Hand/Repetitive Motion

Widespread use of computers has made more people aware of repetitive-motion injuries, but many activities besides typing and mousing can cause pain.

In fact, repetitive-motion injuries (also called repetitive-stress injuries) can result from almost any type of motion repeated throughout our daily routines – from playing a musical instrument to performing assembly-line work to running. Besides repetition of certain motions, these injuries may also be caused by trauma, certain medical conditions like gout and arthritis, awkward  motions, overexertion, poor posture, muscle fatigue or a combination of factors.

While these injuries can occur almost anywhere in the body, they most often affect the wrists, hands, shoulders and elbows. Repetitive-motion injuries affect primarily soft tissues – muscles, tendons, ligaments and nerves.
The most common repetitive motion injuries are tendinitis and bursitis. Tendinitis is inflammation of the tendons that connect muscle to bone. Common types of tendinitis include tennis elbow, golfer's elbow, rotator-cuff tendinitis in the shoulder and biceps tendinitis.

Bursitis is inflammation of the bursae, fluid-filled sacs found throughout the body that act as cushions between bones, tendons and muscles. Usually found near joints, bursae help protect against friction and allow easier movement. Bursitis usually occurs in the shoulder, knee, elbow, hip, heel and thumb.
Other common repetitive-motion injuries include carpal tunnel syndrome in the wrist, ganglion cysts in various areas of the body and trigger finger.

Pain at or near the affected area is the most obvious sign of a repetitive-motion injury. Other symptoms may include swelling and redness, numbness or tingling, weakness, decreased range of motion and a “grating” or “crunchy” feeling in a joint.

If you have these symptoms, see your doctor.


Carpal Tunnel

Nothing can hamper productivity or dampen recreation quite like chronic pain. One minute you may be answering emails and the next minute massaging your wrist due to a recurring sharp, throbbing pain running up the arm.

Whereas a variety of conditions can be attributed to this symptom, the most common is carpal tunnel syndrome, affecting 4 million to 10 million Americans. The condition is caused when the median nerve running from the forearm into the palm is compressed at the wrist — or more specifically, the narrow carpal tunnel comprised of ligament and bones housing the median nerve and other tendons. (What to expect in the physical exam for Carpal Tunnel Syndrome.)

The median nerve is responsible for controlling sensations and impulses to the palm side of the thumb and other fingers, though not the little finger. When pressure is applied to this nerve, a tingling, numbing or burning sensation is most commonly felt. If left unchecked, the symptoms of carpal tunnel syndrome will gradually progress to include:

     • Itching numbness, especially in the palm, thumb, index and middle fingers.
     • Fingers feeling swollen, though little to no swelling evident.
     • Night awakening to “shake out” the hand, as most people sleep with flexed wrists, causing pressure to build in the carpal tunnel.
     • Decreased grip strength.
     • In chronic or severe cases, inability to decipher hot or cold by touch.

Treatments

Depending on condition severity, varied treatments may be prescribed to reverse or minimize the damage imposing upon the median nerve. Your healthcare provider is likely to suggest one or a combination of these treatments:

  • Resting the hand and wrist for at least two weeks.
  • Immobilizing the wrist in a splint.
  • Avoiding activities known to aggravate symptoms.
  • Applying cool packs if there is inflammation.
  • Taking nonsteroidal anti-inflammatory drugs like ibuprofen to reduce swelling and alleviate pressure.
  • Stretching and strengthening exercises under the direction of a physical therapist.
  • Yoga.
  • Either open-release or endoscopic surgery (if symptoms have been lasting for more than six months).

The earlier treatment is applied, the better the recovery. Just because carpal tunnel symptoms appear doesn't mean they have to stay. Catch it in time and you'll soon be waving goodbye to all its annoying and irritating cramps and pains.
—  Dr. Frank Gerratana, orthopedic surgeon, The Hospital of Central Connecticut


Other symptoms and conditions we treat: