Hand & Wrist Conditions: Symptoms & Treatment

Our hands and wrists play an important role in everyday activities, from gripping and lifting to typing, writing and performing fine movements.

Pain, numbness, swelling, weakness or difficulty moving the fingers may sometimes indicate an underlying hand, wrist or nerve condition.

Learn about five common hand and wrist conditions, their symptoms, possible causes, diagnosis and available treatment options.

Common Hand & Wrist Conditions

• Carpal Tunnel Syndrome
• De Quervain’s Disease
• Trigger Finger
• Cubital Tunnel Syndrome
• TFCC Injury

Carpal tunnel syndrome occurs when the median nerve is compressed inside the carpal tunnel at the wrist. This pressure on the nerve may cause numbness, pain and weakness in the hand.

Symptoms of Carpal Tunnel Syndrome

Common symptoms may include:

• Numbness and pain, mainly affecting the index and middle fingers
• Numbness that may also spread to the thumb and ring finger
• Symptoms that become more noticeable in the early morning
• Temporary relief after shaking the hand
• Thinning of the muscles at the base of the thumb as the condition progresses
• Difficulty performing fine hand movements such as sewing or buttoning clothes
• Difficulty making an “OK” sign in more advanced cases

What Causes Carpal Tunnel Syndrome?

In many cases, the exact cause is unknown. The condition occurs more commonly in women.

It may also be associated with:

• Pregnancy
• Menopause
• Wrist fractures
• Dialysis
• Frequent or heavy use of the hands

How Is Carpal Tunnel Syndrome Diagnosed?

A specialist may assess the hand and wrist using several methods.

Tinel’s Sign
Tapping the wrist may cause numbness or pain to travel towards the fingertips.

Wrist Flexion Test
Symptoms may become worse when the wrist remains bent for a period of time.

Nerve Conduction Study
A nerve conduction study may also be used to help diagnose the condition.

Treatment for Carpal Tunnel Syndrome

Patients may be advised to avoid excessive use of the affected hand.

Depending on the condition, treatment may include:

• Oral medication
• Resting the affected area
• Nerve block injections
• Surgery

Surgery may be considered when appropriate to release pressure on the compressed median nerve.

Download the leaflet here.

De Quervain’s disease, also known as De Quervain’s tenosynovitis, affects the tendons on the thumb side of the wrist.

Several tendons are connected to the thumb. Two of these tendons pass through a tendon sheath at the wrist. When inflammation develops in this area, the tendons may no longer glide smoothly.

Symptoms of De Quervain’s Disease

The main symptoms include:

• Pain on the thumb side of the wrist
• Swelling around the affected area
• Pain or discomfort during thumb and wrist movement

What Causes De Quervain’s Disease?

Excessive use of the thumb may cause the tendon sheath to thicken and may damage the surface of the tendons. This can make tendon movement more difficult and cause symptoms to worsen.

The condition may occur more commonly:

• During pregnancy
• After childbirth
• During menopause
• Among athletes
• In people whose work involves frequent use of the fingers and hands

How Is De Quervain’s Disease Diagnosed?

One assessment that may be performed is the Finkelstein test.

The thumb is placed inside the palm and the fingers are closed around it to form a fist. The wrist is then moved towards the little-finger side. Pain during this movement may indicate the condition.

Treatment for De Quervain’s Disease

Conservative Treatment

Conservative treatment is usually the first approach and may include:

• Resting the affected area
• Reducing movements that may irritate the wrist
• A medicated compress where appropriate
• A splint or support to limit movement
• Steroid injection containing local anaesthetic to help reduce inflammation, pain and swelling

Surgical Treatment

Surgery may be considered when the condition does not improve with conservative treatment.

During surgery, the tendon sheath is opened to release the tendons and allow them to move more freely. The procedure takes approximately 30 minutes according to the booklet.

Download the leaflet here.

Trigger finger, also known as stenosing tenosynovitis, occurs when inflammation develops between the flexor tendon and the tendon sheath.

Normally, tendons move through the tendon sheath to allow the fingers to bend and straighten smoothly. When the tendon or tendon sheath becomes swollen or thickened, this movement may become restricted.

Symptoms of Trigger Finger

Symptoms may include:

• Pain at the base of the finger
• Swelling
• A feeling of warmth around the affected area
• The finger catching during movement
• The finger becoming temporarily locked
• A finger that suddenly snaps when bent or straightened

The thumb, middle finger and ring finger are commonly affected.

Who May Develop Trigger Finger?

Trigger finger may occur more commonly:

• Among women going through menopause
• During pregnancy
• After childbirth
• In people with diabetes
• In individuals undergoing dialysis

Overuse of the finger may also cause the tendon sheath to thicken or the tendon to become swollen, preventing smooth movement.

Treatment for Trigger Finger

Conservative Treatment

Treatment may include:

• Resting the affected finger
• Reducing activities that irritate the area
• Using a splint or support
• Steroid injection containing local anaesthetic to help relieve symptoms

Surgical Treatment

Surgery may be considered if:

• Symptoms do not improve with conservative treatment, or
• The finger remains bent and cannot be straightened

During surgery, a small portion of the tendon sheath is released to relieve pressure on the tendon. Only a small incision is required.

Download the leaflet here.

Cubital tunnel syndrome is a nerve condition caused by compression or stretching of the ulnar nerve at the elbow.

The ulnar nerve travels along the inner side of the elbow and provides sensation and muscle control to parts of the hand.

Symptoms of Cubital Tunnel Syndrome

In the early stages, symptoms may include:

• Numbness in the little finger
• Numbness affecting part of the ring finger

As the nerve becomes more affected, patients may experience:

• Reduced hand strength
• Thinning or wasting of the hand muscles
• Changes in the position or shape of the little finger and ring finger

What Causes Cubital Tunnel Syndrome?

The condition may develop when the ulnar nerve is repeatedly or continuously compressed or stretched.

Possible causes include:

• Compression caused by the ligament holding the nerve in place
• A lump such as a ganglion cyst
• Changes or deformity of the elbow associated with ageing
• Elbow deformity following a childhood fracture
• Activities or sports that repeatedly place stress around the elbow

The booklet cites sports such as baseball and judo as possible examples.

How Is Cubital Tunnel Syndrome Diagnosed?

Tapping the inner side of the elbow may reproduce numbness or tingling in the little finger and part of the ring finger.

For patients with a previous elbow fracture, an X-ray may also be performed to check for changes or deformity around the elbow.

Treatment for Cubital Tunnel Syndrome

Conservative treatment such as medication may initially be considered.

If symptoms do not improve, surgical treatment may be performed depending on the underlying cause.

Surgical options described in the booklet include:

• Releasing tissue that is compressing the ulnar nerve
• Removing a ganglion cyst
• Trimming part of the bone when there is significant tension on the nerve
• Moving the ulnar nerve to the front of the elbow
• Correcting an elbow deformity where appropriate

Download the leaflet here.

A TFCC injury, or Triangular Fibrocartilage Complex Injury, affects a structure located on the little-finger side of the wrist.

Damage to the TFCC may result in pain during wrist and arm movements.

Symptoms of a TFCC Injury

Symptoms may include:

• Pain on the little-finger side of the wrist
• Pain when using the arm
• Pain when bending the wrist towards the little finger
• Pain when turning a doorknob
• Pain when lifting an object

In many cases, there may be little or no pain while the wrist is at rest.

What Causes a TFCC Injury?

TFCC injuries are generally divided into two types:

Traumatic injuries
These occur following an injury or trauma.

Degenerative injuries
These develop as the tissues change with age.

Mild TFCC injuries may not cause noticeable symptoms.

How Is a TFCC Injury Diagnosed?

Assessment may include:

• Checking for tenderness on the little-finger side of the wrist
• Assessing pain during wrist movement
• A compression test
• Standard X-ray
• Joint imaging with contrast
• MRI

During the compression test, pain may be reproduced when the wrist is bent towards the little finger while the forearm is rotated.

Treatment for a TFCC Injury

Conservative Treatment

Treatment may include:

• Resting the wrist
• Immobilising the wrist with a cast
• Using a splint or wrist support
• Steroid injection containing local anaesthetic to reduce inflammation

Surgical Treatment

Different surgical options may be considered depending on the condition.

These include:

• Arthroscopic repair
• Ulnar shortening surgery

A hand surgery specialist can assess the condition and recommend the appropriate treatment approach.

Download the leaflet here.

Persistent hand, wrist or finger symptoms should not be ignored, especially when they begin to interfere with daily activities.

Consider seeking specialist assessment if you experience:

• Persistent hand or wrist pain
• Numbness or tingling in the fingers
• Reduced grip strength
• Swelling around the hand or wrist
• Difficulty bending or straightening a finger
• A finger that repeatedly catches or locks
• Pain when lifting, gripping or turning objects
• Symptoms that continue to worsen despite rest

A specialist assessment can help identify the cause of the symptoms and determine an appropriate treatment plan.

Hand and wrist conditions can affect everyday activities, work and mobility. If your symptoms persist or affect your ability to use your hand comfortably, speak to a specialist for further assessment and treatment advice.

Consult a Hand Surgery Specialist at Mahkota Medical Centre.

Dr Liau Chai Jiun
Consultant Orthopaedic, Hand, Upper Limb, and Microsurgeon

Clinic Location
3rd Floor, SOC 3A Room 3

Contact
+606 285 2723 (Ext 2723) / +606 285 2999

Consultation hours

Monday – Friday: 8:30am - 5:30pm

Saturday: 8:30am - 12:30pm

Sunday / Public Holiday: Closed