The human hand is a superbly intricate appendage that is made up of 27 bones, 29 individual joints, 34 muscles, and 48 named nerves. Furthermore, the human hand is a highly mobile structure that is constantly changing and adapting its shape to better manipulate our surroundings and to express and communicate ideas.
Consequently, the hand is without a shred of doubt an essential component of the human body; yet its intrinsic complexity and central role in human function make it extremely susceptible to wear and injury. Our hands often the first to pay the price of age and in fact, one of the most common ailments in patients over the age of 45 is pain in the hand. Find out about MCP dislocation in thumb.
If you experience pain along the wrists, if you experience pain in the palms, or along the base of the thumb, you could be suffering from one, or more, of various possible upper limb injuries and disorders. Most of these conditions are progressive and, if left untreated, over time can cause significant strife and the eventual loss of functionality.
Curiously enough, pain in the hands and wrists is much more prevalent amongst women older than 45; this is clinically significant because women over 40 already suffer from significantly higher incidences of various arthritic and rheumatic diseases.
When experiencing pain in the hand, the first course of action should always be to start with a conversation with your primary health care practitioner about your pain. In order to attempt a proper diagnosis, your doctor will need to know the exact location of your pain, whether it is constant or recurring, and whether there is a presence of swelling or tenderness.
So, what is behind the pain? There could be various factors, active at any one time, responsible for bouts of pain. Additionally, external trauma and multiple, seemingly unrelated, diseases can act as triggers of hand pain. Below we share the most frequent causes of pain of the hand and wrists and give some possible solutions that can offer eventual relief.
Rheumatoid Arthritis
Rheumatoid arthritis is a widespread type of chronic inflammatory disease. It is accurately characterized by a symmetrical development of multiple, specific extra-articular symptoms and the presentation of moderate to severe pain, swelling, and stiffness of the affected joints.
Left untreated rheumatoid arthritis will usually cause significant physical limitations and a measurable deterioration of the patient’s quality of life. Rheumatoid arthritis is particularly dangerous because some of the extra-articular manifestations of the disease affect the heart and lungs.
Rheumatoid arthritis is much more prevalent in the female population than in the male population, especially after the age of 45. When it affects the wrist joint directly, one of the most common manifestations is pain in the palm of the hand and along the base of the thumb. A combination of factors, such as age, stress, genetics, and injury can lead to triggering it.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is one of the most commonly misdiagnosed ailments of the joints. It typically starts with a vague pain in the wrist, which eventually extends outwards into the hand or up the arm.
Carpal tunnel generally occurs when the median nerve, which runs through the carpal tunnel in the forearm and into the hand, is compressed or squeezed. The median nerve controls all sensations and movement of the thumb and fingers. The most common symptoms are persistent tingling and numbness in the fingers.
Ganglion cyst
Ganglion cysts are fluid-filled lumps, typically found near the joints of the wrists and fingers. Although their appearance is almost always painless, sometimes they can cause pain, weakness or numbness along the base of the thumb if they press the nerves near the wrist joint. It is believed that ganglion cysts are caused by a herniation of the joint capsule or tendon sheaths. The apparent risk of suffering from joint capsule or tendon sheath herniation becomes elevated in patients with confirmed cases of osteoarthritis.
Stenosing tenosynovitis
Stenosing tenosynovitis also referred to as trigger finger, is the inflammation and restriction of the tendon sheaths of the fingers and thumb. Stenosing tenosynovitis is a very painful and eventually deforming condition that is caused by overuse and abuse of the joint. Repetitive activities such as computer use and knitting are typically to blame for the development of this condition. Patients with rheumatoid arthritis are also known to manifest trigger finger with frequency.
De Quervain Syndrome
De Quervain syndrome is said to be present when a marked inflammation of the tendons attached to the pollicis brevis and pollicis longus muscles as well as their respective synovial sheaths. De Quervain syndrome manifests in pain alongside the base of the thumb and on the outside of the wrist. Pain intensifies as the wrist is rotated and when the thumb is moved repeatedly.
BEST TREATMENT FOR PAIN OF THE PALM AND BASE OF THE THUMB
While most of these conditions develop gradually, once pain becomes significant there is very little time to lose. Patients, especially females over 45, are advised to minimize repetitive motions of the affected joints. Specific movements such as pinching, clenching, and twisting of the wrist should be kept to an absolute minimum. In the more advanced cases, splinting and immobilization of the joint are recommended for temporary pain relief. 
Over the counter pain, relievers and non-steroidal anti-inflammatory medication are typically prescribed to aid with pain management. In some cases, corticosteroid injections can help to significantly reduce the inflammation of the tendons and nerve sheaths of the affected joint. Exercises and stretches focusing on the tendons and muscles of the hand may be recommended by physical therapists in order to gradually alleviate the restrictive stiffness and loss of motion typically associated with these conditions.
The important thing to remember is that although initially, these types of conditions are slightly annoying if left unchecked they have the potential to become crippling and significantly lower the quality of your life. If you regularly experience pain, numbness, or tingling in the palm of your hand or along the base of the thumb, it is imperative that you seek medical attention and begin working on a therapeutic solution.
REFERENCES:
- Armstrong, A. L., J. B. Hunter, and T. R. C. Davis. “The prevalence of degenerative arthritis of the base of the thumb in post-menopausal women.” Journal of Hand Surgery3 (1994): 340-341.
- Keon-Cohen, Bryan. “De Quervain’s disease.” The Journal of bone and joint surgery. British volume1 (1951): 96-99.
- Arnett, Frank C., et al. “The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.” Arthritis & Rheumatism: Official Journal of the American College of Rheumatology3 (1988): 315-324.
- Rhoades, Charles E., Richard H. Gelberman, and Jon F. Manjarris. “Stenosing tenosynovitis of the fingers and thumb. Results of a prospective trial of steroid injection and splinting.” Clinical orthopaedics and related research 190 (1984): 236-238.
- Thornburg, Lacy E. “Ganglions of the hand and wrist.” JAAOS-Journal of the American Academy of Orthopaedic Surgeons4 (1999): 231-238.
