PATIENT STORY

Types of Hand Pain

Patient Story · ESTIMATE 6-MINUTE READ

Early Trauma Catches Up

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As the sliding gate caught my finger and wedged it into the latch with a loud thud, I knew it would be trouble. My mind teleported me to my 18-year-old self considering Lloyd’s of London coverage of my artistic hands. The mental pendulum then swung to the future when this injury may develop into osteoarthritis. I am now catching up to the future.

Yes, it hurt to slam my finger within a metal gate! Though it did not break the skin, range of motion was reduced to 30 percent of normal. After a few years, I happily regained 90 percent functionality. Now the finger is a little wider than others and mobility is diminishing again.

Death or Pain?

People sometimes imagine they are experiencing a pain worse than death. Hospice patients reach the point that consciousness requires morphine. One patient felt he was in more pain than any amount of medication could remedy. These are extremes.

Aches and pains come with aging. Understand that most doctors expect you to manage a reasonable threshold of pain. To prevent addiction, try not to raise your expectation to live pain-free. Some days will be better than most. Endeavor to remain active. Because given the choice of death or pain, most people prefer to live with some discomfort.

Types of Arthritis

Rheumatoid arthritis results from joint inflammation and deterioration. Osteoarthritis can either stem from trauma or when the cartilage that cushions the ends of bones in your joints gradually deteriorates. The differences are well illustrated on the Understanding Arthritis anatomy poster.

Either form of arthritis is painful and limits range of movement. There is no treatment to reverse arthritis damage, short of prosthetic joint replacement. In some cases a doctor may inject hyaluronic acid. This gel mimics synovial fluid.

Arthritis Treatments

Developing Osteoarthritis

Rheumatologists focus on reducing the pain and slowing progres­sive damage. Treatment begins with recom­menda­tions for NSAIDs. Over-the-counter anti-inflammatory drugs are Motrin, ibuprofen, or naproxen. Some oint­ments include NSAIDs for topical application.

Eventually, these OTC remedies lose their effective­ness and prolonged NSAID use can cause stomach problems and increase your chance of heart attack or stroke. You might then consider physical therapy or acupuncture.

Next, doctors with rheumatology training help you to decide between prescription medications with side effects that are sometimes worse than the ailment. A thorough patient history is necessary to minimize adverse reac­tions.

Mention any allergies or predispositions. For example, have you ever had tuberculosis (TB)? Do you travel to areas where TB is common? Does a pre-existing condition limit your lung capacity? Ask about potential side effects.

Common areas of arthritis are hips, knees, and lower back. Early symptoms are limited range of motion in these weight-bearing joints. Orthopedic surgeon, Bret Gilbert, MD says, “Untreated, osteoarthritis can lead to bone loss, bone spurs, and damage to surrounding ligaments and other soft tissues.”

Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and other symptoms of arthritis of the joints available in petroleum gel. Serious skin reac­tions can occur during treatment with this medicine. Check with your doctor right away if you have any of the following symptoms while using this medicine: blistering, peeling, or loosening of the skin.

Diclofenac hand flaking
Skin flaking after applying several applications of Diclofenac sodium topical gel, 1%.

Injury, infection, gout, psoriasis, and other conditions can also cause arthritis of the hand. Osteoarthritis sometimes causes Bouchard’s nodes, which are bumps at the middle joint, or Heberden’s nodes, which are bumps at the end of the finger.

Not Arthritis

Cubital tunnel syndrome is a form of tendinitis or carpal tunnel syndrome that affects fingers. The non-medical term is “text claw.” It is a common repetitive injury that can result from frequent finger tapping on smartphones or digital tablets. The symptoms are tingling and numbness in the index, thumb, and middle finger.

Types of Repetitive Strain Injuries
  • Bursitis – inflammation and swelling of the fluid-filled sac near a joint
  • Dupuytren’s contracture – a thickening of the tissues in the hand, which causes one or more fingers to bend into the palm
  • Epicondylitis – inflammation of the area where bone and tendon join
  • Ganglion cyst – a sac of fluid that forms around a joint or tendon, usually on the wrist or fingers
  • Nerve entrapment – such as carpal tunnel syndrome
  • Raynaud's phenomenon – interruption of blood supply to extremities especially when exposed to cold
  • Tendonitis – inflammation of a tendon
  • Tenosynovitis – inflammation of the sheath that covers the tendons, most commonly in the hand, wrist or forearms
  • Thoracic outlet syndrome – compression of nerves or blood vessels that run between the base of the neck and the armpit
  • Trigger finger – where swelling in a tendon running along one of the fingers makes it difficult to either bend or straighten

Immobilize affected fingers with a splint and apply ice pack to reduce swelling. Use a stylus in place of your fingers. Flexor tendonitis (trigger finger) is a swelling and inflammation of finger joints. that restricts movement. If hand and wrist stretches or icing do not resolve discomfort within a week, speak to your doctor.

Surgery is a consideration when the non-surgical options are unsuccessful. Joint fusion releases pain with the compromise of restricting range of motion. With joint recon­struc­tion, the rough joint surface is removed and either replaced with your own soft tissue or with an implant. A hand surgeon can help you to decide your best option.

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