When Busy Hands Hurt: What Hand Pain May Be Telling You

**By Julie Roberts, MD**

Numb fingers? Aching wrists? Hand pain? With the pandemic, many of us who are lucky enough to work from home are dealing with new or worsened hand and arm pain related to strange workspaces and unhealthy postures. Not only that, but those of us who are finally getting to that long-overdue yard improvement project may find that these activities are triggering chronic and repetitive overuse injuries. For example, pruning shrubs, raking leaves, or painting can cause tendonitis to flare up or can aggravate pre-existing conditions, such as arthritis.

Here are two common hand issues that folks might be having as a result of working from home and other hands-on activities we’re attempting in the pandemic.

Carpal Tunnel Syndrome

Have numbness and tingling in your hands? It might be related to carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) is caused by a compression of the median nerve at the wrist. Symptoms include numbness and tingling in the hand, particularly affecting the thumb, index, and middle fingers. People often describe a “pins and needles” sensation in the fingers. With early CTS, you might experience symptoms at night. You may wake up at night with your hands asleep and have to shake them to get sensation back. Most people sleep with their hands curled up and their wrists bent; this position puts a lot of pressure on the carpal tunnel.

Another symptom of CTS is hand fatigue with repetitive activities. Less commonly, people will have pain in their hands and forearms related to CTS. If you wake up at night several times a week, or have symptoms throughout the day, you should be evaluated for CTS. There are other, less common causes of numbness and tingling in the hands, and an exam and thorough evaluation is necessary to make the correct diagnosis and discuss treatment.

Treatment options for CTS start with activity modification and night splinting for mild symptoms. More moderate and severe symptoms may require surgical release of the carpal tunnel. There are two main ways to perform a carpal tunnel release including the traditional open approach and a minimally-invasive endoscopic release, which has been shown to allow a faster return to work.

Trigger Finger

Experiencing pain in your palm? It might be related to trigger finger, a type of tendonitis known as tenosynovitis.

Trigger finger symptoms may include clicking, catching, and locking of the fingers and is often associated with pain in one’s palm. The tendons that bend our fingers run through tight tunnels called “pulleys.” In trigger finger, both the tendon and the pulley become inflamed. Repetitive activity, such as weeding your garden or trimming hedges can exacerbate this inflammation. Many people experience symptoms with repetitive activity or in the mornings, because our hands naturally swell at night. There will not be associated numbness or tingling with trigger finger. Interestingly, folks who get trigger finger are predisposed to carpal tunnel, and vice versa. 

Trigger fingers are often treated with steroid injections. One or two injections are often all that is needed to decrease the swelling around the tendon to allow it to glide smoothly again. Steroid injections can cure trigger fingers and symptoms never return. If a trigger finger is persistent, then you might have a discussion with your doctor about surgical release.

It’s important to maintain an ergonomic work position to prevent CTS, trigger finger and other hand and arm conditions related to overuse and repetitive motions. One should sit square to the workstation with a 90-degree bend at the elbows, hips and knees and monitor placed at eye level. Any position can cause strain after long periods of time, so it’s also important to move! Take short breaks to get up, walk around and stretch. 

When symptoms are persistent, despite initial care, it can be advantageous to see a specialist to confirm diagnosis and discuss further treatment options. If you’re experiencing hand pain, numbness, or tingling, see a specialist when symptoms have persisted or worsened, despite trying rest and activity modification for a few weeks.


Julie Roberts MDJulie Roberts, MD, is an orthopedic hand surgeon who practices at Virginia Mason Medical Center in Federal Way and Seattle. She specializes in hand and wrist surgery and performs minimally invasive endoscopic carpal tunnel releases.

Comments

  1. The way you have provided detailed tips, opinions, and discussions about The Carpal Tunnel Syndrome(CTS), and the guidance you provided, it’s imperative. Reading this post will make everyone feel better about “Carpal Tunnel Syndrome(CTS)“…

    Thank You

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

<span>%d</span> bloggers like this: