Carpal tunnel syndrome

This condition is most common in women in their 50s and men with heavy physical jobs. It is also common in pregnancy. Characterised by numbness in the hand and occasionally pain radiating from the forearm to the shoulder, it is fortunately a very treatable condition.

Dupuytren’s contracture

This condition is characterised by nodules in the palm which progress to pull the fingers down into a contracted position. There is a strong genetic predisposition to this condition and it is most common in northern Europeans. It is a very slowly progressive condition and there is never any urgency to treat it. Interference with daily function would be an indication for treatment. Common functional impairments would include an inability to get clothes on, awkwardness when shaking hands or face washing.

Trigger finger

This is one of the commonest condition seen by hand surgeons. The finger may lock in flexion, most commonly in the morning. During the day there maybe an annoying and painful click as the finger flexes and extends. Steroid injection is a very effective primary treatment and may be curative in 70 to 80% of cases. Occasionally a 2nd injection is required, and if the condition persists a surgical release under local anaesthetic is a day case will usually cure the condition. Some patients are unfortunately afflicted by this condition in more than one digit.

Tendinitis

Patients who are stressing their wrists were often get inflammation around the tendons of the rest. Lifting small babies will often cause pain at the base of the thumb which is known as DeQuervain’s tendinitis. Sports which stress the wrist will often cause inflammation in the sense trawled dorsal part of the wrist or towards the little finger (ulnar) side of the wrist.

The central pain is usually caused by impingement, which is essentially entrapment of soft tissue. The pain on the ulnar side of the wrist is usually caused by inflammation of the extensor carpi ulnaris (ECU) tendon. An MRI scan will often shared more light on this diagnosis. Both of these conditions can be treated by steroid injection.