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Worcestershire Health and Care NHS Trust
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Hand Pain


What is hand pain?

Under ‘What is hand pain?’ change ‘trapped nerves’ to ‘nerve irritation’, and ‘wear and tear’ to ‘tendon pain’

The carpal tunnel is a canal formed between the small bones of the wrist called carpal bones and a ligament that lies across the front of the wrist.  The median passes through this canal.

In Carpal Tunnel Syndrome the nerve becomes compressed within the canal.

Symptoms include pins and needles, pain and/or numbness in the index and middle fingers and weakness of some muscles in the fingers and/or thumb which may cause poor grip.
De Quervain's is inflammation and pain of tendons at the base of the thumb. These tendons include the extensor pollicis brevis and the abductor pollicis longus tendons, which move the thumb away from the palm.
Osteoarthritis in the thumb is the most common form of arthritis that affects the hands. It can affect the joint at the base of the thumb near the wrist joint. 
Trigger finger or thumb is a common disorder characterized by snapping, catching or locking of the finger flexor tendon. It is associated with pain and inability to use the finger/ hand. 
Dealing with hand pain

Carpal Tunnel Syndrome (CTS) is more common in manual workers, especially with jobs involving a lot of wrist movement, so overuse of the hand may be a factor.

The following are all associated with CTS: pregnancy, obesity, an underactive thyroid, diabetes and the menopause.

Ice your wrist (using a damp towel) or soak it in an ice bath for 10 minutes once an hour.

Relieve night-time pain by gently shaking your hand and wrist or hanging your hand over the side of the bed.

Buy a comfortable wrist splint to keep your hand straight at night (take off during the day).
Strengthening the hand can help resolve De Quervains making sure that the exercises are comfortable. 
Gently stretching the thumb backwards for 30 seconds can help along with gentle comfortable thumb strengthening.
Applying heat using warm (not too hot) water several times throughout the day may help. A steroid injection may also be beneficial.
Avoiding hand pain
Avoid over-use of your wrist by excessive squeezing, gripping or wringing.

Regarding Carpal Tunnel Syndrome, if this was caused by a work-related or sporting activity then reducing or modifying these can help settle symptoms. Losing weight may also be helpful if you are overweight.

Avoid repetitive wrist movements. Change your actions to reduce the stress on your wrists and take frequent breaks to rest if you are using your wrist a lot. Wear a

De Quervain’s thumb splint if necessary but do not use continually to avoid weakening and stiffening hand.
Take precaution to avoid injuring your hand, as preventing a prior incident can significantly reduce the risk of arthritis.
Avoiding overuse of hand can helps prevent trigger finger or thumb. If you begin to experience stiffness and swelling in your fingers rest you hand and try alternating activities to keep your fingers from becoming inflamed
 
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For a patient information leaflet click here. 

For a shared decision making leaflet please click here.