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Elbow, Wrist, & Hand Conditions

At every stage of life and in nearly every occupation, you need your hands to perform a wide range of duties. Therefore, injuries, defects, and disease in this area can be significantly debilitating. While there is a broad array of issues that can affect these hard-working parts, our experienced orthopaedic surgeons can diagnose and treat hand, wrist, and elbow conditions utilizing traditional and advanced methods. If pain or immobility is reducing your capacity to participate in your favorite activities or to perform your job, we can help.

Upper extremity discomfort can affect your quality of life. Follow the links below for more information about common hand, wrist, and elbow concerns. If you have more questions, or if you would like to schedule a consultation, please contact us today.

Tendonitis/Tendinitis

There are several different types of tendonitis, a condition in which any tendon is inflamed or irritated. Tendons are the cord-like fibers that hold muscle onto bone. Some examples of conditions caused by tendonitis include trigger finger, Dequervain’s disease, and lateral epicondylitis (tennis elbow). These concerns are difficult or impossible to cure; however, they can typically be treated with a variety of surgical and non-surgical options.

Trigger finger often occurs as a result of repetitive motion such as gripping. The finger often will make a snapping sound when straightened, and it can become permanently stuck in a bent position if left untreated. Non-surgical treatment options include cortisone injections and splinting. In more severe cases, surgery may be necessary.

DeQuervain’s tenosynovitis, also called Mommy’s disease, affects the tendons of the wrist closest to the thumb. Turning, grasping, and making a fist can cause significant discomfort. Repetitive motion may be a contributing factor, and this condition is most commonly seen in new mothers. Treatment options include braces, physical therapy, medication, injections, or, in rare cases, surgery.

Tennis elbow and golfer’s elbow – medically known as lateral epicondylitis and medial epicondylitis, respectively – are common concerns. Repetitive activities, heavy lifting, and contusions are primary causes. These conditions can be treated non-surgically with therapy, injections, and rest; however, the pain may return. We can help you alleviate discomfort and modify your behavior to reduce recurrences.

Carpal Tunnel Syndrome (CTS)

In addition to conditions related to the tendons, the hand can also experience a number of nerve-based concerns, including compression syndromes, injuries, and neurologic tumors. We will diagnose your condition during your initial consultation and develop a customized treatment plan tailored to your needs.

Carpal tunnel syndrome (CTS) is an example of a nerve compression disorder, and CTS is the most common one. The carpal tunnel is a small channel inside the wrist that the median nerve runs through. If the nerve becomes irritated or inflamed, as a result of pressure or another concern, it can cause pain, tingling, numbness, and reduced function. CTS is idiopathic, which means the cause is unknown. Repetitive movements are believed to contribute; however, typing will not typically result in CTS, despite that common misconception. In most cases, CTS can be addressed with rest, braces, injections, and medication. Only in rare instances will surgery be necessary.

Cubital tunnel syndrome is another prevalent nerve compression disorder, one that affects the ulnar nerve, or “funny bone.” As with CTS, repetitive motion can lead to cubital tunnel syndrome, which causes discomfort, numbness, and tingling in the ring and small (pinky) finger. Cubital tunnel syndrome symptoms can overlap with the signs of other conditions, so our skilled orthopaedic surgeons will typically request an EMG and nerve studies to pinpoint the source of the issue. Once diagnosed, treatment may include splinting. Surgery may be recommended if the discomfort increases over time.

Arthritis

There is a multitude of forms of arthritis that affect the hands, including degenerative, rheumatoid, psoriatic, lupus, and many more. This condition is caused by inflammation of the joint, and it typically worsens with age. Millions of Americans suffer from arthritis, but there are numerous treatment options that can help minimize discomfort, improve mobility, and enhance quality of life.

Degenerative arthritis, also called osteoarthritis, typically affects the fingers, causing pain in the joints furthest from the hand. Symptoms tend to flare up, fade away, and return again. During periods of discomfort, splinting, anti-inflammatory medications, heat and ice, and cortisone injections can be helpful to address these concerns. In the event minimally invasive techniques prove ineffective or the pain worsens over time, surgery may help you to achieve longer-lasting relief.

Rheumatoid arthritis, commonly called inflammatory arthritis, can affect any area of the body, including the organs. In many cases inflammatory arthritis of the hand will be felt near the wrist, which may cause visible deformity. This disorder can advance over time, and it’s important for you to seek out a medical professional experienced in rheumatology to minimize progression.

Basal joint arthritis occurs in the hand near the base of the thumb, and it is one of the most common types of arthritis addressed by orthopaedists who specialize in the upper extremity. Fortunately, non-surgical treatment usually can offer significant relief of symptoms and may include medication, splinting, or a cortisone injection. Although uncommon, a joint replacement (tendon arthroplasty) or fusion may be recommended if conservative methods prove ineffective.

Hand Tumors

Although they may sound scary, tumors of the hand are not uncommon. If benign, they may cause no discomfort and require no intervention. At the Orthopaedic Institute of Central Jersey, we can diagnose these issues using state-of-the-art technology, including radiographs, MRIs, CT scans, or other imaging tests. We will also perform a physical examination of the area of concern. Surgery for benign tumors is often not necessary, unless the growth increases in size, causes pain, or you prefer to have the tumor removed. As with most hand conditions, there are several types of hand tumors:

Ganglion cysts are a type of hand tumor that generally develops on the back of the wrist. These common growths can also be found on the side of the wrist or at the base of a finger or fingernail (mucous cyst).

There are several other tumors that can develop along the hand or fingers, including lipomas (fat), schwannomas and neurofibrommas (nerve), and hemangiomas (blood vessel) tumors. In many cases they cause no discomfort; however, they may become larger and aesthetically unappealing with time.

Giant cell tumors of the tendon sheath should be carefully observed. These benign masses may begin in the hands and then expand to nearby tendons, bone, and other tissue. Aggressive and fast growing, they are one of the few benign tumors that can spread to the lungs. Giant cell tumors should be excised to reduce the risk of them becoming larger, which can make removal more difficult, or before they extend into other structures, which can increase the likelihood of recurrence.

If you notice any new mass in your hand, it’s important to have a qualified hand surgeon evaluate it to determine if the growth could be a tumor. Our experienced medical team will be happy to answer questions about hand tumors or to help you to set up a consultation.

Dupuytren’s Contracture

Developing over several years, Dupuytren’s contracture is a deformity of the hand that occurs due to nodules growing in the palm and fingers. As the masses become larger, they can become cord-like and pull the fingers into a fist. Unfortunately, once in this position they cannot be manually straightened. Pain and immobility are the most common symptoms. If addressed early, non-surgical treatment can help to alleviate discomfort and to limit the progression of the disease. If necessary, surgical intervention can be used to loosen the cords or remove the nodules.

Fractures

Breaking a bone in the hand or the wrist can be a very painful experience, but it’s not an uncommon one. This condition usually occurs when you fall and extend your hands out to catch yourself. Other causes may include certain sports, such as snowboarding, skiing, baseball, softball, and football, which result in regular impact of the hands or wrists. If you believe you may have broken a bone in your hand, you should see a qualified orthopaedic physician right away. Fractures that are out of alignment (where the broken bone ends fail to meet up) can lead to long-term concerns if left to heal that way. In most cases, you will have to wear a brace or cast until the bone is healed, after which physical therapy may be recommended. In the event of a more severe break, misalignment, or compound fracture (where the bone pushes through the skin), surgery may be necessary.

You use your hands for so many purposes, and pain or debility can significantly impact your life. If you experience a concern involving your hand, wrist, or elbow, we can help. Contact us today for more information or to schedule a consultation.