and commonly affects the hands and larger weight-bearing joints, such as hips and knees. Osteoarthritis can cause pain and deformity and can limit the range of motion of the joint.
A number of factors are thought to be important in the development of osteoarthritis. Mechanical considerations (for example, joint stability and alignment, or arrangement) affect how forces are distributed across the joint, and therefore have an impact on how long the joint will last. Also, certain substances (biochemical factors) in the cartilage itself are thought to play a role in the eventual abnormal changes of this tissue.
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Risk factors for osteoarthritis include age, traumatic injuries (such as a broken wrist), joint infections, and possibly overuse. Some people inherit the tendency to develop osteoarthritis. How this happens is not well understood. These people are usually affected at an earlier age.
Arthritis may also result from inflammatory conditions that can occur anywhere in the body. The most common inflammatory condition is rheumatoid arthritis. Other inflammatory “arthropathies” include lupus, gout, pseudogout, ankylosing spondylitis, and arthritis related to inflammatory bowel disease or psoriasis.
Rheumatoid arthritis is an inflammatory and presumed autoimmune disease that affects the entire body, especially the joints. (Autoimmune means the body’s immune system attacks its own tissue.) With regard to the joints, rheumatoid arthritis targets the synovium. Synovium is a tissue that lines and nourishes joints and tendons throughout the body. As part of this condition, the synovium grows, causing local damage to bones, joints, and soft tissues.
Rheumatoid arthritis commonly begins in the hands, wrists, ankles, and feet, and often affects the same joints on each side of the body. Eventually, many other joints are affected. The cause of rheumatoid arthritis is unknown, though genetic factors are thought to be critical.
What are the symptoms of arthritis?
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Not all patients with arthritis will complain of pain, loss of motion, or deformity. The severity of the symptoms is only loosely linked with the severity of arthritis as seen on X-rays.
Minor joint injuries may aggravate existing joint damage, resulting in arthritic symptoms that the patient has not had before. These symptoms are more likely to be caused by the pre-existing arthritis, and not by the recent, relatively minor traumatic injury.
Symptoms of osteoarthritis and rheumatoid arthritis are in some ways the same. However, rheumatoid arthritis often will cause more long-lasting morning stiffness and lead to more swelling and redness of the joints. This inflammation of the soft tissues surrounding the joints can eventually result in deformities that limit patients’ ability to use their hands. In addition, patients in the early stage of rheumatoid arthritis may have such symptoms as weakness/tiredness, general discomfort, and loss of appetite.
Symptoms of arthritis from any cause can include:
- Pain that is limited to the joint itself. This is the main symptom. At first, the pain will come and go and is made worse when in use (such as when gripping heavy objects). However, pain is relieved with rest. There may be days or weeks without pain, but also periods of constant discomfort. As the disease advances, the pain becomes more constant, even occurring at rest. The pain changes from a dull ache to a sharp pain, which sometimes extends beyond the joint area.
- Loss of motion in the joints as arthritis progresses. However, sometimes as motion is lost, pain is lessened.
- Joint motion that is accompanied by grinding, clicking, or cracking as the cartilage continues to wear down.
- Joints that swell and often become red and tender to the touch. This is a sign of damage to the tissues surrounding the joint and the body’s response to the constant irritation. The deformity occurs as these stabilizing soft tissues are worn away.
- Weakness that results from joint pain, loss of motion, and joint deformity.