1. Radial wrist pain
A. <40 years old/mother holding baby – De Quervain’s tenosynovitis
Intro: De Quervain’s tenosynovitis involves inflammation and swelling of the of the space where two tendons of the thumb pass through. This condition may happen due to repetitive motion and overuse, especially in mothers holding their baby for a prolonged period.
Symptoms: Pain on movement of the wrist and tenderness to palpation.
Treatment: Therapy, medication, and short-term thumb spica bracing at night. A steroid injection into the area of inflammation may provide relief for this condition. Regenerative treatment such as plasma rich platelet (PRP) injection, which promotes healing of the tendon, is another treatment modality for this condition. In unimproved cases, surgery may be considered.
B. >60 years old – 1st carpometacarpal joint arthritis
Intro: The first carpometacarpal joint of the hand is a common area to develop degeneration and therefore arthritis and pain. Advance age, overuse, and prior injury are some exacerbating factors.
Symptoms: The first carpometacarpal joint of the hand is a common area to develop degeneration and therefore arthritis and pain. Advance age, overuse, and prior injury are some exacerbating factors.
Treatment: Medication and short-term thumb spica bracing at night. A steroid injection into the joint may help this condition. In unresolving cases, surgery may be considered.
2. Carpal tunnel syndrome
Intro: Carpal tunnel syndrome is a condition where the median nerve is compressed at the wrist. Repetitive motion and overuse are common culprits and can happen in many occupations as well as during pregnancy.
Symptoms: Pain and numbness/tingling sensation of the first three and a half fingers on the palmar side. In severe cases, the thumb muscle may shrink in size. Repetitive motion and overuse are common culprits and can happen in many occupations as well as during pregnancy.
Treatment: Therapy, activity modification, medication, and use of a wrist night splint at night. A steroid injection may provide relief for this condition. In unimproved cases, surgery release of the carpal tunnel may relieve median nerve compression.
3. Trigger finger/thumb
Intro: Trigger finger/thumb is a condition where the flexor tendon of the finger or thumb is stuck as it glides through a pulley resulting in the digit to lock. This is caused by thickening of the tendon or pulley. Diabetes is a risk factor for this condition, although there may be no cause in getting trigger finger/thumb.
Symptoms: Pain and the finger/thumb to lock in flexion at times.
Treatment: Medication, activity modification, or a steroid injection at the level of the pulley. In unimproved cases, surgical release of the pulley may help.