Table of Contents
Generality
The pain in his hand is a characteristic symptom of various pathological conditions, which can affect, in particular, the fingers, the base of the fingers, the palm, the back of the wrist.
Its presence can have various repercussions on the gestures of the affected hand (s), for example, preventing them from grasping objects or bending the fingers to clench the fist.
So,the leading causes of hand pain are carpal tunnel syndrome, arthritis, tendon cysts, De Quervain syndrome, trigger finger and bone fractures.
Pain in the Hand
The pain in the hand is a symptom that characterizes many morbid conditions, some more serious than others.
It can have various locations: it can affect the fingers, the base of the fingers, the palm, the back of the wrist;
It can have multiple repercussions on gestures: some pains in the hands appear when the person involved makes a fist. when grasping objects, when carrying out simple daily life gestures such as uncorking a bottle or turning the car keys, etc.
Depending on the triggering causes, pain in the hand can be sharp, dull, intermittent, continuous or deep.
Causes
Hand pain can result from injury or disease affecting one or more anatomical structures of the hands, including bones, joints, tendons, ligaments, muscles, and blood vessels.
The leading causes of hand pain include:
Carpal tunnel syndrome;
Arthritis;
Tendon cysts;
The so-called trigger finger;
The fracture of a bone of the hand.
These conditions can be responsible for both unilateral pain (i.e. in one or both hands) and bilateral pain (i.e. in both hands).
Carpal Tunnel Syndrome
Carpal tunnel syndrome wrist level corresponds precisely to the osteo-ligamentous structure known as carpal tunnel.
In addition to pain in hand, carpal tunnel syndrome causes numbness and tingling in the wrist, palm and fingers. The symptoms worsen with time and become more acute and unbearable at night.
Typically, this nerve compression syndrome results from a combination of favouring/triggering factors; rarely, it comes from a single cause.
Carpal tunnel syndrome drugs.
Carpal Tunnel
Figure: carpal tunnel anatomy. It is possible to recognize the transverse carpal ligament, the tendons and the median nerve that run through the tunnel and the carpal bones.
Arthritis
Arthritis is the medical term for an inflammatory process affecting one or more joints.
Several types (or forms) of arthritis, each with unique causes and characteristics.
Among the primary forms of arthritis that can cause pain in the hands, Osteoarthritis (or arthrosis ) and rheumatoid arthritis deserve a special mention.
L ‘ Osteoarthritis is the most common type of arthritis in the general population.
The inflammatory processes that characterize it derive from the progressive degeneration of the cartilage, which covers the bony surfaces of the affected joints.
L ‘ Osteoarthritis of the hands causes pain in the wrist, at the base of the thumb, to the proximal interphalangeal joints ( Bouchard’s nodules ). And at the level of the distal interphalangeal joints ( Heberden’s nodes ).
Hand pain from Osteoarthritis is often associated with other symptoms, including joint stiffness, swelling, and reduced joint mobility.
L ‘ rheumatoid arthrRheumatoid arthritis induces throbbing and poignant pain in the hands.
The intensity of which is most significant in the morning or after long periods of inactivity.
This is the second most common form of arthritis in the general population.
The most common symptoms that accompany the painful sensation in the hands are swelling, a sense of joint stiffness and reduced mobility of the affected joints.
In some cases, rheumatoid arthritis can induce the appearance of Bouchard’s nodules and Heberden’s nodules.
Tendon Cysts in the hands
The tendon cyst (or cysts synovial ) to the hand’s bulges fill with fluid.
It forms close to the tendons (tendon sheaths) or joints (joint capsule).
Their size is highly variable: some tendon cysts are the size of a pea, others are the size of a golf ball.
The most common tendon cysts in the hands are the wrists; however, the central part of the hands (palm and back) and fingers can also develop these problems.
The fluid contained in the cyst is similar to the synovial fluid; it is light in colour and has a muco-gelatinous consistency.
Synovial cysts are painful in all those cases in which they develop near a nerve end. And cause it to crash.
De Quervain Syndrome
The syndrome De Quervain, or stenosing tenosynovitis of De Quervain’s disease, is a painful condition subsequent irritation of the synovial sheath.
It surrounds the tendons of the abductor muscles long and short extensor pollicis.
Generally, the irritation above has a multifactorial origin;
It can cause by several factors, including a certain individual predisposition, the continuous repetition of specific movements with the hand, rheumatic diseases, and sudden functional overloads.
The precise locations of hand pain induced by De Quervain syndrome are the outer face of the wrist and the base of the thumb.
The painful sensation, in particular, is caused by the gripping movements performed with the thumbs. And the inclination movements of the wrist.
In addition to pain in hand, other typical symptoms are the development of swelling along the course of the irritated tendons, a painful protrusion at the level of the wrist and the appearance of pain in the forearm.
What does tenosynovitis mean? From where does the word stenosing come?
In medicine, the term tenosynovitis indicates any inflammatory or irritative process affecting the synovial sheath, which surrounds the tendons of the human body.
The physiological role of the synovial sheath that surrounds the tendons is to preserve the latter from friction and friction.
The word stenosing derives from the term stenosis, which, in the medical field.
It indicates any abnormal and unnatural narrowing of a blood vessel, a hollow or tubular organ or an anatomical orifice.
Snap Finger
The trigger finger, or stenosing tenosynovitis of the flexors of the fingers, is a disorder.
It is characterized by narrowing of the synovial sheath that surrounds the tendon of one of the flexor muscles of the fingers.
The presence of the trigger finger means that when the finger affected by the narrowing above is bent.
It remains temporarily in the bent position, only to straighten up suddenly and with a bad snap.
The trigger finger most commonly occurs in the dominant hand. And affects the thumb, middle or ring finger in most cases.
The disorder can affect multiple fingers simultaneously and involve both hands.
From unknown causes, trigger finger tends to occur more frequently in people with diabetes, hypothyroidism, history of hand trauma and rheumatic diseases.
The precise locations of the pain in hand induced by the trigger finger are the palm and the wrist.
In addition to pain, joint stiffness in the affected finger or fingers. And the formation of a lump at the base of the affected finger or fingers are other typical clinical manifestations.
Bone Fractures in the hands
The bone fractures of the hands are accidents of nature, for the most part, traumatic, which consist in the rupture of one or more bones constituting the skeleton of the hands.
Briefly Recalling that the bony skeleton of a human hand comprises 27 bones divided into three categories. They are 45nn
b4known as carpal bones, metacarpal bones and phalanges. Bone fractures of the hands can be: simple, complex, multiple or compound.
The pain in hand, induced by a fracture, is very intense and usually occurs at the breaking point.
In addition to pain in hand, other typical symptoms are stiffness, swelling, and reduced mobility.
Diagnosis
The physical examination and the anamnesis are the starting diagnostic tests in the path that leads to identifying the precise causes of pain in hand.
Then, depending on what emerges from these, doctors may prescribe a radiograph ( X-ray ) of the hand, an MRI of the hand, a bone scan, an ultrasound, electromyography, or electroneurography.
Recognizing the precise triggers of hand pain is essential for planning the most appropriate therapy.
