One of the most common complaints in general medical practice is pain in the hand and arm. Given everything we do with our arms and hands, combined with all of the varied tissue types involved, a host of conditions can contribute to pain. Yet there is a short list of the most common conditions generally presented in the doctor's office. Diagnosing which condition you might have is vital to providing the proper treatment.
Introduction
Hand and arm pain can result from any number of factors. Generally, pain can result from either soft tissue or bony injury. The hand, wrist and fingers are among the most used and abused structures of the body. They are therefore susceptible to mechanical trauma, such as fractures and repetitive strain injury and other pathologies of hard and soft tissues. The pain can take many forms, from mild to severe and from intermittent to constant. The pain usually is the sign of a dysfunction that requires attention. Depending on what type of pain you have and where the pain is located, a physical exam and other supportive tests can determine the exact nature of the pathology.
Repetitive Strain Injury
Although the classification of carpal tunnel syndrome as a repetitive strain disorder is controversial, there is no doubt that certain hand activities bring on this condition. Pain from carpal tunnel syndrome can range from mild to quite severe and debilitating. Usually the pain is accompanied with numbness and tingling in the hand and fingers. Tendinitis also is associated with repetitive hand activities. It is common to athletic people, assembly line workers and computer users. Tendinitis is due to inflammation of the tendon and its sheath, which prevents smooth gliding and therefore elicits pain when the hand, fingers or arm is moved. Both carpal tunnel syndrome and tendinitis generally respond well to rest, splinting and other non-surgical treatments.
Sprain
If the ligaments in the wrist are over-stretched, they form micro-tears. This is a sprain, and the result can be quite painful, especially if the joint is moved or touched. Athletic people frequently sprain the wrist or fingers, but anyone is susceptible to this injury. Sprains generally heal over time with rest and immobilization of the wrist or finger joints.
Fractures
A fracture is a break in the bone. The break may be a simple crack in the bone or a complete separation of fragmented pieces. The latter can produce serious injuries to adjacent tissues like nerves and blood vessels. Fractures almost always produce swelling and accompanying pain, the degree of either depending on the fracture's location and severity. The pain is most pronounced when the area is moved or touched, and the fracture can be confirmed by x-ray. Fractures of the hand and arm normally heal completely if the joint is immobilized, usually with a cast, for weeks to months.
Other
Another common cause of hand and arm pain is arthritis. The most common form in the hand and wrist is rheumatoid arthritis. This disease actually is the body's immune response to itself. Arthritis can be quite painful and even debilitating, and a number of treatments exist. Pain, particularly in the wrist, can also be attributed to ganglion cysts. These are expansions of fluid filled sacks inside the wrist joint and the tendinous sheaths inside. Ganglion cysts are benign, though they may grow larger. They usually are painful to the touch or if the wrist is bent. Even though they can disappear on their own, they can also be aspirated or removed surgically.
References
- "American Family Physician"; A Clinical Approach to Diagnosing Wrist Pain; T. Foreman, et.al.; November 2005
- Mayo Clinic: Wrist Pain Causes
- FamilyDoctor.org Hand/Wrist/Arm Problems
